POWER OF ATTORNEY MUST BE SIGNED AND NOTARIZED

 

 

LIMITED POWER OF ATTORNEY

 

 

TO WHOM IT MAY CONCERN:

 

THAT, ON THE_____________  DAY OF _______________________________,  20_______

 

 


                                                                (Company Name)

 


                                                    (Physical Address of Company)

 

DOES HEREBY MAKE AND APPOINT SHIRLEY MURPHY, DEBORAH BELANGER, LYDIA STRONCHECK, AND PATTI HOLBROOKS OF ROAD LEGAL, INC., 1900 TEXAS AVENUE, (P.O. BOX 100) BRIDGE CITY, TX 77611, AGENT TO PREPARE, SIGN AND FILE CARRIER APPLICATIONS AND/OR CANCEL ACCOUNTS FOR THE FOLLOWING: FUEL DECALS, CAB CARDS, PERMITS, IFTA, FUEL TAX RETURNS, FEDERAL HIGHWAY ADMINISTRATION AUTHORITY AND REGISTRATION, SSRS, EXEMPT BINGO STAMPS, INTRASTATE AUTHORITY, FORM 2290, FORM SS4, PUBLIC UTILITIES COMMISSION'S STAMPS, DOT NUMBER AND/OR VEHICLE REGISTRATION AS REQUIRED OF MOTOR CARRIERS BY THE VARIOUS STATES OF AMERICA AND PROVINCES THROUGHOUT CANADA.

 

 

     *****THIS POWER OF ATTORNEY WILL REMAIN IN FULL FORCE UNTIL*****

    **********FURTHER WRITTEN NOTICE FROM ROAD LEGAL, INC.***********

 

 

__________________________             SUBSCRIBED AND SWORN TO BEFORE ME,

     (Authorized Signature)                     THIS _____ DAY OF _________________ 20____

 

                                                                   _________________________________________

__________________________                                      ( Notaries Signature)

               (Title)

                                                                   Date Commission Expires ______/______/______

 

 

ALL PARTNERS MUST SIGN IF PARTNERSHIP

 

 _________________________                       _________________________

(Partner's Signature)                                  (Partner's Signature)

 

 _________________________                       _________________________

(Partner's Signature)                                  (Partner's Signature)

 

Rev. 20030415