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                              General Power of Attorney 
                  BY A CORPORATION FOR THE COLLECTION OF CERTAIN
                        CHECKS DRAWN ON THE                                   UNITED STATES TREASURY

Know all by these presents:

That _____________________________________________________________________ , a corporation
                                     (Exact name of corporation)
duly organized and existing under and by virtue of the laws of _____________________________________
with its principal office at ________________________________________________ , does hereby appoint
____________________________ , whose address is _________________________________________ as
attorney to receive, endorse, and collect checks in its name, drawn on the United States Treasury, and to give
full discharge for same.

The said corporation hereby ratifies and confirms all that may lawfully be done by virtue hereof. 

IN WITNESS WHEREOF said corporation has caused this instrument to be executed in its behalf,
pursuant to authority of its Board of Directors, by its_____________________________________ and its
                                                                               (Official title of officer)
corporate seal to be hereunto attached, attested by its secretary or assistant secretary, this
_____ day of__________________ , 20___
                                                                                      _______________________________
                                                                                        (Name of corporation)
               [IMPRESS SEAL HERE]                                                   By _______________________________
                                                                                      (Official signature of officer)
Attest:  _____________________________                                      _______________________________
                  Secretary                                                             (Official title of officer)

* Personally appeared before me the above-named ________________________________________________
known or proved to me to be the same person who executed the foregoing instrument, and to be the
___________________ of ______________________________________________________________ and 
(Title of officer)                                        (Name of Corporation)
acknowledged to me that he executed the same as his free act and deed and the free act and deed of said 
corporation.

WITNESS my signature, official designation, and seal.
                                                                                     ________________________________
[IMPRESS SEAL HERE]                                                                  (Signature of attesting officer)

                                                                                     ________________________________
                                                                                     (Official designation)
Dated at ____________________ , this ______ day of ____________________ , 20 _____

                                                     My commission expires ______________________, 20 _____ 

IMPORTANT –             Do not execute this instrument without first reading the instructions on the next
page.  Exact compliance with these instructions will avoid complications.
* See Instructions on next page – Paragraphs 2(a) and 2(b)
FORM                                                                                                               DEPARTMENT OF THE TREASURY
FMS       1-04 234(SUPERSEDES SF 234 (APRIL 1963)                                                                    FINANCIAL MANAGEMENT SERVICE

INSTRUCTIONS FOR FMS FORM 234 – READ CAREFULLY
                   See 31 CFR Part 240 for more information

1.  A general power of attorney on this form may be executed by a corporation to confer authority to
endorse and collect checks drawn on the United States Treasury, in payment of principal or interest on
public debt obligations or obligations guaranteed by the United States, tax refunds, and payments for
goods and services.

2(a). Where desirable or where required by foreign, state or local law this power of attorney should be
acknowledged before a notary public or other officer authorized by law to administer oaths generally. If
in a foreign country, the acknowledgment should be made before a United States diplomatic or
consular representative. If such an officer is not available, it may be acknowledged before a notary or
other officer authorized to administer oaths, but his official character and jurisdiction must be certified
by a United States diplomatic or consular officer, under the seal of his office.

2(b). Where the power of attorney is acknowledged pursuant to paragraph 2(a), the seal of the attesting
officer must always be impressed (or stamped) provided, however, that where acknowledgments before
a notary public, or other officer authorized by law to administer oaths, are not thus authenticated by
the official impression seal of such officer, the power should be accompanied by a certificate from the
proper official showing that the officer was in commission on the date of the acknowledgment. The date
when the officer’s commission expires should appear in any event. If a certificate is furnished, such
certificate should show the dates of the beginning and expiration of the officer’s commission, and such
period of commission should include the date of acknowledgment of the power.

3.  This power of attorney may be revoked by notice from the grantor to the parties concerned. Notice of
revocation to the Treasury will not ordinarily serve to revoke the power.

4.  The authority of the officer of the corporation to act in its behalf should be shown by appropriate
resolution of the governing body of the corporation, preferably using FMS Form 235.

5.  If it is desired that checks be mailed to the attorney instead of to the payee, formal notice of change in
the post-office address, identifying the checks affected, should be forwarded to the administrative office
that authorized issuance of the checks.

6.  POWERS OF ATTORNEY NEED NOT BE FILED WITH THE UNITED STATES TREASURY.