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                              Specific Power of Attorney 
                           BY A  CORPORATION FOR THE                    COLLECTION OF A
                  SPECIFIED      CHECK 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 check No. _____________________________ , dated ________________ , 20 _______ for 
___________________________________________________________ dollars drawn on the United States Treasury, by
_________________________________________ in favor of _________________________________ , 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)
_____________________________                     _____________________________
(Signature of Witness)                            (Signature of Witness)

*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.           ________________________________
                                                                (Signature of attesting officer)
[IMPRESS SEAL HERE]                                             ________________________________
                                                                (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       1-04 236(SUPERSEDES SF 236 (APRIL 1963)                                                                             FINANCIAL MANAGEMENT SERVICE

   INSTRUCTIONS FOR FMS FORM 236 – READ CAREFULLY
   See 31 CFR Part 240 for more information

1. A specific 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 to cover a specific check, after such
   check is issued, for any class of payment.

2(a). Where desirable or where required by foreign, state or local law this power of attorney should be
   acknowledged by the grantor in the presence of two attesting witnesses, and 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 represen-
   tative. If such an officer is not available, it may be acknowl-edged 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 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 tile 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.