Blank General Power of Attorney Form

Blank General Power of Attorney Form I, the undersigned, ________________________________________________________________ of ______________________________________________________________ (address) born on the _________________ day of ______________________ 19_______ do hereby appoint _________________________________________________ of_______________________________________________________________ (address) (hereinafter called "the Agent") to be my lawful agent for managing and transacting my business in the Republic of South Africa with full power and authority for me and in my name, and for my account and benefit: 1..