Mandate and
Fee Agreement
Step
1
of
16
6%
MANDATE AND FEE AGREEMENT
ENTERED INTO BY AND BETWEEN
REENEN VAN REENEN(Hereinafter referred to as “The Attorney”)
And
REENEN VAN REENEN INC. (Hereinafter referred to as “the Firm”)
And
Name
(Required)
First
Last
(hereinafter referred to as “the Client”)
Identity/Registration Number
(Required)
Domicilium Citandi et Executandi
Physical Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Postal Address same as physical address?
Yes
No
Postal Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Email Address
(Required)
Home Telephone No.
(Required)
Work Telephone No.
(Required)
Cellphone No.
(Required)
1. DEFINED TERMS
The meaning of the following words and phrases shall be set out below:
“the Agreement”: This means this document together with its annexures, each as amended from time to time;
“the Firm”: This means the firm under which name and style the Attorney practises, being Reenen van Reenen Inc.;
“the Attorney”: This means Reenen van Reenen;
“the Client”: The Client, as described on the heading of the Agreement;
“the Party/ies”: The Client, Reenen van Reenen and the Firm;
“the Services”: The work performed and services rendered or to be rendered by the Attorney and the Firm in terms of clause 3.1 below; and
“VAT”: Value added tax in terms of the Value Added Tax Act, No. 89 of 1991, as amended.
I've read the above and agree
(Required)
Yes
2. Preface
The Attorney and the Firm will deliver professional legal services to the Client with reasonable care and skill and the Client will remunerate the Firm in accordance with the Firm’s fee structure as set out below in clause 4.
All work carried out by the Attorney and the Firm are subject to the terms and conditions set out hereunder.
The terms and conditions of the Agreement supersede any prior arrangement between the Parties.
In providing the Services the Attorney and the Firm will require the Client’s full co-operation and assistance. The Attorney and the Firm will rely on the Client to furnish or to cause others to furnish to it the information and/or assistance it considers necessary to provide the Services in a timely, effective and professional manner. All reasonable care will be taken of such documentation, but the Attorney and the Firm will not be liable for any damages or loss sustained in the event of damage, loss or destruction of such evidence and / or documentation from whatsoever cause and howsoever arising.
The rendering of the Services by the Attorney and the Firm are subject to the full settlement of the statement of account by the Client in accordance with clause 7.2 below.
I've read the above and agree
(Required)
Yes
3. Services
The Client hereby nominates and appoints the Attorney, the Firm, and its nominees with the power of substitution to render professional legal services to the Client in connection with, inter alia,
Choose a services
(Required)
Family Law
Mediation
Last Will & Testament
Administration of Deceased Estate
Company & Trust Registration
Criminal Law
Constitutional Disputes
Appeal / Review
Appointment as Receiver & Liquidator
Drafting of Agreements
General / Commercial Litigation
Other
Choose a Family Law service:
(Required)
Divorce
Maintenance
Contact to children
Guardianship application
Curatorship applications
Drafting and endorsing parenting plans
Resolving parental rights and responsibilities disputes
Surrogacy agreements
Assist in adoptions
Drafting and registering antenuptial marriage contracts
Changing marriage regimes
Obtaining and setting aside domestic violence interdicts
Choose a General/Commercial Litigation service:
(Required)
Property/Construction
Contractual Disputes
Damages claim
Collections
Evictions
Please specify
(Required)
I've read the above and agree
(Required)
Yes
4. Basis of fees
The Firm’s fees are based on the amount of time spent on each matter. Each attorney in the Firm has a standard hourly rate which is carefully calculated on the basis of his or her experience and expertise.
The Attorney’s standard hourly rate multiplied by the number of hours, or 5-minute increment thereof, spent on the matter is the initial basis for determining the fee payable to the Firm in respect of the Services rendered.
The Attorney’s standard hourly rate may be adjusted in accordance with the complexity and urgency of the matter. Any such adjustment will be discussed with the Client before any further Services are rendered or costs are incurred.
The Attorney’s hourly rate is set out in clause 4.9 below. The Attorney’s hourly rate shall escalate annually at a rate 10% effective from 1 March of each year.
The Client confirms that the difference between attorney-own-client costs, attorney-client costs and party-party costs have been explained to the Client. The Client further confirms that he/she understands the difference between attorney-client costs and party-party costs. For more information on legal costs, please visit the following web page:
https://www.golegal.co.za/guide-legal-costs-south-africa/
and for an exemplar of a time-based legal invoice, please visit the following web page:
http://forms.rvrlaw.co.za/wp-content/uploads/2023/03/EXAMPLE-OF-A-TIME-BASED-LEGAL-FEE-STRUCTURE-1.pdf
.
VAT is chargeable on the Firm’s fees at the statutory rate of 15% or any amended statutory rate applicable from time-to-time.
In return for the provision of the Services, the Client agrees to pay the Firm’s fees, without any right of set off. A statement of account will be rendered on a monthly basis, or at reasonable intervals, by the Firm and is payable by the Client on presentation thereof. Should the Client not agree with any statement of account, the Client must notify the Attorney and the Firm in writing of his/her/its objection within 15 working days of the date reflected on the statement of account. The Client’s failure to do so will constitute an acceptance of both the correctness of the statement of account as well as his/her/its indebtedness to the Firm in terms thereof.
The Firm will be entitled to charge interest at the mora interest rate on all amounts outstanding (including fees and disbursements) for whatsoever reason, for than 7 days from the date reflected etc from the date reflected on the Firm’s statement of account. Such interest will be calculated on a monthly basis. All payments will be allocated first to interest, then to expenses incurred and then to the oldest outstanding fee.
The Attorney’s services rendered in terms of the Agreement will be charged at an hourly rate of R2, 500.00 (excluding VAT) and is subject to an annual escalation as stipulated in clause 4.4 above.
All invoices rendered by the Firm are payable regardless of the outcome of the matter on which the Attorney and the Firm have been instructed.
I've read the above and agree
(Required)
Yes
5. Disbursements
The disbursements which the Client will be charged for, in addition to the hourly rates as set out in clause 4 above, are as follows:
DISBURSEMENT
AMOUNT
1. Printing
R3.50 per page
2. Copies (B&W)
R3.50 per page
3. Copies (Colour)
R6.00 per page
5. Telephone Costs
R3.50 per minute
6. Travelling
R20.00 per km
The Client will be liable for any disbursements incurred in respect of any service providers required in order to render the Services.
The Client will be liable for the payment of any government charges or any tariffs or charges payable in respect of any legislation.
The Client will be liable for any accommodation, airfares, travelling (in addition to those set out in the table in clause 5.1 above) or similar disbursements incurred by the Attorney and the Firm in respect of the Services. Such disbursements shall be confirmed by the Client before they are incurred.
I've read the above and agree
(Required)
Yes
6. Deposit
The Attorney and the Firm may require advance deposits from the Client based on estimated fees and disbursements incurred or disbursements to be incurred. Any deposit received from the Client will be held in the Firm’s trust banking account and applied, either to the Client’s final statement of account or to any current statements of account where timely direct payment is not made. All interest accrued on deposit amounts held in the Firm’s trust account shall accrue to the Legal Practitioner’s Fidelity Fund in line with the Legal Practice Act No 28 of 2014.
A minimum deposit of R2, 875,00 is payable prior to confirmation of the first consultation. A larger deposit may be requested in circumstances where a lengthy consultation is anticipated.
Should any further services be required subsequent to the first consultation, a minimum floating deposit R20, 000.00 shall be payable in respect of the Agreement before any such services shall be rendered by the Attorney and the Firm. A larger floating deposit may be requested in circumstances where the Attorney deems it appropriate.
I've read the above and agree
(Required)
Yes
Upload proof of payment of deposit amount
(Required)
Max. file size: 128 MB.
7. Withdrawal or Termination of mandate
Should the Client terminate the Agreement before the matter is finalised, the Attorney and the Firm will be entitled to prepare a statement of account for all Services rendered, including disbursements incurred. In such event the Client undertakes to settle the statement of account in full prior to the Attorney and the Firm handing over the Client’s file contents, documents and records to the Client or his/her/its appointee, whether these documents were drafted by the Attorney and the Firm or not. The Attorney and the Firm will be entitled to copies of the documents it deems necessary at the cost of the Client prior to the handing over the file to the Client. The right to retain the Client’s file contents, documents and records does not preclude the Attorney and the Firm from using any other remedies it may have against the Client in terms of any law to recover the money owed to it.
If the required deposit in terms of clause 6 or any of the Attorney and the Firm’s statements of accounts are not paid/settled in a timely manner, the Attorney and the Firm reserves the right to immediately suspend or withdraw the Services. The Attorney and the Firm further reserves all their rights to all remedies available to them in law in order to recover the moneys owed to them.
Should the Client fail to settle the statement of account as stipulated in clause 7.2 above, the Attorney and the Firm will be entitled to serve and file a Notice of Withdrawal as Attorneys of Record in all litigation matters.
I've read the above and agree
(Required)
Yes
8. Copyright
Original work products generated by the Attorney and the Firm for the Client are protected by copyright, which belong to the Attorney and the Firm. The fee payable by the Client for the Services entitles the Client to use the work product for the purposes obtained, however, the Client does not obtain ownership or the copyright in the work product unless the Attorney and the Firm agrees to this in writing.
I've read the above and agree
(Required)
Yes
9. Confidentiality
The contents of this agreement are confidential and the Client shall not be entitled to disclose any information whatsoever without the prior written consent of the Attorney and the Firm.
In order for the Attorney and the Firm to render the Services, the Client may make information available to them (“Confidential Information”). The Attorney and the Firm will take appropriate steps to ensure that such Confidential Information be kept secret and confidential and will not, without the Client’s prior written consent, disclose such information.
Notwithstanding the aforegoing, but subject always to any legal-professional privilege that may apply, the Attorney and the Firm will be entitled to disclose such Confidential Information pursuant to an order of any Court or other Government authority.
Furthermore, the Attorney and the Firm being an accountable institution in terms of Schedule 1 of the Financial Intelligence Centre Act 2001, as amended (FICA), the Client acknowledges that the Firm is obliged to keep a record of specified details of its clients and the transactions they conduct. The Attorney and the Firm may have a legal obligation in terms of FICA (or other statutory provisions), to report the Client and to disclose such information to the Financial Intelligence Centre or (other statutory body) without divulging same to the Client. The Client acknowledges that such statutory obligation of disclosure to the Financial Intelligence Centre (or other statutory body), does not constitute a breach of any legal-professional privilege, nor does it constitute a breach of the Attorney and the Firm's duties in terms of the Protection of Personal Information Act 2013 (POPIA). For more information on FICA, please visit the following web page:
https://www.fic.gov.za/Pages/Home.aspx
.
The Client acknowledges and agrees that, by reason of law or duties of confidentiality owed to other persons or the rules of any regulatory authority, the Attorney and the Firm may be prohibited from disclosing information to the Client (or such disclosure may be inappropriate), including information received pursuant to other Client relationships.
I've read the above and agree
(Required)
Yes
10. COMPLIANCE IN TERMS OF THE PROTECTION OF PERSONAL INFORMATION ACT NO. 4 OF 2013 (POPIA) AND PROMOTION OF ACCESS TO INFORMATION ACT NO. 2 OF 2000 (PAIA)
The Attorney and the Firm herewith confirm compliance with the necessary specifications and regulations as set out in the Protections of Information Act No. 4 of 2013 (“POPIA”) and Promotion of Access to Information Act No. 2 of 2000. (“PAIA”) .
POPIA compliance has been achieved by implementing a policy setting out how the Client’s personal information is securely processed, stored and destroyed.
The POPIA terms and conditions do not affect the Attorney and the Firm’s obligation to provide the Client with the Services. The Attorney and the Firm strives to empower the Client with information on how they handle the processing personal information, which has been their standard practice.
What is POPIA?
POPIA is the comprehensive data protection legislation that obliges organisations to handle personal information by applying specific principles and conditions. POPIA deals with the Client’s constitutional right to privacy and the right to access information. POPIA was signed into law on 1 July 2020 to be enforceable by 1 July 2021.
What does POPIA mean for you?
The Attorney and the Firm has always been committed to treating all of their clients’ information in an ethical manner and POPIA provides the legal framework and requirements for this treatment. All law firms, including the Firm, are now legally obligated to deal with client information with far more diligence than ever before. This includes how and why information is collected, processed, shared, stored and accessed. For more information on POPIA, please visit the following web page:
https://popia.co.za/
.
WHAT IS PAIA?
PAIA sets out the manner in which information can be accessed and the process to be followed in order to access personal information.
The necessary PAIA Manual in terms of Section 51 of PAIA has been implemented in order to ensure that the correct process is followed when personal information is requested by- and submitted to- the Attorney and the Firm.
Download the PAIA Manual here
The Attorney and the Firm collects and processes various types of personal information in the course and scope of rendering the Services, execution of their duties and complying with statutory and regulatory requirements.
The Client’s rights in terms of Section 15 of POPIA are:
To have the Client’s personal information processed only in accordance with the conditions of POPIA;
To be notified when personal information about the Client is being collected;
To be notified if personal information has been acquired by an unauthorised person;
To inquire what personal information of the Client is held by the Attorney and the Firm;
To request the correction, destruction or deletion of personal information (note personal information can only be deleted if it is not required for its operational needs);
To object on reasonable grounds to the processing of personal information;
To submit a complaint to the Information Regulator regarding personal information that has been handled incorrectly.
The Attorney and the Firm will collect information and documentation which they are required to obtain in order to comply with the laws of the Republic of South Africa and those required so as to enable them to provide the Services and advice to the Client. Examples of information and documentation which will typically be collected include, among others, the following:
Personal details such as the Client’s name, telephone or cell phone number, email address;
Next of kin details;
Physical address, postal address, business address;
Identity or Passport number;
Date of birth;
Gender;
Bank details;
Marriage certificate;
Antenuptial agreement;
Pay slips;
Personal correspondence and agreements;
Tax information;
Photographs, diagrams, reports and other records;
CIPC documents;
Recordings of engagements with the client, including records of consultations, court appearances, telephone conversations and the like.
The Client remains responsible to ensure that the Attorney and the Firm are provided with the Client’s correct and updated personal information, in the event of any changes.
By signing this agreement, the Client expressly consents and authorises the Attorney and the Firm to collect and store his/her/its personal information, and to release such personal information to third parties at their sole and absolute discretion, pursuant to the rendering of the Services, and/or any statutory or other obligations
I've read the above and agree
(Required)
Yes
11. Joint and Several Liability
Where the Attorney and the Firm is instructed to act on behalf of a consortium, an unincorporated joint venture, partnership or other legal entity, the members of that consortium, joint venture, partnership or other legal entity will be jointly and severally liable to the Attorney and the Firm for the payment of their fees.
I've read the above and agree
(Required)
Yes
12. Indemnity
In the course of the Attorney and the Firm’s engagement with the Client, the Attorney and the Firm may express opinions and beliefs concerning the matters in which it represents the Client. Each such statement or opinion made by the Attorney or any director or employee of the Firm are intended to be an expression of opinion only, based upon information available to the Attorney and the Firm at that time and cannot be construed as a promise or guarantee.
The Attorney and the Firm will not be answerable for or liable to make good any loss occasioned to or sustained by the Client of whatsoever cause arising, save and except such loss may arise from or be occasioned by dishonesty.
The Client hereby indemnifies the Attorney and the Firm against all claims and demands of whatsoever nature that may be made against them arising out of the bona fide exercise or purported exercise of any of the powers conferred upon them herein.
I've read the above and agree
(Required)
Yes
13. Dispute Resolution
Any dispute between the Parties arising out of or in connection with the Agreement in respect of the payment of the fees shall be determined by a Court of competent jurisdiction and the South African Law will apply to the Agreement.
I've read the above and agree
(Required)
Yes
14 Non-Variation
This agreement contains all the terms and conditions of the Agreement between the Parties.
No variation of or abandonment or waiver of rights or obligations whether express or implied, shall be binding unless contained in this Agreement, or subsequently reduced to writing and signed by the Parties.
I've read the above and agree
(Required)
Yes
15. Binding Over Estates
This Agreement shall be binding on the Parties’ respective estates, heirs, beneficiaries and assigns.
I've read the above and agree
(Required)
Yes
16. Indulgences
No indulgence or extensions given by either Party shall be construed to be a waiver or novation of such Party’s rights and at all times shall be without prejudice to such Party’s rights.
I've read the above and agree
(Required)
Yes
Name
(Required)
First
Last
Place of acceptance
(Required)
Date
(Required)
MM slash DD slash YYYY
Signature
(Required)
Power Of Attorney
I, the undersigned, do hereby appoint Reenen van Reenen to be the lawful attorney to act on my behalf. I authorise and instruct Reenen van Reenen and his firm/s ("the attorneys") to appoint Counsel, to pay Counsel’s fees, to proceed to the final determination of my matter and generally for effecting the purposes aforesaid to do or cause to be done whatsoever shall be necessary, as fully and effectually as I might or could do if personally present, hereby ratifying whatsoever the attorneys shall lawfully do by virtue of these instructions. (Fill in your full names to submit this form).
Name
(Required)
First
Last
Place of Acceptance
(Required)
Date
(Required)
DD slash MM slash YYYY
Signature
(Required)