SAMPLE FORM

____________________________________________________________¹
 (SPACE ABOVE RESERVED FOR RECORDING INFORMATION)

     Buck Daniel McSween,  20 F Avenue,  Harper, OH  45011  (999) 774-2233²         
(RESERVED FOR NAME, ADDRESS, AND TELEPHONE NUMBER
OF PERSON PREPARING INSTRUMENT)

POWER OF ATTORNEY

            I/We,                                    Diana Lynne Ruls³                                                
 the undersigned, of                          1450 South Street,  Harper, OH  45011⁴                 
 __________________________ (address) of                        Linn⁵                       County,
 State of              OHIO⁶                    , appoint             Philip Brian Locke⁷                   
 (name) of                  1470 South Street,  Harper, OH  45011⁸                       (address) of
                  Linn⁹                    County, State of                   OHIO¹⁰                         , as
 my/our attorney-in-fact for me/us and in my/our name, place and stead, to convey, sell, or
 otherwise transfer or encumber real estate located in                  Linn¹¹                County,
 State of             OHIO¹²                            , described as follows (set forth below the legal
 description of the real estate affected by this instrument):

            The south quadrant of section 10, township 21, range 4.¹³

This is not a substitute for legal advice.  An attorney must be consulted.
Copyright © 1994 - 2014 by LAWCHEK, LTD.

POWER OF ATTORNEY FORM cont'd.

            The street address of the real estate is              1440 South Street¹⁴             
 ______________________________________________________________________.

            My/Our attorney-in-fact is authorized to convey, sell, or otherwise transfer or
 encumber the above-described real estate to any persons at such times and terms and
 conditions as he/she deems proper.  My/Our attorney-in-fact is authorized to make, execute,
 acknowledge, and deliver a deed or other instrument necessary to convey and transfer such
 real estate and has full power and authority to do and perform any other act necessary to
 complete such conveyance and transfer as I/we might or could do if personally present.
 My/Our attorney-in-fact is authorized to release and relinquish my/our rights of dower,
 homestead and distributive share in and to the above-described real estate.

            This Power of Attorney shall take effect immediately upon my/our execution of it
 and it is irrevocable unless and until I/we file an executed and acknowledged revocation of
 this instrument with the office where this instrument is recorded.

            I/We revoke any and all Powers of Attorney previously made by me/us authorizing
 any person to do any acts related to the above-described real estate.

            All words and phrases contained in this instrument (and the attached
 Acknowledgment, if any) shall be construed in the singular, plural, masculine, feminine or
 neuter according to the contents.

                                                                         Date:                11/17/01¹⁵                  

 ________________________________¹⁶             _________________________________¹⁷
 Grantor                                                              Grantor

 ________________________________¹⁸             _________________________________¹⁹
 Witness (If required by law)                                  Witness (If required by law)

 Attach Acknowledgment If Required By Law.

This is not a substitute for legal advice.  An attorney must be consulted.
Copyright © 1994 - 2014 by LAWCHEK, LTD.

1. This space is reserved for the county and/or state officials' use.
2. The full name, address and telephone number of the lawyer or banker preparing the document.
3. The full name of the grantor.
4. The full address of the grantor.
5. The county in which the grantor resides.
6. The state in which the grantor resides.
7. The individual to whom the power of attorney is granted.
8. The full address of the individual.
9. The county in which the individual resides.
10. The state in which the individual resides.
11. The county in which the property is located.
12. The state in which the property is located.
13. A legal description of the property.
14. The street address of the property.
15. The date on which the document is signed.
16. The signature of the grantor.
17. The signature of a second grantor.
18. The signature of a witness.
19. The signature of a witness.