Instructions for: Power of Attorney

1. Carefully read the Power of Attorney document that follows this Instructions page.
2. Complete all sections of the form that apply to you either by keying the information directly into
the online form or by printing the form and completing it by hand.
3. Sign this document before a Notary Public and have your signatures notarized.
4. Complete all the information required for the Grantee of Power section below.
5. Mail the original Power of Attorney, signed, and notarized document along with the completed
information to:

NetBank
P.O. Box 2368
Alpharetta, GA 30023-2368
Attn: New Accounts

If this applies to a CD account, send the document to the attention of New Accounts Department. If this is
for a money market or checking account, please return it to the attention of our Customer Care Department.
Please allow 5 business days upon receipt for it to become effective.

If you have any questions, please send a Bank Mail or contact NetBank Customer Care at:
1-888-BKONWEB (256-6932).

Grantee of Power Information:

We require the following information for the Grantee of Power listed on the Power of Attorney:

1.) Full Name:

2.) U.S Social Security Number - -

3.) Date of Birth / /

4.) Drivers License Number/ State of issuance: /

5.) Physical Residential Address:

Street Address:

City, State Zip Code

6.) Home Phone Number

7.) Business Phone Number

 Power of Attorney
I, ________________________________________ (grantor of power), hereby constitute and appoint

______________________________ (grantee of power) as my attorney-in-fact, to deposit or withdraw

funds held in account number(s) ________________________________________________at NetBank.

Grantor of power: You must indicate whether or not this power of attorney will be effective if you become
legally incompetent. Use a check mark or an “x” on the line beside the statement below that expresses your
intent.

(A)_____ This is a durable power of attorney, and it will continue to be effective if I become legally
incompetent.

(B) _____ This power of attorney will not be effective if I become legally incompetent.

TERMS AND CONDITIONS OF THIS POWER OF ATTORNEY

1. The power of so granted will continue as between the grantor and grantee of the power until the earlier
to happen of the following: (a) revocation by the grantor of the power, (b) termination of the account(s)
that the grantee has power of attorney over, (c) death of the grantor of the power, or (d) appointment of a
guardian of the estate of the grantor of the power. The power will also terminate if the grantor becomes
legally incompetent unless the grantor has, by checking line A above, indicated his/her intent that the
power remain effective if the grantor becomes legally incompetent or disabled.
2. The financial institution may rely upon the validity of this Power of Attorney and will be held harmless
from doing so until written notice is received by this financial institution as to any of the events of
termination of power. Grantee of the Power of Attorney must notify this financial institution of any
information that he/she has that would cause the power to terminate (such as death of grantor) as soon as
possible after learning that information.
3. The grantee of power acting hereunder will maintain such books or records as will permit an
accounting of the acts of the grantee of power, if an accounting is requested by a legal representative of
the grantor of power.
4. The grantee of power will be liable for any disbursement other than a disbursement to or for the benefit
of the grantor of power, unless the grantor will have authorized a disbursement in writing.
5. Any power of attorney not signed before and acknowledged by a Notary Public, may be rejected by the
financial institution until the grantor of the power will have satisfied this financial institution of the
validity of the power.

Signature of Grantor ______________________________________Date ________________________

Signature of Grantee ______________________________________Date ________________________

Signature of Witness ______________________________________Date ________________________

On ___________________________(month, day, year), before me, the undersigned, a Notary Public in

and for said State, personally appeared ___________________________, personally known to me or
proved to me on the basis of satisfactory evidence to be the person whose names are subscribed to the
within instrument and acknowledged that they executed the same.

Witness my hand and official seal.

_______________________________________
Notary Public in and for said State

Power of Attorney NetBank 020430