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Limited Power of Attorney

Lets MTSi sign your IFTA, fuel tax, titling and registration paperwork for you.

This one needs an ink signature and a notary. Fill in the boxes, tap Print, then sign it in front of a notary and mail or bring it to us.

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MTSi~DATS123 E. 3rd St., Stuttgart, AR 72160 · 870-672-7469 · allison.erwin@mtsidats.com

LIMITED POWER OF ATTORNEY

TO ALL PERSONS, be it known, that I, , individually and on behalf of , ("Company") as Grantor, do hereby make and grant a limited and specific power of attorney to:

MTSi and the employees of said entity located at
123 E. 3rd St. - Stuttgart, AR 72160

and appoint and constitute said entity as my Attorney-In-Fact, with full power and authority to sign reports and applications pertaining to IFTA bonds, fuel tax reports, state applications, or any other documents which pertain to fuel use taxes, titling and registration of all fleet vehicles.

The authority granted shall include such incidental acts as reasonably required or necessary to carry out and perform the specific authorities and stated or contemplated herein.

This power of attorney shall continue in full force and effect until revoked by subsequent writing.

Signed
Date:

NAME / POSITION:

COMPANY:

Subscribed and sworn before me, a Notary Public, on this ______ day of ______________, in the year __________.
My Commission Expires: ______________      ________________________________ Notary Public
(SEAL)

Questions? Call 870-672-7469.