KNOW ALL MEN BY THESE PRESENTS:
I, __________________________________, of legal age, single/ married, with residence at _____________________________ do hereby appoint, name and constitute ___________________, likewise of legal age, single/married, with residence at ______________________________, who is related to me and/or is my next-of-kin, and is not a lawyer, as my true and legal representative to act for and in my name and stead and to represent me during the hearing of Civil Case No. ____________, to enter into amicable settlement, to submit to alternative modes of dispute resolution and to make admissions or stipulations of facts and documents without further consultation from me.
I hereby grant my representative full power and authority to execute and perform every act necessary to render effective the power to compromise as though I myself have so performed it and hereby approving all that he may do by virtue of these presents.
In witness whereof, I hereunto set my hand this ___________ day of ______________, 20______, at ______________________________.
Attorney in Fact