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Client: name:
Gender:
Age:
Id number:
Registration address:
Marriage history information:
Marital status:
The trustee: name:
Id number:
Registration address:
The entrusted matters: the principal unable to carry out the no marriage registration record to prove himself, "the agent entrusted the trustee for this client to handle the client deal with unmarried certificate. Any trustee in above-mentioned entrust authorized agent of the principal laws behavior caused by the legal consequences, entrust per capita admit. Entrust the period from the date of the client sign the power of attorney to . , .
Client: the trustee:
(date) (month) (year) (date) (month) (year)