Your Préname/Name

Address

Postal Code/ CITY

Done à [your city], on [précate the date].

Object :Procuration for a real estate purchase

I, the undersigned, [state your name and surname], born [state your date of birth], [state your place of birth] and residing [state your address] hereby give full power of attorney to [state your date of birth]; [state name and surname of your representative], born [state date of birth] à [state place of birth] and residing [state address] to perform the acts necessary to purchase the real property located [state address of property].

This power of attorney will terminate upon completion of the sale.

[Your signature]