OAR 740-050-0060. Form of Appointment of Agent

The following form will be used in giving a power of attorney to an agent: POWER OF ATTORNEY To be filed with the Oregon Department of Transportation __________(Name of Carrier in full)________ ___________(Place)__________(Date)_______ Form A.F. 1 No.__________ To the OREGON DEPARTMENT OF TRANSPORTATION Salem, Oregon This is to certify that (name of carrier) has made, constituted and appointed and by these presents does make, constitute and appoint (name of person appointed) the true and lawful attorney and agent for the said carrier and in its name, place and stead: (1) for it alone, and (2) for it jointly with other carriers, to file tariffs, classifications, and exception sheets and supplements thereto, as required of transportation companies under the laws of Oregon and rules and regulations established by the Oregon Department of Transportation, thereunder for the period of time, the traffic and territory herein named: _______________________________________ _______________________________________ And the said (name of carrier) does hereby give and grant unto said attorney and agent full power and authority to do and perform all and every act and thing above specified, as fully to all intents and purposes as if the same were done and performed by the said carrier, hereby ratifying and confirming all that said attorney and agent may lawfully do by virtue hereof, and assuming full responsibility for the acts and neglects of said attorney and agent hereunder. IN WITNESS WHEREOF, the said carrier has caused these presents to be signed (in its name by its legal executive officer) at __________ in the State of Oregon, on this_____ day of __________, 19__. __________(Name of Carrier)__________ By: __________(Name of Officer)__________ __________(Title of Officer)__________ Attest: (Corporate Seal) Carrier issuing this form will file the original with the Department and will furnish duplicate to the agent to whom power of attorney is given.