POWER OF ATTORNEY

I hereby authorize the person mentioned below
to hand over the vehicle to Nurmon
Autopurkaamo for scraping.

Car owner information

Name _____________________________________
Social security number / date of birth
__________________________
Contact information (tel.) ______________________

Donor information

Name ____________________________________
Social security number / date of birth
__________________________
Contact information (tel.) _____________________

Car information

Brand and model ___________________________
Registration number ________________________

Place and time ____________________________
Signature ________________________________