Statutory Durable Power Of Attorney Template For Asset Management (Page 2 of 4) in pdf

Statutory Durable Power Of Attorney Template For Asset Management Page 2

(K) Benefits from social security, medicare, medicaid, or other governmental

programs, or civil or military service.

(L) Retirement plan transactions.

(M) Tax matters.

(N) ALL OF THE POWERS LISTED ABOVE.

YOU NEED NOT INITIAL ANY OTHER LINES IF YOU INITIAL LINE (N)

SPECIAL INSTRUCTIONS:

ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS

LIMITED OR EXTENDING THE POWERS GRANTED TO YOUR AGENT.

______________________________________________________________________________

UNLESS YOU DIRECT OTHERWISE ABOVE, THIS POWER OF ATTORNEY IS

EFFECTIVE IMMEDIATELY AND WILL CONTINUE UNTIL IT IS REVOKED.

This power of attorney will continue to be effective even though I become incapacitated.

STRIKE THE PRECEDING SENTENCE IF YOU DO NOT WANT THIS POWER OF

ATTORNEY TO CONTINUE IF YOU BECOME INCAPACITATED.

If I have designated more than one agent, the agents are to act

IF YOU APPOINTED MORE THAN ONE AGENT, AND YOU WANT EACH

AGENT TO BE ABLE TO ACT ALONE WITHOUT THE OTHER AGENT JOINING, WRITE

THE WORD “SEPARATELY” IN THE BLANK SPACE ABOVE. IF YOU DO NOT INSERT

ANY WORD IN THE BLANK SPACE OR IF YOU INSERT THE WORK “JOINTLY”, THEN

ALL OF YOUR AGENTS MUST ACT OR SIGN TOGETHER.

I agree that any third party who receives a copy of this document may act under it.

Revocation of the power of attorney is not effective as to a third party until the third party has

actual knowledge of the revocation. I agree to indemnify the third party for any claims that arise

against the third party because of reliance on this power of attorney.

Signed this ______ day of ________________________, 2010.

__________________________________________

(your signature)

Statutory Durable Power of Attorney for Asset Management

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Statutory Durable Power Of Attorney Template For Asset Management Page 2