Statutory Power Of Attorney For Finances And Property

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LIABILITY OF AGENT

The meaning of the authority granted to you is defined in the Uniform Power of Attorney for Finances and

Property Act in Chapter 244 of the Wisconsin Statutes. If you violate the Uniform Power of Attorney for

Finances and Property Act in Chapter 244 of the Wisconsin Statutes or act outside the authority granted, you

may be liable for any damages caused by your violation.

If there is anything about this document or your duties that you do not understand, you should seek legal

advice.

OPTIONAL SIGNATURE OF AGENT

I have read and accept the duties and liabilities of the agent as specified in this Power of Attorney.

Agent’s signature

Date

Attached:

(1) Agent’s certification as to the validity of Power of Attorney for Finances and Property and agent’s

authority (Optional).

(2) Appendix: Power of Attorney for Finances and Property Statutory Authority Definitions (Optional).

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Wisconsin Power of Attorney for Finances and Property

F-00036 (Rev. 09/10)

Statutory Power Of Attorney For Finances And Property - Wisconsin Page 7