Durable Power Of Attorney - State Of Florida Page 3
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3(v)
To apply for public benefits, where necessary, such as Medicare and Medicaid, for me and have
access to information regarding my income and assets to the extent required to make such
application if necessary.
(vi)
To make all health care decisions on my behalf including but not limited to those set forth in F.S.
Chapter 765.
11. GENERAL POWERS:
(a) In general to do all other acts, deeds, matters and things whatsoever in or about my estate, property and
affairs, or to concur with persons jointly interested with me therein in doing all acts, deeds, matters and things
herein particularly or generally described, as fully and effectually to all intents and purposes as I could do
myself.
(b) This instrument is executed by me in the State of Florida but it is my intention that the powers and authority
herein conferred upon my attorney as authorized by the laws of Florida now or hereafter in force and effect
shall be exercisable in any other state or jurisdiction where I may have any property or assets.
I hereby ratify and confirm, and promise at all times to ratify and confirm all and whatsoever my duly authorized attorney
hereunder shall lawfully do or cause to be done by virtue of these presents, including anything which shall be done
between the revocation of this instrument by my death or in any other manner and notice of such revocation reaching my
attorney; and I hereby declare that as against me and all persons claiming under me everything which my said attorney
shall do or cause to be done in pursuance hereof after such revocation as aforesaid shall be valid and effectual in favor of
any persons claiming the benefit thereof who, before the doing thereof, shall not have had notice of such revocation.
IN WITNESS WHEREOF, I have executed this Durable Power of Attorney.
___________________________________
____________________________________________
Witness Signature
Date
Signature
Date
___________________________________
____________________________________________
Witness Signature
Date
Print Name
State of Florida
County of ___________________________
Before me, the undersigned authority, duly authorized to take acknowledgements and administer oaths, personally
appeared ________________________________, personally known to me to be the person described above, who being by
me first duly sworn states that (His or Her) is the person who executed the foregoing instrument for the reasons expressed
therein.
Dated this ___________day of ____________,____________.
_______________________________________________________
NOTARY PUBLIC
My Commission Expires:__________________________________
*POA*
*POA* 11/2010
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