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Full Name: Address:
Full Name: Address: Would you like to add a second Attorney In Fact (Agent)? No Yes You may choose to appoint more than one person to act on your behalf. This may require that the two people act jointly, both signing any instrument in order for it to be binding, or may permit them each to act individually on your behalf. Difficulties may arise from conflicting representatives; therefore it is usually recommended that a single representative be appointed instead. Second Attorney In Fact (Agent) Full Name: Address: Decisions by the Attorney In Facts: will be made together can be made together or independantly Attorney In Fact Compensation Would you like to indicate that your agent is entitled to compensation? No Yes Please enter details on how the agent will be compensated:
Attorney In Fact Compensation
Would you like to include an Alternate Attorney In Fact? No Yes You may also choose an alternative representative who will act in the event that the first person you named dies, becomes disabled, or no longer wishes to act as your representative. Please use the checkboxes to add your alternate agents: Full Name: Address: Full Name: Address:
Manage your real estate/property; To lease, purchase, exchange, acquire, accept, maintain, insure, and in any way or manner deal with all or any part of any interest in real property that the principal owns at the time of execution or may thereafter acquire. Handle your personal property; To purchase, sell or otherwise deal with any type of personal property the principal may have presently or in the future. Manage your stock, bond & commodity transactions; To buy, sell, endorse, transfer, and borrow against stock, bonds or other securities. Conduct your banking transactions; To make, receive, sign, and execute checks, drafts, bills of exchange, letters of credit, notes, and deposit instruments relating to accounts, banks, or savings for the principal. Conduct your business operating transactions; To conduct, engage in, and transact any and all lawful business of whatever nature or kind for the principal. Safety deposit matters; To have free access at any time or times to any safe deposit box or vault to which the principal might have access. Exercise rights of the settlor or grantor of a trust; To request, recover, collect, and hold all legacies owned or owing to the principal; and to execute all acquaintances, releases, receipts, or other sufficient discharges for the same. Manage legal claims on your behalf; To receive, collect, or settle any money, claims, or debts owing to the principal. Handle your personal and family support and care; To do all acts necessary to maintain the standard of living of the principal, spouse, children, and other dependents of the principal. Collect your Social Security benefits and other government aid; To prepare, to execute and to file all tax, social security, unemployment insurance and information returns required by the laws of the United States. Manage your insurance transactions; To purchase, pledge, liquidate, borrow or make claim against any insurance policy. Handle retirement plan benefits and transactions; To make contributions, withdrawals, roll-overs, and make elections with respect to retirement plans, including an individual retirement account. Employ agents; To employ and grant agents such as legal counsel, accountants and others as may be appropriate, such powers of attorney or other appropriate authorization as may be required. Manage your tax matters; To make, sign and file tax returns; to settle or exercise any right or election in any tax matter with federal, state, local and other governmental bodies. Make gifts; To make gifts to my spouse, children, parents, and more remote descendants, not to exceed in the aggregate $10,000 to each of such persons in any year. All other matters: Please specify the details of any other Powers you would like to add:
To lease, purchase, exchange, acquire, accept, maintain, insure, and in any way or manner deal with all or any part of any interest in real property that the principal owns at the time of execution or may thereafter acquire.
To purchase, sell or otherwise deal with any type of personal property the principal may have presently or in the future.
To buy, sell, endorse, transfer, and borrow against stock, bonds or other securities.
To make, receive, sign, and execute checks, drafts, bills of exchange, letters of credit, notes, and deposit instruments relating to accounts, banks, or savings for the principal.
To conduct, engage in, and transact any and all lawful business of whatever nature or kind for the principal.
To have free access at any time or times to any safe deposit box or vault to which the principal might have access.
To request, recover, collect, and hold all legacies owned or owing to the principal; and to execute all acquaintances, releases, receipts, or other sufficient discharges for the same.
To receive, collect, or settle any money, claims, or debts owing to the principal.
To do all acts necessary to maintain the standard of living of the principal, spouse, children, and other dependents of the principal.
To prepare, to execute and to file all tax, social security, unemployment insurance and information returns required by the laws of the United States.
To purchase, pledge, liquidate, borrow or make claim against any insurance policy.
To make contributions, withdrawals, roll-overs, and make elections with respect to retirement plans, including an individual retirement account.
To employ and grant agents such as legal counsel, accountants and others as may be appropriate, such powers of attorney or other appropriate authorization as may be required.
To make, sign and file tax returns; to settle or exercise any right or election in any tax matter with federal, state, local and other governmental bodies.
To make gifts to my spouse, children, parents, and more remote descendants, not to exceed in the aggregate $10,000 to each of such persons in any year.
This Power of Attorney shall have no end date. This will create a Durable Power of Attorney. This option would mean that the Power of Attorney would remain in effect even after death or mental incapacitation. This Power of Attorney will terminate: August February March April May June July August September October November December 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2005 2006 2007 2008 This option will create a Non-Durable Power of Attorney. This option would mean that the Power of Attorney would be rendered invalid should you pass on or become mentally incapacitated. Would you like to have the document signed in front of a Notary Public? No Yes How many witnesses would you like to sign the document? None One Two State where this Power of Attorney will be carried out: Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming This option is very important as it ensures that you create a custom Power of Attorney for your State. Agreement Signing Date: August January February March April May June July August September October November December 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2005 2006 2007 2008 Leave Date Blank Would you like to add an additional paragraph? No Yes Title of Paragraph:Details:
How many witnesses would you like to sign the document? None One Two