GENERAL POWER OF ATTORNEY
I, __________________________, residing at__________________________,
hereby appoint ______________________ of ___________________________,
as my Attorney-in-Fact ("Agent").
I hereby revoke any and all general powers of attorney that previously
have been signed by me. However, the preceding sentence shall not have
the effect of revoking any powers of attorney that are directly related
to my health care that previously have been signed by me.
My Agent shall have full power and authority to act on my behalf. This
power and authority shall authorize my Agent to manage and conduct all
of my affairs and to exercise all of my legal rights and powers, including
all rights and powers that I may acquire in the future. My Agent's powers
shall include, but not be limited to, the power to:
1. Open, maintain or close bank accounts (including, but not limited to,
checking accounts, savings accounts, and certificates of deposit),
brokerage accounts, and other similar accounts with financial institutions,
including, but not limited to:
a. Conduct any business with any banking or financial institution with
respect to any of my accounts, including, but not limited to, making
deposits and withdrawals, obtaining bank statements, passbooks, drafts,
money orders, warrants, and certificates or vouchers payable to me by any
person, firm, corporation or political entity.
b. Perform any act necessary to deposit, negotiate, sell or transfer
any note, security, or draft of the United States of America, including
U.S. Treasury Securities.
c. Have access to any safe deposit box that I might own, including its
contents.
2. Sell, exchange, buy, invest, or reinvest any assets or property
owned by me. Such assets or property may include income producing or
non-income producing assets and property.
3. Purchase and/or maintain insurance, including life insurance upon
my life or the life of any other appropriate person.
4. Take any and all legal steps necessary to collect any amount or
debt owed to me, or to settle any claim, whether made against me or
asserted on my behalf against any other person or entity.
5. Enter into binding contracts on my behalf.
6. Exercise all stock rights on my behalf as my proxy, including all
rights with respect to stocks, bonds, debentures, or other investments.
7. Maintain and/or operate any business that I may own.
8. Employ professional and business assistance as may be appropriate,
including attorneys, accountants, and real estate agents.
9. Sell, convey, lease, mortgage, manage, insure, improve, repair,
or perform any other act with respect to any of my property (now
owned or later acquired) including, but not limited to, real estate
and real estate rights (including the right to remove tenants and to
recover possession). This includes the right to sell or encumber any
homestead that I now own or may own in the future.
10. Prepare, sign, and file documents with any governmental body or
agency, state or federal, including, but not limited to, authorization to:
a. Prepare, sign and file income and other tax returns with federal,
state, local, and other governmental bodies.
b. Obtain information or documents from any government or its agencies,
and negotiate, compromise, or settle any matter with such government or
agency (including tax matters).
c. Prepare applications, provide information, and perform any other
act reasonably requested by any government or its agencies in connection
with governmental benefits (including military and social security
benefits).
11. Make gifts from my assets to members of my family and to such other
persons or charitable organizations with whom I have an established pattern
of giving.
12. Transfer any of my assets to the trustee of any revocable trust created
by me, if such trust is in existence at the time of such transfer.
13. Disclaim any interest, which might otherwise be transferred or distributed
to me from any other person, estate, trust, or other entity, as may be
appropriate.
14. Make decisions about Child Support and Custody issues, communicate with
any persons regarding such issues, and any State or Federal agencies regarding
Child Support or Custody.
15. To act on my behalf when for any reason I am not physically available
to: retrieve school records, Doctor and dental records, to provide and make
available medical or dental attention, to pick up and drop off from school,
daycare, after school and extracurricular activities and any other means
needed to provide care for my child.
This Power of Attorney shall be construed broadly as a General Power of
Attorney. The listing of specific powers is not intended to limit or restrict
the general powers granted in this Power of Attorney in any manner.
Any power or authority granted to my Agent under this document shall be
limited to the extent necessary to prevent this Power of Attorney from
causing: (i) my income to be taxable to my Agent, (ii) my assets to be
subject to a general power of appointment by my Agent, and (iii)
my Agent to have any incidents of ownership with respect to any life
insurance policies that I may own on the life of my Agent.
My Agent shall not be liable for any loss that results from a judgment
error that was made in good faith. However, my Agent shall be liable
for willful misconduct or the failure to act in good faith while acting
under the authority of this Power of Attorney.
I authorize my Agent to indemnify and hold harmless any third party who
accepts and acts under this document.
My Agent shall be entitled to reasonable compensation for any services
provided as my Agent. My Agent shall be entitled to reimbursement of all
reasonable expenses incurred in connection with this Power of Attorney.
My Agent shall provide an accounting for all funds handled and all acts
performed as my Agent, if I so request or if any authorized personal
representative or fiduciary acting on my behalf makes such a request.
This Power of Attorney shall become effective immediately, and shall
not be affected by my disability or lack of mental competence, except
as may be provided otherwise by an applicable state statute. This Power
of Attorney shall continue for a period of one year from the date signed
by me below, unless revoked prior to that date. I may revoke this Power
of Attorney at any time by providing written notice to my Agent.
Dated:_________________________, 20XX at_________________________.
__________________________________
(Person giving Powers)
__________________________________
[WITNESS' FULL LEGAL NAME]
__________________________________
[WITNESS' FULL LEGAL NAME]
STATE OF____________, COUNTY OF________________________.
The foregoing instrument was acknowledged before me this _____ day
of _______________, 20XX by
______________________________, who is personally known to me or who has
produced __________________________________ as identification.
_________________________________
Signature of person taking acknowledgment
_________________________________
Name typed, printed, or stamped
_________________________________
Title or rank
_________________________________
Serial number (if applicable)
This document was prepared by:
Name: ______________________
Address: ___________________
|