Financial Power Of Attorney

THIS FINANCIAL POWER OF ATTORNEY is given by [NAME OF PERSON GRANTING POWER] (hereinafter “Principal”), an individual residing in the County of [PRINCPAL’S COUNTY], State of [PRINCIPAL’S STATE], at [COMPLETE ADDRESS, CITY, STATE, AND ZIP CODE OF PRINCIPAL].

I, the undersigned, do hereby appoint [AGENT'S NAME - PERSON RECEIVING POWER]
of [ADDRESS, CITY, STATE, AND ZIP CODE OF AGENT] to be my true and lawful ATTORNEY-IN-FACT (hereinafter “Agent”) for financial matters with the following limited powers:

PRINCIPAL:  INITIAL EACH POWER GRANTED; CROSS OUT, RATHER THAN INITIAL, EACH POWER WITHHELD:

______ (A)  Real property transactions.
______ (B)  Tangible personal property transactions.
______ (C)  Stock and bond transactions.
______ (D)  Commodity and option transactions.
______ (E)  Banking and other financial institution transactions.
______ (F)  Business operating transactions.
______ (G)  Insurance and annuity transactions.
______ (H)  Estate, trust, and other beneficiary transaction.
______ (I)   Claims and litigation.
______ (J)  Personal and family maintenance.
______ (K)  Benefits from Social Security, Medicare, Medicaid, of 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).)

SUBJECT, HOWEVER, TO THE FOLLOWING LIMITATIONS:
 
[ENTER ANY LIMITATIONS ON THE POWERS GRANTED ABOVE].

[If my Agent is unable to serve for any reason, I designate {NAMES AND ADDRESSES OF ANY ALTERNATE AGENTS; NONE IS REQUIRED – DELETE THIS SENTENCE IF NO ALTERNATES ARE SELECTED} as my successor Agent.]

I authorize my Agent to execute, acknowledge, and deliver any instrument and do all things necessary to carry out the intent hereof, hereby granting to my Agent full power and authority to act in and concerning the premises as fully and effectually as I may do if present, provided, however that all business transacted by my Agent hereunder shall be transacted in my name, and that all endorsements and instruments executed by my Agent for the purpose of carrying out the foregoing powers shall contain my name, followed by that of my Agent, and the designation “Attorney-in-Fact.”

The effective date of this Power of Attorney is [SPECIFY THE DATE YOU WANT THIS POWER OF ATTORNEY TO TAKE EFFECT, GENERALLY THE DATE IT IS EXECUTED.  TO MAKE THE POWER OF ATTORNEY EFFECTIVE ONLY WHEN YOU BECOME INCAPACITATED, YOU MUST INSERT THE FOLLOWING LANGUAGE AND CHOOSE ONLY ‘DURABLE’ BELOW:  the date on which my personal ].

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 Power of Attorney.

My Agent shall be entitled to reimbursement of all reasonable expenses incurred in connection with this Power of Attorney, [CHOOSE ONE: and shall OR but shall not] be entitled to reasonable compensation on account of the services performed hereunder.

My Agent shall provide an accounting for all funds handled and all acts performed as my Agent, if I so request or if such a request is made by any authorized personal representative or fiduciary acting on my behalf.

This Power of Attorney [CHOOSE ONE:  shall not be durable  OR  shall be durable and this Power of Attorney and the authority of my Agent shall not terminate if I subsequently become disabled or incapacitated].  This Power of Attorney may be revoked by me at any time by written notice to my Agent. This Power of Attorney shall automatically be revoked upon my death.

IN WITNESS WHEREOF, I have executed this Power of Attorney on this ____ day of _________, 201(x)__.

 

                                                                                   
SIGNATURE OF PRINCIPAL


                                                                                   
PRINTED NAME OF PRINCIPAL
 

 

Witness Signature:___________________________________

Name:_____________________________________________

Address:___________________________________________

 

Witness Signature:___________________________________

Name:_____________________________________________

Address:___________________________________________

 

(THIS AREA FOR NOTARY PUBLIC)

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