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HomeMy WebLinkAbout876258 DURABLE POWER OF ATTORNEY I, Erwin J. Merritt, being a person legally competent to enter into contracts, hereby 'make, constitute and appoint my daughter, Colleen M, Wright, my true and lawful attorney-in-fact as hereinafter set forth, 11 I hereby acknowledge and state that this Durable Power of Attorney has been made and executed in accordance with the provisions of Wyoming Statutes Sections 3-5-101 to 3-5-103, and in anticipation of infirmity resulting from injury, old age, senility, blindness, disease or other similar cause. III I further expressly state that this power shall not become ineffective by reason of any subsequent change in my mental or physical condition inCluding, but not restricted to, incompetency or disability, ,. IV This Durable Power of Attorney shall be effective until my attorney-in-fact has actual knowledge of my death or until the recording of an instrument of revo(;ation, with a true copy of this Durable Power of Attorney attached, in the Office of the County Clerk of the county in which I reside at the time such revocation is filed. V I further declare and stipulate that from and after the date of execution hereof, this General Power of Attorney, shall be effective without condition or limitation over all property, whether real or personal, tangible or intangible, which I may now own or hereafter acquire, and wheresoever situated. This General Power of Attorney shall be exercised solely by Colleen M. Wright; · however, in the event Colleen M. Wright dies, ceases to act, refuses or is unable to serve, resigns or is removed for cause by a court, then and in such event, I hereby make, constitute and appoint my daughter, Lennis M. Franklin, as my successor attorney-in-fact, and if she fails to serve, my son, Clyde E. Merritt. None of my attorneys-in-fact will be required to furnish or maintain bond. VII My attorney-in-fact shall have complete authority to provide for the care of my person and property and, in addition thereto but without limitation upon the generality of the foregoing, my attorney-in-fact shall have the power to: 1 Demand, sue for, collect, receive and hold all sums of money, dividends, interest, payments on account of debts and legacies and all property now due or which hereafter may become due and owing to me, and give good valid receipts and discharges for such payments. 2. Buy, sell, assign, transfer, acknowledge and deliver stocks, bonds and other securities standing in my name or belonging to me at such prices as shall seem appropriate to my attorney-in-fact. 3. Borrow money and pledge securities for such loans if in the judgment of my attorney-in-fact such action is necessary. 4. Consent in my-name to reorganization and mergers, 'and to the exchange of securities for new securities. 5., Manage real property; to sell, convey and mortgage realty; to foreclose mortgages; to take title to property in my name if my attorney-in-fact thinks proper; to execute, acknowledge and deliver deeds to real property, mortgages, releases, satisfactions and other instruments relating to realty which my attorney-in-fact considers necessary; and to record this Durable Power of Attorney concurrently 2 with such deedsl mortgages, releases, satisfactions and other instruments relating to realty. 6. Procure, pay for and maintain such insurance on tangible personal property or the improvements upon real estate as my attorney-in-fact deems appropriate. 7. Do business with banks, and particularly to endorse all checks and drafts made payable to my order and collect the proceeds thereof, and further, to enter into and deposit therein or withdraw therefrom property of every kind, tangible or intangible, from safe deposit boxes standing in my name or in the name of my attorney-in-fact at any bank wherever situated in which I shall at any time have a safe deposit box registered in my name or in the name of my attorney-in-fact. 8. Sign in my name checks on all accounts standing in my name, and to withdraw funds from said accounts; to open accounts in my name or in the name of my attorney-in- factl 9. Assign and convey real and personal property which I may now own or hereafter acquire into any living trust created by me; any such property to be held, administered and distributed pursuant to the terms thereof. 10. Make such payments and expenditures as may be necessary in connection with any of the foregoing matters or with the administration of my affairs. 11. Retain counsel and attorneys on my behalf; to appear for me in all actions and proceedings to which I may be a party in the courts of the State of Wyoming or any other state in the United States, in the'United States courts; to commence actions and proceedings in my name if necessary; and to sign and verify in my name all complaints, petitions, answers and other pleadings of every description. 12. Make and verify income tax returns, and to represent me in all income tax matters before any office of the Internal Revenue Service, Within the limitations of the applicable Revenue Rulings and Procedures. 13. Act as trustee for any trust for which I am the duly appointed and acting trustee under any trust agreement or other document. VIII My attorney-in-fact shall be entitled to reimbursement for reasonable expenses incurred in the performance of her duties and to a reasonable compensation for services rendered hereunder, payable out of my income and assets. My attorney-in-fact shall be required to account to me or my legal representative only when requested in writing to do so by myself or my legal representative. IN WITNESS WHEREOF, I have hereunto set my hand as of this 18th day of November, 1999. ' Erwir~. Me'Fritt STATE OF WYOMING SS. COUNTY OF LINCOLN The foregoing Durable Power of Attorney was acknowledged before me by Erwin J. Merritt this ~ day of November, 1999. Witness my hand and official seal. ~ ! My Commission E×p,res: F,b. 2~ 20~ - ~TAffY ~-UBLiC My commission expires: Februaw 26, 2000. ~"' ~'~':~'~'~"'~ DURABLE POWER OF ATTORNEY FOR HEALTH CARE I, Erwin J. Merritt of Bedford, Lincoln County, Wyoming, (mailing address: 4534 County Road 123, Bedford, WY 83112), hereby appoint my daughter, Colleen M. Wright, to serve as my agent ("agent") and to exercise the powers set forth below. In addition, in order to provide for succession in the event my agent cannot continue to serve, I hereby appoint the following persons to serve as consecutive alternates to my agent named above to serve in the order specified: my daughter, Lennis M. Franklin, and my son, Clyde E. Merritt. By this document I intend to create a Durable Power of Attorney for Health Care pursuant to W.S. 3-5- 201 et seq. If no agent designated in this document is available or able to serve, I request that my desires as expressed in this document be given full force and effect as a written expression of intent under applicable law. The following powers granted to my agent shall be immediately effective and shall not be affected by my disability or lapse of time. I desire that my wishes as expressed herein be carried out through the authority given to my agent by this document despite any contrary feelings, beliefs or~ opinions of members of my family, relatives, friends or guardian of my estate. ARTICLE I MY AGENT'S GENERAL POWERS REGARDING MY HEALTH CARE My agent is authorized in my agent's sole and absolute discretion to exercise the powers granted herein relating to matters involving my health and medical care. In exercising such powers, my agent should' first try to discuss with me the specifics of any proposed decision regarding my medical care and treatment if 1 am able to communicate in any manner, however rudimentary. My agent is further instructed that if I am unable to give an informed consent to a proposed medical treatment, my agent shall give, withhold or withdraw such consent for' me based upon any treatment choices that I have expressed while competent, whether under this document or otherwise. If my agent cannot determine the treatment choice I would want made under the circumstances, then my agent should make such choice for me based upon what my agent believes to be in my best interests. Accordingly, my agent Is authorized as follows: A. Gain Access to Medical Records and Other Personal Informat on To request, receive and review any information, verbal or written, regarding my personal affairs or my physical or mental health, including medical and hospital records, and to eXecute any releases or other documents that may be required in order to obtain such information, and to disclose such information to such persons, organizations, firms or corporations as my agent shall deem appropriate. B. Employ and Discharqe Health Care Personnel To employ and discharge medical personnel including physicians, psychiatrists, dentists, nurses, or therapists as my agent shall deem necessary for.my physical, mental and emotional well-being, and to pay them (or cause to be paid to them) reasonable compensation. C. Giy.e, Withhold or Withdraw Consent to Medical Treatment To give or withhold consent to any medical procedure, test or treatment, !ncluding surgery; to arrange for my hospitalization, convalescent care, hospice or home care; to summon paramedics or other emergency medical personnel and seek emergency treatment for me, as my agent shall deem appropriate; and under circumstances in which my agent determines that certain medical procedures, tests or treatrhents are no longer of any benefit to me or, where the benefits are outweighed by the burdens imposed, to revoke, withdraw, modify or change consent to such procedures, tests and treatments, as well as hospitalization, convalescent care, hospice or home care which I or my agent may have previously allowed or consented to or which may have been implied due to emergency conditions. My agent's decisions should be guided by taking into account (1) the provisions of this document, (2) any reliable evidence of preferences that I may have expressed on the subject, whether before or after the execution of this document, (3) what my agent believes I would want done in the circumstances if I were able to express myself and (4) any information given to my agent by the physicians treating me as to my medical diagnosis and prognosis, and the int~'usiveness, pain, risks and side effects associated with the treatment. D. Exercise and Protect My Rights ~ To exercise my right of privacy and my right to make decisions regarding my medical treatment even though the exercise of my rights might hasten my death or be against conventional medical advice. E. Authorize Relief from Pain To consent to arrange for the administration of pain-relieving drugs of any kind or other surgical or medical procedures calculated to relieve my pain, including unconventional pain-relief therapies which my agent believes may be helpful, even though such drugs or procedures may lead to permanent physical damage, addiction or hasten the moment of (but not intentionally cause) my death, F. Grant Releases , To grant, in conjunction with any instructions given under this Article, releases to hospital staff, physicians, nurses and other medical and hospital administrative personnel who act in reliance on instructions given by my agent or who render opinions to my agent in connection with any matter described in this article from all liability for damages suffered or to be suffered by me; to sign documents titled or purporting to be a "Refusal to Treatment" and "Leaving Hospital Against Medical Advice" as well as any necessary waivers of or releases from liability required by a hospital or physician to implement my wishes regarding medical treatment or non-treatment. MY AGENT'S POWERS REGARDING LIFE-SUSTAINING MEDICAL TREATMENT I wish to live and enjoy life as long as possible. However, I do not wish to receive medical treatment which will only postpone the moment of my death from an incurable and terminal condition or prolong an irreversible coma, For purposes of this document, (1) "terminal condition" shall refer to a condition that is described in W,S, 35-22-101(a){ix) and (2) "Irreversible coma" shall refer to a condition as described in W.S. 3-5-201 (a)(viii). Therefore, I declare pursuant to W.S. 35-22-102 that if two. (2) licensed and qualified physicians who have personally examined me and are familiar with my condition, one of whom is my attending physician, have diagnosed and noted in my medical records that (1) I am unable to give informed consent to medical treatment that is proposed or available for my condition and my condition is terminal as defined above, or (2) I have been in a coma for at least thirty (30) days and that the coma. is irreversible as defined above, then my agent is authorized to , (a) direct that treatment or procedures which will only postpone the moment of my death or prolong an irreversible coma be withheld or, if previously instituted, direct that they be withdrawn; (b) direct that procedures other than manual feeding used to provide me with nourishment and hydration (including, for example, ail forms of intravenous and parenteral feeding, all forms of tube feeding, and misting) be withheld or, if previously instituted, to direct that they be withdrawn; (c) sign on my behalf any documents necessary to carry out the powers granted in this article (including waivers or releases of liability required by any health care provider); (d) direct and consent to the writing of a "No Code" or "Do Not Resusciiate" order by any health care provider; and (e) order whatever is appropriate to keep me as comfortable and as free of pain as is reasonably possible, including the administration of pain relieving drugs, surgical or medical procedures calculated to relieve my pain, and unconventional pain-relief therapies which my agent believes may be helpful, even though such drugs or procedures may lead to permanent physical damage, addiction or hasten the moment of (but not intentionally cause) my death. I'n exercising the powers given my agent under this article, my agent shall follow the instructions of this document and any other subsequent instruction, oral or written, that I may' give my agent while I am competent, Notwithstanding such instruc~ons, if my agent cannot determine the treatment choice I wouJd want made under the circUmstances, then my agent should make Such choice for me based upon what my agent believes to be in my best interest. ARTICLE III MY AGENT'S POWERS REGARDING . MY CARE AND CONTROL OF MY BODY My agent is authoiized as follows with respect to my care and the control of my body: A. Provide For My Residence To make all necessary arrangements for me at any hospital, hospice, nursing home, 'convalescent home or similar establishment and to assure that all my essential needs are provided for at such a facility. B. Provide for Compaqionsh p To provide for such c. ompanionship for me as will meet my needs and preferences at a time when I am disabled or otherwise unable to arrange for such companionship myself. C. Make Advance Funeral Arranqements To make advance arrangements for my funeral and burial, including the purchase of a burial plot and marker, and such other related arrangements as my agent shall deem appropriate, if I have not already done so myself. D. Make Anatomical Gifts To make anatomical gifts which will take effect at my death to such persons and organizations as my agent shall deem appropriate and to execute such papers and do such acts as shall be necessary, appropriate, incidental or convenient in connection with such gifts. ARTICLE IV THIRD PARTY RELIANCE For the purpose of inducing any individual, organization, or entity, (including, but not limited to any physician, hospital, nursing home, insurer, °r other party, all of whom will be referred to in this Article as a "person") to act in accordance with the instructions of my agent as authorized in this document, I hereby represent, warrant and agree that: A. Reliance on Aqent's Authority and Representations No person who relies in good faith upon the authority of my agent under this document shall incur any liability to me, my estate, my heirs, successors or assigns. In addition, no person.who relies in good faith upon 4 any representation my agent may make as to (a) the fact that my agent's powers are then in effect, (b) the scope of my agent's authority granted under this document, (c) my competency at the time this document is executed, (d) the fact that this document has not been revoked, or (e) the fact that my agent continues to serve as my agent shall incur any liability to me, my estate, my heirs, successors or assigns for permitting my agent to exercise any such authority. B. No LiabilitY For Unkqgwn Revo. cation or Amendmeqt. If this document is revoked or amended for any reasons, I, my estate, my heirs, successors and assigns will hold any person harmless from any loss suffered or liability incurred as a result of such person acting in good faith upon the instructions of my agent prior to the receipt by such person of abtual notice of such revocation or amendment. C. Agent May Act Alone The powers conferred on my agent by this document may be exercised by my agent alone and my agent's signature or act under the authority granted in this document may be accepted by persons as fully authorized by me and with the same force and effect as if I were personally present, competent, and acting on my own behalf. Consequently, all acts lawfully done by my agent hereunder are done with my consent and shall have the same validity and effect as if I were personally present and personally exercised the powers myself, and shall inure to the benefit of and bind me, my estate, my heirs, successors, assigns and personal representatives. D. Release of Information I hereby authorize all physicians and psychiatrists who have treated me, and all other providers of health care, including hospitals, to release to my agent all information or photocopies of any records which my agent may request. If I am incompetent at the time my agent shall request such information, all persons are authorized to treat any such request for information by my agent as the request of my legal representative and to honor such requests on that basis, I hereby waive all privileges which may be applicable to such information and records and to any communication pertaining to me and made in the course of any confidential relationship recognized by law. My agent may also disclose such information to such Persons as my agent shall deem appropriate. E. Resort to Courts hereby authorize my agent to seek on my behalf and at my expense: (a) a declaratory judgment from any court of competent jurisdiction interpreting the validity of this document or any of the acts authorized by this document, but such declaratory judgment shall not be necessary in order for my agent to perform any act authorized by this document; or lb) mandatory injunction requiring compliance with my agent's instructions by any person obligated to comply with instructions given by my agent; or lc) actual and punitive damages against any person obligated to comply with instructions given by agent who negligently or willfully fails or refuses to follow such instructions. ARTICLE V MISCELLANEOUS PROVISIONS The following additional provisions shall apply to this document: A. Reimbursement of Costs My agent shall be entitled to reimbursement for all reasonable costs and expenses actually incurred and paid by my agent on my behalf under any provision of this document, but my agents shall not be entitled to compensation for services rendered hereunder. B. Execute Documents and Incur Costs i.n Implementiqg the Above Powem My agent shall be entitled to sign, execute, deliver and acknowledge any contract or other document that may be necessary, desirable, convenient or proper in order to exercise any of the powers described in this document and to incur reasonable costs in the exercise of any such powers. In addition, my agent shall render bills for all costs incurred in the exercise of the powers granted in this document to the person then responsible for my financial affairs. C. Governing Law This document shall be governed by the laws of the State of Wyoming in all respects, including its validity, construction, interpretation, and termination. I intend for this Durable Power of Attorney for Health Care to be honored in any jurisdiction where it may be presented and for any such jurisdiction to refer to Wyoming law to interpret and determine the validity of this document and any of the powers ~ranted under this document. .~_~ D. Revocation and Amendment I' revoke all prior Durable Powers of Attorney for Health Care that I may have executed and I retain the right .to revoke or amend this document and to substitute other agents in the place of those named. Amendments to this document shall be made in writing by me personally and shall be attached to the original of this document. E. Resignation of Aqent. My agent and any alternate agent may resign by the execution of a written resignation delivered to me or, if I am mentally incapacitated, by delivery to the Guardian of my person (other than the agent), the trustee of my revocable trust, and absent such person then to any person with whom I am residing or who has the care and custody of me, or, in the case of the resignation of an alternate agent, by delivery to my agent. In addition, the incapacity of my agent or any alternate agent shall be deemed a resignation by such individual, as agent or alternate agent as the case may be. For purposes of this paragraph, a person's incapacity shall be deemed to exist when the person's incapacity has been declared by a court of competent jurisdiction, or when a guardian for such person has been appointed, or upon presentation of a certificate executed by two (2) physicians licensed to practice in the state of such person's residence which states the physicians' opinion that the person is incapable of caring for himself or herself and is physically or mentally incapable of managing his or her personal or financial affairs. The effective date of such incapacity shall be the date of the decree adjudicating the incapacity, the date of the decree appointing the guardiah, or the date of the physicians' certificate, as the case may be. F. Photocopies My agent is authorized to make photocopies of this document as frequently and in such quantity as my agent shall deem appropriate. All photocopies shall have the same force and effect as any original. I specifically direct my agent to have a photocopy of this document placed in my medical records if such a copy does not already constitute a part of my medical records. .. G. Severability If any part of any provision of this document shall be invalid or unenforceable under applicable law, such part shall be ineffective to the extant of such invalidity only, without in any way affecting the remaining parts of such provision or the remaining provisions of this document. H. Exculpation My agent and my agent's estate, heirs, successors and assigns are hereby released and forever discharged by me, my estate, my heirs, successors and assigns from all liability and from all claims or demands of all kinds arising out of the acts or omissions of my agent, except for willful misconduct or gross negligence. I understand the full import of this document, and I am emotionally and mentally competent to make this power of attorney. NOTICE ~' This document has significant medical, legal and possible ethical implications and effects. Before you sign this document, you should become completely familiar with these implications and effects. The operation, effects and implications of this document may be discussed with a physician, a lawyer, and a clergyman of your choice. I CERTIFY THAT I HAVE READ THE PROVISIONS OF THIS INSTRUMENT AND THAT SUCH PROVISIONS HAVE BEEN EXPLAINED TO ME TO MY SATISFACTION, THAT I UNDERSTAND SUCH PROVISIONS AND THAT SUCH PROVISIONS STATE MY WISHES AND DESIRES UNDER THE CIRCUMSTANCES DESCRIBED. I execute this Durable Power of Attorney for Health Care on this 18th day of November, 1999.' The declarant has been personally known to me and I believe him to be of sound mind. I did not sign the declarant's signature above for or at the direction of the declarant. I am not related to the declarant by blood or marriage, entitled to any portion of the estate of the declarant according to the laws of intestate succession or under any will of the declarant or codicil thereto, or directly financially responsible for declarant's medical care. Witness No. 1 Witness No. 2 Signature f Gerald L. Goulding Signature P.O. Box 968 Ted Frome Alton, WY 83110 P.O. Box 969 Alton, WY 83110 STATE OF WYOMING - ' SS. COUNTY OF LINCOLN · Erwin J. Merritt, being first duly sworn and put on his oath, deposes and states that he has read the foregoing Durable Power of Attorney for Health Care, that he 'understands the provisions thereof, that it reflects his desires in the matters addressed therein and acknowledges that he executes it of his own free will and choice. Erwin ,~Merritt k Subscribed to and sworn to before me by Erwin d. Merritt this ('~'~_ day of November, 1999. Witness my hand and official seal. (~ -~~/i~! My commission expires: February 26, 2000.