Loading...
HomeMy WebLinkAbout891970ORIGI 89197O LF240-04 R240-04 LIMITED POWER OF ATTORNEY (With Durable Provision) NOTICE: THIS IS AN IMPORTANT DOCUMENT. BEFORE SIGNING THIS DOCUMENT, YOU SHOULD KNOW THESE IMPORTANT FACTS. THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON WHOM YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO HANDLE YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO PLEDGE, SELL OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT AD¥~NCE NOTICE TO YOU OR APPROVAL BY YOU. YOU MAY SPECIFY THAT THESE POWERS WILL EXIST EVEN AFTER YOU BECOME DISABLED, INCAPACITATED OR INCOMPETENT. THIS DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL OR OTHER HEALTH CARE DECISIONS FOR YOU. IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU. YOU MAY REVOKE THIS POWER OF ATTORNEY IF YOU LATER ;VISH TO DO SO. as Grantor, do hereby m~ake amd grant a limited and specific power of attorney to ~J~F~ ~ 5 ~' ' q- ct , and appoint and constitute s~d individ~¢t as my attorney-in-fact. My named attorney-in-fact shall have full power and authority to ur~dertake, COlnmit and perform only the following acts on my behalf to the same extent as if I had done so personally; all with full power of substitution and revocation in the presence: (Describe specific authority) The authority granted shall include such incidental acts as are reasonably required or necessary to carry out and perform the specific authorities and duties stated or contemplated herein. My attorney-in-fact agrees to accept this appointment subject to its terms, and agrees to act and perform in said fiduciary capacity consistent with my best interests as my attorney-in-fact deems advisable, and I thereupon ratify all acts so carried out. I agree to rein~burse my attorney-in-fact all reasonable costs and expenses incurred in the fulfillment of the duties and responsibilities enumerated herein. IMPORTANT NOTE: This form is not valid for delegating personal financial and or property matters in the state of Maine. To obtain the correct form, call 1-800-822-4566 or visit www. MadeE-Z. com and click "access bonus forms" for a free downloadable form. © 1992-2001 Made E-Z Products, Inc. Page 1 Rev. 03/02 This product does not constitute the rendering of legal advice or services, This product is intended for informalional use only and is not a substitute for legal advice. State laws vary, so consult an attorney on all legal matters. This product was not necessarily prepared by a person licensed to practice law in your state. Special durable provisions: ..~] i/l This power of attorney shall not be affected by subsequent incapacity of the Grantor. This power of attorney may be revoked by the. Grantor giving written notice of revocation to the attorney-in-fact, provided that any party-relying in good 'faith 'upon this power of attorney shall be protected unless and until said party has either a) actual or constructive notice of revocatig~,.,9.r.b) upon recording of said revocation in the public records where the Grantor resides. ·: Other terms: .~r~'{~o~,~ 5o ~rc,.,<~¢~ ~l,c~l( _a~-~/,~'¢ ~gv~ ~L~c~,~r~ ~/~? Signed under seal this /q day of ~~~~S' in the presenc of: Witness Witness Witness ,20 Grantor Attorney-in-Fact State of County of Onappe~~_~_~' '- ~' ~oo~before me, ~~~.~~ , personally ~own to me (or proved to me on the basis of satisflcto~ evidence) to be the person(s) whose name(s) is/~e subscribed to the wit~ instrument and ac~owledged to me that he/she/they executed the same in his~e~eff authorized capaciW(ies), ~d that by ~s~effthek si~amre(s) on the instrument the person(s), o~entity upon behalf of w~ch the person(s) acted, executed the Nstmment. WI2~S~nd an~i~eM. /ff _ / i ~fi~t ~own Produced D '" "* ~':' ~ ;' ' ..... '" ~ '"' ~" ' ' .... (Seal) State of County of On before me, , appeared personally ~own to me (or proved to me on the basis of satisfacto~ evidence) to be the person(s) whose nme(s) is/~e subscribed to the wit~ instrument and ac~owledged to me that he/shehhey executed the same in t5s~er/thek authorized capacity(les), ~d that by ~sD~er/thek signature(s) on the ~stmment the person(s), or the entity upon behalf of w~ch the person(s) acted, executed the instrument. WI~SS my hand and official seal. 'Signature Affiant Known Produced D Type of D (Seal) Page 2