HomeMy WebLinkAbout897802A205-10
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RECEIVED
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GENERAL POWER OF ATTORNEY
(With Durable Provision)
NOTICE: THIS IS AN IMPORTANT DOCUMENT. BEFORE SIGNING THIS DOCU-
MENT, YOU SHOULD KNOW THESE IMPORTANT FACTS. THE PURPOSE OF-THIS
POWER OF ATTORNEY IS TO GIVE Tttlg 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 'PERSON-
AL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. YOU
MAY SPECIFY THAT TIIESE POWERS WILL EXIST EVEN AFTER YOU BECOME DIS-
ABLED, INCAPACITATED OR INCOMPETENT. THIS DOCUMENT DOES NOT
AUTHORIZE ANYONE TO MAKE MEDICAL OROTItER HEALTH CARE DECISIONS
FOR YOU. IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDER-
STAND, YOU SHOULD AsK A LAWYER TO EXPLAIN IT TO YOU. YOU MAY REVOKE
THIS POWER OF ATTORNEY IF YOU LATER WISH TO DO SO.
TO ALL PERSONS, be it .known that I, ~/~/~c~ M%A ,/~. , , ,Y" ,-,~%o '
th.h.e undersigned 0rantor, do hereby make and grant a general power of attorney to ' __
.o'r'r w. .of 1 5'5'-
and do thereupon constitut~ and appoint said individual as my-attorney-in-fact. '
My attorney-in-fact shall act in my name, place and stead in any way which I myself could do, if I were per-
sonally present, with respect to the following matters, to the extent that I am permitted by law to act through an agent:
(NOTICE: The grantor must write, his or her initials in the corresponding blank space of a box below with respect to
each of the subdivisions (A) through (O) below for which the Grantor wants to give the agent authority. If the blank
Space within a box for any particular subdivision is NOT initialed, NO AIYFIIORITY WILL BE GRANTED for mat-
ters that are included in that subdivision. Cross out each power withheld.)
[ I~/a, .F-..,] (A)
[ -----' ] (B)
[ ~ ,1 (c)
[ V, ~. I<.] (D)
[ ~----- ] (E)
['7, rq-K] (F)
[ ] (O)
[ V' A' '1%] (H)
[ ----- ] (D
[ .~----- ] (J)
[ ]
Real eslate transactions
l;le~d-commod iCy-~an~etiens'
Banking transactions
B-urCmes~ op~r-a0ng ~ansac.qc. ns
Insurance transactions . :
,,.'ibeX2 ......... mey~m~Faet
Gifla_lo_~barities-andSndividuals ~' h~,,., s ,,~ '
__~lXll.St tl|.~lrlh~llnn~vi~eoh~tl ut Lm~ ~oiisequences-ar~-antieipated,"F61~ult-an-at/o~ev.)
Claims and litigation
p~e!afiensbjF, s mud
,B4mefit~.rem _milil,rm~ ~ee
Records; reports and statements
AZ}IF
; ?F:.:
'%3:.:i:!
':':',!:::::;;~::,:
:.;;I.;~F:',:;:;,: -
[ -----, ] (L) ~--'el~ndmaq~a~,.r".ed audmdtY-m-mymu'em..%'-m-faet-t°-delegatem~Lnr allBLthe-fr)regoing
~p,,we.xkto any .marsan-or-p~ns-whom my_atlo~-y-dfwfact shall%d'6'ct
[ ------- ] (M) ,-Acccs~, to safc deposit bo~es)
[ ~ ] (N)
Durable Provision:
[. ] (0) If the blank space in the block to the left is initialed by the Grantor, this power of attor-
ney shall not be affected by the subsequent disability or incompetence of the Grantor.
Other Terms:
My attorney-in-fact hereby accepts this appointment subject to its terms and agrees to act and
perform in said fiduciary capacity consistent with my best interests as he/she in his/her best dis-
cretion deems advisable, and I affirm and ratify all acts so undertaken.
TO INDUCE ANY THIRD PARTY TO ACT HEREUNDER, I HEREBY AGREE THAT ANY
THIRD PARTY RECEIVING A DULY EXECUTED COPY OR FACSIMILE OF THIS
INSTRUMENT MAY ACT HEREUNDER, AND THAT REVOCATION OR TERMINATION
HEREOF SHALL BE 'INEFFECTIVE AS TO SUCH THIRD PARTY UNLESS AND UNTIL
ACTUAL NOTICE OR KNOWLEDGE OF SUCH REVOCATION OR TERMINATION
SHALL HAVE BEEN RECEIVED BY SUCH THIRD PARTY, AND I ,FOR MYSELF AND
FOR MY HEIRS, EXECUTORS, LEGAL REPRESENTATIVES AND ASSIGNS, HEREBY
AGREE TO INDEMNIFY AND HOLD HARMLESS ANY SUCH 'THIRD PARTY FROM
AND AGAINST ANY AND ALL CLAIMS THAT MAY ARISE AGAINST SUCH THIRD
PARTY BY REASON ,OF SUCH THIRD PARTY HAVING RELIED ON THE PROVISIONS
OF THIS INSTRUMENT
Signed under seal this
Signed in the Presence of:
Witness
S,ate of
County of //i tdC:O/~/
Gran-t.o~ ~ i_ ~ ~
Attorney-in-Fact ! d '
¢~ ,J~t~t,~ ' ,appeared
before me, ~'d?O,. t~, ~{ , personally known
o. ',
to me (or proved to me on thd basis of satisfactory evidence) to be the person(s) who~e name(s) is/are subscribed to
the within instrument and acknowledged to'me that he/she/they executed the same in his/her/their authorized capaci-
ty(ies), and that by his/her/their signature(s) on the instrument tbe person(s), or the entity upon behalf of which the
person(s) acted, execnted the instrument.
WITNES~~,
S i g n atu, r.~-"~/,...~/
Tyne of ID