HomeMy WebLinkAbout904139~/~/~o~ ~B:04 19B94694§47
GENERAL D~RI~'- ~ I,:~..,!.','. (.,OUNTY CLERK
**... 0 k i 3'9.
SoCial Security No.
the undersigned, domiciled at -_~e~me~.~, ~ , _ ~,~ na,~zn4.,-l,r(:,~ L%.,<..'.~nty,
Wyoming, do hereby make, constitute, and appoint ~,~h,,
Social Securi~ No. ~20-70-7470 .-.'. residing at
Campbell Count, ~oming as my a~orney-in-fact (herein called
agent), or if he is unable to-act as such for any reason, I appoint Jeanne
Social Securi~ No. ~-~6-i974 residing at
as such agent, with the following pow~be exercise~ jn my nam~ ~Or my
benefit:
PAGE
1. Ge.rl¢ral Grant of Power, To exercise or perform any act, power, duty, right .
or obligation whatsoever that I now have or may hereafter acquire, relating to any
person, matter, transaction or property, real or personal, tangible or intangible, now
owned or hereafter acquired by me, including, without limitation, the following
specifically enumerated powers. I grant to my agent full power and authority to do
everything necessary in exercising any of the powers herein granted as fully as I might
or could do if personally present, with full power of substitution or revocation, hereby
ratifying and confirming all that my agent sh~il lawfully do or cause to be done by virtue
of this power of attorney and the powers here~n granted.
2. Collection powern. To forgive, request demand, sue for, recover, collect,
receive, and hold all such su~ns of money, debtsl dues, commercial paper, checks,
drafts, accounts, deposits,' legacies, bequests, devises, notes, interests, stock
certificates, bonds, dividends, certificates of deposit, annuities, pension, profit sharing,
retirement, social security, insurance and other contractual benefits and proceeds, all
documents of title, all property, real or personal, intangible or tangible property and
property rights, and demands whatsoever liquidated or unliquidated, now Or hereafter
owned by, or due, owing, payable or belonging to, me or m which I have or may heater
acquire an interest; to have, use, and take all lawful means and equitable and legal
remedies and proceedings in my name for the collection and recovery thereof, and to
adjust, sell, compromise, and agree for the same, and to execute and deliver for me, on
my behalf, and in my name, all endorsements, releases, receipts, or other sufficient
discharges for the same. ·
3. Real Property Power.,-, To bargain, contract, agree for, option, purchase,
acquire, receive, improve, maintain, repair, insure, plat, partition, safeguard, lease,
demise, grant, bargain, sell, assign, transfer, remise, release exchange, convey,
mortgage, and hypothecate real estate and any interest therein (and including any
interest which I hold with any other person as joint tenants with full rights of
survivorship, or as tenants by the entireties), lands, tenements and hereditaments, for
such price, upon such terms and conditions, as my agent shall determine.
4. Personal Property Power,,-. To bargain, contract, agree for, purchase,
option, acquire, receive, imp~'ove,.maintain, repair, insure, safeguard, lease, assign,
sell, exchange, redeem, transfer, mortgage, hypothecate and in any and every way and
manner deal Jn and with goods, wares, merchandise, furniture and furnishings,
automobiles, bills, notes, debentures, bonds, stocks, limited partnership interests,
certificates of deposit, commercial paper, money market instruments, and other
securities, chooses in action and'other tangible or intangible personal property in
possession or Jn action, for such price, upon such terms and conditions, as my agent
shall determine.
5. Contract Powem_. To make, do and transact every kind of business of
whatever nature, and 'also for me and in my name, and as my act and deed. to sign,
seal, execute, deliver and acknowledge such stock certificates, stock powers,
assignment separate from certificates, deeds, conveyances leases and assignments of
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leases, covenants, indentures, options, letters of intent, contracts, agreements, closing
agreements, certificates, mortgages, hypothecations, bills of lading, bills, bonds,
debentures, notes, receipts, evidences of debts, releases and satisfaction of mortgage,
judgments and other debts, Waivers of statutes of limitations, and such other
documents and instruments in writing of whatever kind and nature as may be necessary
or proper in the premises, as fully as I might do if done in my own capacity.
6. Bankino powers,. To make, draw, sign in my name, deliver and execute
checks, drafts, receipts for moneys, notes, or other orders for the payment of money
against, or otherwise make withdrawals from any commercial, checking or savings
account which I may 'have in my sole name or in joint name with other person(s), in any
bank or financial institution, for any purpose which my agent may think necessary,
advisable or proper; and to endorse and negotiate in my name and to deliver checks,
drafts, notes, bills, certificates of deposit, commercial paper, money market
instruments, bills of exchange or other instruments for lhe payment of money and to
deposit same, as cash or for collection, and into my commercial, checking or savings
account which I may have in my sole name or in joint name with other person(s)', in any
bank or financial institution; and to carry on all my ordinary banking business.
7. Ta.,x; Returns. To prepare, execute, and file reports, returns, declarations,
forms and statements for any and all tax purposes including income tax, gift tax, real
estate tax, personal property tax, intangibles tax, single business tax, or any other kind
of tax whatsoever, to pay such taxes and any interest or penalty thereon or additions
thereto; to make and file objections, protests, claims for abatement, refund or credit Jn
relation to any such tax proposed, levied or paid; to represent me and to institute and
prosecute proceedings in court or before any administrative authority to contest any
such tax in whole or in part or for recovery of any amount paid in respect of any such
tax, to defend or settle any amount paid in respect of any such tax, to give full and final
receipt for any refund or credit and to endorse and collect any check or other vouchers
therefor; to pay any and all such taxes and any interest, penalty or other additional
amounts; to employ attorneys, accountants, or other representatives and grant powers
of attorney of letters of appointment thereof for any of Ihe purposes aforesaid.
8. Safe Deposit Box, To have any safe deposit box of which I am a tenant or
cotenant with full power to withdraw or change from time to time the contents thereof;
and to exchange or surrender the box and keys thereto, renew any rental contract
therefor, and to do all things which any depository, association, or bank or its agents
may requi're, hereby releasing the lessor from all liability in connection therewith.
9, Employ. Agent. To employ and compensate agents, accountants, attorneys,
appraisers, financial consultants, real estate brokers and other professional assistants
and to retain and compensate such persons for services rendered; and to waive any
attorney/client privilege.
10..~Motor Vehicles.- To apply for a Certificate of Title upon, and endorse and
transfer title thereto, for any automobile, or other'motor vehicle, and to represent in
such transfer assignment that the title to said motor vehicles is free and clear of all liens
and encumbrances except those specifically set fodh in such transfer assignment.
11. Settlement.powers. To adjust, settle, compromise, or submit to arbitration
any accounts, debts, claims, demands, disputes or matters which are now subsisting or
may hereafter adse between me and my agent and any other person or persons, or in
which any property, right, title, interest or estate belonging to or claimed by me may be
concerned.
12. Legal Actions. To commence, prosecute, enforce or abandon, or to
defend, answer, oppose, confess, compromise or settle all claims, suits, actions or
other judicial or administrative proceedings in which I am or may hereafter be
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interested, or in which any property, right, title, interest or estate belonging to, coming to
or claimed by me may be concerned.
'13. Dividends. To receive all dividends which are or shall be payable on any
and all shares of stock in any corporation which may stand in my name on the books of
such corporation or to which I may be, in equity or otherwise, beneficially entitled; or to
elect to reinvest such dividends, all as my agent may deem appropriate.
'14. Vote Stock. To vote at all stockholder meetings of corporations and
°therwise to act as my proxy or representative in respect of any shares now held or
which may hereafter be acquired by me therein and for that purpose to sigh and
execute any proxies or other instruments in my name and on my behalf.
15. Transfer of Stock. To sell, assign, transfer, and deliver all and any Shares
of stOck standing in my name on the books of any corporation, of which I may be, in
equity or otherwise, beneficially entitled, and for that purpose to make and execute all
necessary acts of assignment and transfer.
16. Insurance and Employee Benefit Plans. To redeem, surrender, borrow,
extend, cancel, amend, pledge, alter or change, including change 'of beneficiary, any
insurance policies in which I may have an interest, as my agent may deem proper and
expedient, and for such purpose to sign and execute any documents, affidavits or forms
required in my name and on my behalf, except however, my agent shall have no power
and authority over life insurance policies I may own on my agent's life; and to exercise
ali powers and options involving retirement programs, compensation plans, pension,
profit sharing and other employee benefit plans.
'17. Social Securit'v and Governmental Benefits, To make application to any
governmental agency for any benefit or government obii~-ation to which I may be
entitled; to endorse any checks or drafts made payable to me from any government
agency for my benefit, including any social security checks.
18. Busjpess Interests, To continue to conduct or participate in any business
in which I may be engaged or to carry out, modify, or amend any agreement to which I
may be a party, and to sell, exchange,, modify, or terminate such interest to or with
such person and persons as my agent may deem proper and on such terms and with
such security as my agent may deem appropriate; to execute partnership agreements,
and amendments thereto; to incorporate, reorganize, merge, consolidate, recapitalize,
sell, liquidate or dissolve any business; to elect or employ officers, directors and agents;
and to carry out the provisions of any agreement for the sale of any business interest or
the stock therein.
'19. Borrow. To borrow from time to time such sums of money and upon such
terms as my said agent may think expedient for or in relation to any purpose or object
which my agent may deem proper or expedient, unsecured or upon the security of any
of my properly, whether real or personal or otherwise, and for such purpose to give,
execute in my name, deliver, and acknowledge promissory notes and/or renewals
thereof, mortgages, pledges and guaranties with such powers and provisions as my
agent may think proper or requisite.
20. Debts and Expense_~. To pay, compromise, and settle any and all bills,
loans, notes, or other forms of indebtedness owed by me at the present time, or which
may be owed by me or incurred by my agent hereunder for my benefit at any time in the
future, and incur and pay from any of my assets or property all reasonable expenses in
connection with control, management, and dependent upon me, including reasonable
compensation for the services of my agent, and including the fees and charges of such
agents, attorneys, accountants, or others as my agent may, in the exercise of
discretion, employ in the management of any of my affairs.
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21. Investments. To invest and reinvest in loans, stocks, bonds, including
United States Bonds purchased at a discount but redeemable at face value, securities,
real estate, life insurance, annuities, or endowment policies or combinations thereof, or
in any other investment which my agent may deem proper; to reduce the interest rate at
any time and from time to time on any mortgage or land contract; to deal with and give
instructions to any brokerage firm with respect to the purchase, sale or other disposition
of securities and other assets; to add assets to or withdraw assets from any account in
my'name and sign any representation, certification or agreement, including agreements
regarding margin, option trading, or commodities accounts that my agent deems
advisable. '
22. Persona! and.Medical Care. To the extent permitted by Wyoming law
governing powers of attorney for health care, to make each and every judgement
necessary for the proper and adequate care and cuslody of me and my family; to hire,
fire, employ, pay for and discharge such domestic help, nursing services, and practical
and/or registered nurses as my agent may determine to be Jn the best interest of my
health; and to give an informed consent or an informed refusal on my behalf with
respect.to my physical and'mental health care and comrorl, including specifically, by
way of illustration only and not by away of limitation:
a. Any medical care, diagnosis, surgical procedure, therapeutic
procedure and/or other treatment of any type or nature except convulsive treatment or
psychosurgery (or any other treatment which may from time to time be listed as a
treatment which may not be authorized by an attorney in fact for health care under
Wyoming law);
b. Any physical rehabilitation program;
c. Any dental procedure;
d. Any psychiatric or psychological care or treatment except convulsive
treatment or psychosurgery;
e. The admission to any hospital, medical center, nursing home, but not
including a mental health treatment facility;
f. The use of any drugs, medication, therapeutic devices, or other
medicines or items related to my health;
g. The execution of waivers, medical authorizations and such other
approval as may be required' to permit or authorize care which I may need;
h. The waiver of any doctor/patient privilege;
and in general to take and authorize all acts with respect to my health and well being,
and to expend all amounts in connection therewith, to the same extent as I could, if
mentally competent to do'so. The prices, costs, expenses and compensation incurred
in furtherance of the foregoing are all to be within the sole and absolute discretion of my
agent.
23. A.n. atomical Gift~. To donate my blood, a kidney, or other organ or body
p.art during my lifetime to a relative of mine, and upon rny death, However, my body is
not to be donated for use as a cadaver.
24. ~ift in Power. To continue any annual gifting program I have begun prior
to my permanent incapacity, to individuals to whom I have made, or have expressed an
intention in writing to make, at least one gift prior to that permanent'incapacity. My
agent shall decide from year to year, in her discretion, the persons to whom such gifts
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would be made, which may include my agent, and may make gifts in amounts up to the
maximum amount which may be gifted to each such person without the imposition of
gift tax.
25. _Terminate Life Su ----ort S -stems. Determine whether and when life
support shall be withdrawn from me. And to contest the fees and charges of any heaith
care providers for services rendered by them contrary to my desire that life-sustaining
procedures be withheld if they only serve to prolong the dying process. Only the herein
stated attorney-in-fact, other than myself may make these decisions. And all means of
life support until he can be apprised of the situation and make any contrary decision,
With respect to the application of life-sustaining procedures which would serve
only to artificially prolong the dying process, by way of direction and inclusion, but not
limitation, should I ever. have an incurable injury, disease or other illness or condition
certified to be a terminal condition as provided for herein above, including irreversible
brain damage that makes me unable to recognize people or swallow or I am in an
untreatable coma with no chance or recover, I would not want these measures taken or
I would want them to be discontinued it there is not. improvement within a shod time:
Involuntary nourishment and hydration;
· Cardiopulmonary resuscitation to start my head beating;
· Use of a respirator if I cannot breathe;
· Feeding by a tube into the stomach; or
· Treatment with antibiotics if pneumonia er any other infections develop.
26, _Restrictipn on Agent's_Pow_g.W_Q~,
a. My agent cannot execute a Will or Codicil 'on my behalf,
b. My agent cannot execute any trust on my behalf; however, my agent can
enter into a custodial agreement with a financial Institution having trust powers;
c. My agent cannot dived the beneficial use of my assets to himself, his
creditors, or his estate (although my agent may have legal title to the same by virtue of
joint ownership or otherwise);
d. My agent shall not exercise, and shall not be vested with any incidents of
ownership as to insurance policies insuring my agent's life, owned by me;
e. My agent is a fiduciary, possessing no genera or limited power of
appointment;
f. My agent shall not exercise any powers which I received in a fiduciary
capacity, and my agent shall have no authority to exercise any powers, the exercise of
which would cause assets of mine to be considered as taxable in my agent's estate for
the purpose of the federal estate tax.
health treatment g' My agentfacility.Cannot consent to my commitment to or placement in a mental
h. My agent cannot consent to any convulsive treatment on my behalf.
I. My agent cannot consent to psycho surgery on my behalf.
27. Special Al:lent for Benefit Pla, nnino. My special agent shall be authorized
on my behalf to take such steps as shall be necessary to ensure or enhance my
eligibility for governmental medical and other benefits. The power of my special agent
shall arise only with respect to transactions which might involve transfers to my agent or
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the entry into contractual relationships with my agent in my agent's individual rather
than fiduciary capacity. My special agent's power shal include but no be limited to: to
enter into an agreement with my agent with respect to the_ division of assets which
might be jointly owned by myself and my agent; to mako transfers of property to my
agent; to discharge any legal obligation of support I might have with respect to my
agent; to acquire asset jointly with my agent; to convert as to which might be considered
in reducing available governmental benefits into assets which would be exempt .from
such consideration; to expend or acquire assets for the joint benefit of myself and my
agent; and to take any and all other actions which might retain, secure or enhance my
eligibility for governmental benefit regardless of whether my agent might incidentally
benefit as well.
28. Interpretation and Governing Law. This instrument is to be construed and
interpreted as a general durable power of attorney. The enumeration of specific powers
is not intended to, not does it, limit or restrict the general powers herein granted to my
agent. Paragraph headings are for convenience only and are not to be deemed to be
part of this instrument. This instrument is executed and delivered in the State of
Wyoming, and the laws of the State of Wyoming shall govern all questions as to the
validity of this power and construction of its provisions.
29....Third-Party Reliance, Third parties may rely upon the representation of my
agent as to all matters relating to any power granted to my agent, and no person, who
may act in reliance upon the representations of my agent or the authority granted to my
agent shall incur any liability to me or my estate as a resull of permitting my agent to
exercise any power, and for the purpose of inducing third parties to rely on this power of
attorney, I warrant that, if this power is revoked by me or otherw'se terminated, I will
indemnify and save such third party harmless from any loss suffered or liability incurred
by such third party in good faith reliance on the authority of my agent prior to such third
party's actual knowledge of revocation or termination of this power of attorney whether
such termination is by operation of law or otherwise. This warranty shall bind my heirs,
devisees and personal representatives.
30. Dis~bili.ty of Principa._l. This power of attorney shall become effective upon
my disability or incapacity. The authority of my agent sba I be exercisable
notwithstanding any uncertainty as to whether I am alive. [ shall be deemed disabled or
incapacitated upon the election by my agent to accept the written opinion of two
licensed physicians, one of which shall be the attending physician or otherwise shall
have previously rendered services to me, stating that I am incapacitated through illness,
age, or other cause and that I am therefore incapable of altending to my business
affairs. Any act done by my agent during any period of my disability or incompetence or
dui'lng any period of uncertainty as to whether I am alive shall have the same effect as
though I were alive, competent, and not disable, and shall inure to the benefit of and by
me, my heirs, devisees, and personal representatives.
31. Photographic Copies, Photographic or other facsimile reproductions of
this executed power may be made and delivered by my agent and may be relied upon
by any person to the same extent as though the copy were in original. Anyone who
acts in reliance upon the representation or certificate of my agent, or upon a
reproduction of this power, shall not be liable for permitting my agent to perform any act
pursuant to this power.
,,tr.~ Law Office P.C.
Box 1550
~n, ivy 83110
7) 856~0f,40
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have signed and delivered this general durable power of attorney this~-,-~Pday
of~PY'l / 2000.
I declare under penalty of perjury under the laws of Wyoming that the person who
signed or acknowledged this document is personally known to me to be the principal,
that the principal signed acknowledged this durable power of attorney in my presence,
that the principal appears to be of sound mind and under no duress, fraud, or undue
influence, that I am not the person appointed as attorney n fact by this document, and
that I am not a treating health care provider, an employee of a treating health care
provider, the operator of a community care facility, an employee of an operator of a
community care facility, the operator of a residential care facility, nor an employee of an
operator of a residential care facility. I further declare under penalty of perjury under the
laws of Wyoming that I am not related to the principal by blood, marriage, or adoption,
and, to the best of my knowledge, I am not entitled to any part of the estate of the
principal under the death of.the principal undei' a will now existing or by operation of
law..
~Vilnd~s'
STATE OF WYOMING )
)ss
COUNTY OF LINCOLN )
The foregoing General Durable Power of Att0rney was sworn to and
Acknowledgec[ before me by J~J3~%. ~Y'(~/- _ .... gr.c.a._n.~r,
~-VI~'~;~_~ / ~dJ'l/'J~ and ~_~l'/-lJJl"l' Pt .[A)IL~F(% as witnesses, this Z:"' ~day of'~,
odo. - ' ....
Witn.esseth my hand and official seal.
Lincoln ~JJjJ~ Wyoming t
"y Commission £~s ~-'~-2Z.1~] j
My Commission Expires:
NOTARY PUBLIC
Bower~ Law Office P. C
P.O. Box 1550
Afton, tYY ~3110
(~07) 886-0640
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