Pennsylvania General Power Of Attorney Form (Page 4 of 8) in pdf

KNOW ALL PERSONS BY THESE PRESENTS:

I, ____________________________________ (“Principal”) maintaining an address at

_______________________________________________ do hereby make and appoint

________________________________________ (“Agent”) maintaining an address at:

_____________________________________________________ my true and lawful

attorney-in-fact for me and in my name, and in my behalf.

My Agent shall have full power and authority to perform any act, power, duty, legal right

or obligation whatsoever that I now have or may later acquire in connection with or

relating to any person, item, transaction, thing, business, property, real or personal,

tangible or intangible, or matter whatsoever as I could do if personally present. I hereby

ratify and confirm all acts that my Agent, or my Agent’s substitute or substitutes, shall

lawfully do or cause to be done by virtue of this power of attorney and the rights hereby

granted. My Agent’s powers and authority shall empower him (her) to do any or all of the

following, each of which is defined in 20 Pa.C.S.A.5603 (relating to implementation of

power of attorney):

1. “To make limited gifts.”

2. “To create a trust for my benefit.”

3. “To make additions to an existing trust for my benefit.”

4. “To claim an elective share of the estate of my deceased spouse.”

5. “To disclaim any interest in property.”

6. “To renounce fiduciary positions.”

7. “To withdraw and receive the income or corpus of a trust.”

8. “To authorize my admission to a medical, nursing, residential or similar

facility and to enter into agreements for my care.”

9. “To authorize medical and surgical procedures.”

10. “To engage in real property transactions.”

11. “To engage in tangible personal property transaction.”

12. “To engage in stock, bond and other securities transactions.”

13. “To engage in commodity and option transactions.”

14. “To engage in banking and financial transactions.”

15. “To borrow money.”

16. “To enter safe deposit boxes.”

17. “To engage in insurance transactions.”

18. “To engage in retirement plan transactions.”

19. “To handle interests in estates and trusts.”

20. “To pursue claims and litigation.”

21. “To receive government benefits.”

22. “To pursue tax matters.”

23. “To make an anatomical gift of all or part of my body.”

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Pennsylvania General Power Of Attorney Form Page 4