New York General Power Of Attorney Form Page 2

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(b) DESIGNATION OF AGENT(S):
I, ___________________________________________________________________, hereby appoint:
(name and address of principal)
______________________________________________________________________ as my agent(s).
(name(s) and address(es) of agent(s))
If you designate more than one agent above, they must act together unless you initial the statement
below.
(
) My agents may act SEPARATELY.
(c) DESIGNATION OF SUCCESSOR AGENT(S): (OPTIONAL)
If every agent designated above is unable or unwilling to serve, I appoint as my successor agent(s):
__________________________________________________________________________________
(name(s) and address(es) of successor agent(s))
Successor agents designated above must act together unless you initial the statement below.
(
) My successor agents may act SEPARATELY.
(d) This POWER OF ATTORNEY shall be affected by my subsequent incapacity
(e) This POWER OF ATTORNEY REVOKES any and all prior Powers of Attorney executed by me
unless I have stated otherwise below, under "Modifications." If you are NOT revoking your prior
Powers of Attorney, and if you are granting the same authority in two or more Powers of Attorney, you
must also indicate under "Modifications" whether the agents given these powers are to act together or
separately.
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