Power Of Attorney Alberta (Page 2 of 2) in pdf

This Power of Attorney has been prepared for your convenience and the Government of Alberta

makes no representation whatsoever about the form, usability, or validity of this Power of Attorney. If

you have any questions about the use or effect of this document, you should seek the advice of a

consequences of using this document.

lawyer who can advise you about the validity and the

POWER OF ATTORNEY

For Student Aid Alberta

This POWER OF ATTORNEY is given by me, _________________________________________________________

(Full legal name of the student, the “Donor”)

of ____________________________________________________________________________________________

(Address)

1. Appointment: I appoint _______________________________________________________________________

(Full legal name of the attorney, the “Attorney”)

of _________________________________________________________________________________________

(Address)

as my lawful attorney to do anything on my behalf that I may lawfully do by an attorney in respect of all student

loans, grants and other financial assistance (collectively the “Alberta Student Loans”) made available to me for

educational purposes by Her Majesty the Queen in right of Alberta as represented by the Minister of Enterprise

and Advanced Education (“Student Aid Alberta”), but excluding the signing and submission of any Application for

Student Financial Assistance to Student Aid Alberta (whether in paper or electronic form, including without

limitation the submission of the Consent and Declaration form).

2. Personal Information: I consent to the disclosure of my personal information by Student Aid Alberta to my

Attorney for use in relation to the exercise of my Attorney’s powers under this Power of Attorney.

3. Previous Power of Attorney: This Power of Attorney does not revoke any Power of Attorney that I have

previously signed, except that this Power of Attorney shall solely govern over any matters in respect of the Alberta

Student Loans. Student Aid Alberta shall be entitled to rely solely upon this Power of Attorney.

4. Termination: This Power of Attorney shall terminate upon Student Aid Alberta receiving written notice of: (a) my

termination of this Power of Attorney, (b) my Attorney’s resignation, death, bankruptcy or mental incapacity or

infirmity, or (c) my mental incapacity or infirmity, together with such supporting documents as may be required by

Student Aid Alberta. I acknowledge that until Student Aid Alberta receives such notice and supporting documents

all acts of my Attorney in accordance with this Power of Attorney will be binding on me.

5. Representations and Warranties: I and my Attorney (by signing below) jointly and severally represent and

warrant to Student Aid Alberta that: (a) my Attorney and I are 18 years of age or older, and (b) my Attorney and I

have the mental capacity to understand the nature and effect of this Power of Attorney.

6. Indemnity: I and my Attorney (by signing below) jointly and severally indemnify and hold harmless Student Aid

Alberta, and its directors, officers, employees and agents, against any and all claims, losses, liabilities and

expenses (including legal costs on a solicitor and client basis) that Student Aid Alberta incurs in any way relating to

its actions under, or in reliance upon, this Power of Attorney.

7. Acceptance: This Power of Attorney is subject to the acceptance and approval of Student Aid Alberta or its

agents.

This Document has been signed and delivered by the Donor (Student) named in this Power of Attorney in the

presence of two Witnesses:

_____________________________________________

Dated the _______ day of _______________, 20______.

Signature of Donor (Student) giving the Power of Attorney

Signed by two Witnesses in the presence of the Donor (Student):

(For Witnessing Requirements, see “Who is the ‘Witness’?” on the instruction sheet attached to this form)

By signing below, each Witness confirms that they are eligible witnesses as described in the attached

instruction sheet.

_____________________________________________ Dated the _______ day of _______________, 20______.

Signature of First Witness

__________________________________________________________________________________________

Print full legal name and address of First Witness

_____________________________________________ Dated the _______ day of _______________, 20______.

Signature of Second Witness

______________________________________________________________________________________________

Print full legal name and address of Second Witness

By signing below, the Attorney does hereby give to Student Aid Alberta the representations, warranties and indemnity set

out in paragraphs 5 and 6 above for good and valuable consideration, the receipt of which is hereby acknowledged.

___________________________________________ Dated the _______ day of ______________, 20_____.

Signature of Attorney named in this Power of Attorney

(cannot sign on behalf of Donor (Student))

__________________________________________________________________________________________

Print full legal name and address of the Attorney

__________________________________________________________________________________________

Relationship of Attorney named in this Power of Attorney to the Donor (Student)

June 2012

Power Of Attorney Alberta Page 2

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