Power Of Attorney New York Statutory Short Form Page 2

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New York Statutory Short Form Power of Attorney, Effective. Sept. 12, 2010 
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 any agent designated above is unable or unwilling to serve, I appoint as my successor agent(s):
_______________________________
___________________________________________
(name of successor agent)
(address of successor agent)
_______________________________
___________________________________________
(name of second successor agent),
(address of second successor agent)
Successor agents designated above must act together unless you initial the statement below.
(
) My successor agents may act SEPARATELY.
You may provide for specific succession rules in this section. Insert specific succession provisions here:
(d)
This POWER OF ATTORNEY shall not be affected by my subsequent incapacity unless I have
stated otherwise below, under “Modifications”.
(e)
This POWER OF ATTORNEY DOES NOT REVOKE any Powers of Attorney previously
executed by me unless I have stated otherwise below, under “Modifications”.
If you do NOT intend to revoke your prior Powers of Attorney, and if you have granted the same
authority in this Power of Attorney as you granted to another agent in a prior Power of Attorney, each agent
can act separately unless you indicate under “Modifications” that the agents with the same authority are to
act together.
(f)
GRANT OF AUTHORITY:
To grant your agent some or all of the authority below, either
(1)
Initial the bracket at each authority you grant, or
(2)
Write or type the letters for each authority you grant on the blank line at (P), and
initial the bracket at (P). If you initial (P), you do not need to initial the other lines.
I grant authority to my agent(s) with respect to the following subjects as defined in sections 5-1502A
through 5-1502N of the New York General Obligations Law:
(
) (A) real estate transactions;
(
) (B) chattel and goods transactions;
(
) (C) bond, share, and commodity transactions;
(
) (D) banking transactions;
(
) (E) business operating transactions;
(
) (F) insurance transactions;
Chapter 340 of the Laws of 2010, the New York Legislature
Page 2 of 6 

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