Power Of Attorney New York Statutory Short Form/power Of Attorney New York Statutory Major Gifts Rider Authorization To Make Major Gifts Or Other Transfers Form (Page 6 of 9) in pdf

Power Of Attorney New York Statutory Short Form/power Of Attorney New York Statutory Major Gifts Rider Authorization To Make Major Gifts Or Other Transfers Form Page 6

New York State Bar Association

New York Statutory Short Form Power of Attorney, 8/18/10, Eff. 9/12/10

(p) SUCCESSOR AGENT’S SIGNATURE AND ACKNOWLEDGMENT OF APPOINTMENT:

It is not required that the principal and the SUCCESSOR agent(s), if any, sign at the same time, nor

that multiple SUCCESSOR agents sign at the same time. Furthermore, successor agents can not use this

power of attorney unless the agent(s) designated above is/are unable or unwilling to serve.

I/we, _________________________, have read the foregoing Power of Attorney. I am/we are the

person(s) identified therein as SUCCESSOR agent(s) for the principal named therein.

Successor Agent(s) sign(s) here:

==> ____________________________________________

STATE OF NEW YORK

)

ss:

COUNTY OF ____________ )

On the _____ day of __________, 20___, before me, the undersigned, personally appeared

___________________, personally known to me or proved to me on the basis of satisfactory evidence to be

the individual whose name is subscribed to the within instrument and acknowledged to me that he/she

executed the same in his/her capacity, and that by his/her signature on the instrument, the individual, or the

person upon behalf of which the individual acted, executed the instrument.

Notary Public

2010 N.Y. Laws ch. 340

Page 6 of 6

Power Of Attorney New York Statutory Short Form/power Of Attorney New York Statutory Major Gifts Rider Authorization To Make Major Gifts Or Other Transfers Form Page 6

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