New York Public Employee Retirement System Special Durable Power Of Attorney (Page 3 of 6) in pdf

New York Public Employee Retirement System Special Durable Power Of Attorney Page 3

(d) This SPECIAL POWER OF ATTORNEY shall not be affected by my subsequent

incapacity unless I have stated otherwise below, under “Modifications”.

(e) This SPECIAL POWER OF ATTORNEY DOES NOT REVOKE any prior 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:

By executing this Power of Attorney, I grant the authority to my agent to act in my name, place

and stead with respect to retirement benefit transactions involving any applicable public

retirement system of the state. This specific authority shall include the ability to:

 prepare, execute, deliver, submit and/or file any document or instrument;

 make investment directions;

 select and change payment options;

 designate a beneficiary or beneficiaries; provided, however, that the agent may not

designate himself or herself as a beneficiary unless the agent is my spouse, domestic

partner, parent or child; and

 exercise any other election for the principal with regard to any retirement benefit

provided by any applicable public retirement system of the state.

This authority must be exercised pursuant to my instructions, or otherwise for purposes which

the agent reasonably deems to be in my best interest.

(g) MODIFICATIONS: (OPTIONAL) In this section, you may make additional

provisions, including language to limit or supplement authority granted to your agent:

(h) TERMINATION: This Special Power of Attorney continues until I revoke it or it is

terminated by my death or other event described in section 5-1511 of the General Obligations

Law. Section 5-1511 of the General Obligations Law describes the manner in which you may

revoke your Power of Attorney, and the events which terminate the Power of Attorney.

(i) ACCEPTANCE BY THIRD PARTIES AND COPY/FACSIMILE CLAUSE:

To induce any third party to act hereunder, I hereby agree that any third party receiving a duly

New York Public Employee Retirement System Special Durable Power Of Attorney Page 3