Uniform Statutory Form Power Of Attorney - California (Page 2 of 2) in pdf

Uniform Statutory Form Power Of Attorney - California Page 2

STRIKE THE PRECEDING SENTENCE IF YOU DO NOT WANT THIS POWER OF ATTORNEY TO

CONTINUE IF YOU BECOME INCAPACITATED.

EXERCISE OF POWER OF ATTORNEY WHERE

MORE THAN ONE AGENT DESIGNATED

If I have designated more than one agent, the agents are to act ________________________________.

IF YOU APPOINTED MORE THAN ONE AGENT AND YOU WANT EACH AGENT TO BE ABLE TO ACT

ALONE WITHOUT THE OTHER AGENT JOINING, WRITE THE WORD “SEPARATELY” IN THE BLANK SPACE

ABOVE. IF YOU DO NOT INSERT ANY WORD IN THE BLANK SPACE, OR IF YOU INSERT THE WORD

“JOINTLY,” THEN ALL OF YOUR AGENTS MUST ACT OR SIGN TOGETHER.

I agree that any third party who receives a copy of this document may act under it. Revocation of the

power of attorney is not effective as to a third party until the third party has actual knowledge of the revocation. I

agree to indemnify the third party for any claims that arise against the third party because of reliance on this

power of attorney.

Signed this __________ day of _________________________, __________.

________________________________________

(your signature)

State of ________________________, County of _________________________,

BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT ASSUMES THE FIDUCIARY

AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT.

CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC

State of California

County of __________

On__________________________________before me, ________________________________,

personally appeared_____________________________, who proved to me on the basis of satisfactory

evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and

acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and

that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the

person(s) acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the

foregoing paragraph is true and correct.

WITNESS my hand and official seal.

Signature __________________________________ (Seal)

Uniform Statutory Form Power Of Attorney - California Page 2