Texas Statutory Durable Power Of Attorney (Page 3 of 3) in pdf

Texas Statutory Durable Power Of Attorney Page 3

IF NEITHER (A) NOR (B) IS CROSSED OUT, IT WILL BE ASSUMED THAT

YOU CHOSE ALTERNATIVE (A).

If Alternative (B) is chosen and a definition of my disability or incapacity is not

contained in this power of attorney, I shall be considered disabled or incapacitated for

purposes of this power of attorney if a physician certifies in writing at a date later than the

date this power of attorney is executed that, based on the physician's medical examination of

me, I am mentally incapable of managing my financial affairs. I authorize the physician who

examines me for this purpose to disclose my physical or mental condition to another person

for purposes of this power of attorney. A third party who accepts this power of attorney is

fully protected from any action taken under this power of attorney that is based on the

determination made by a physician of my disability or incapacity.

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

Revocation of the durable power of attorney is not effective as to a third party until the third

party receives actual notice 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.

If any agent named by me dies, becomes legally disabled, resigns, or refuses to act, I

name the following (each to act alone and successively, in the order named) as successor(s)

to that agent: ________________________________________________________.

Signed this ______ day of ________________________, 20___

_________________________________ (your signature)

State of _______________________

County of _____________________

This document was acknowledged before me on _________________________(date)

by _______________________________ (name of principal)

____________________________ (signature of notarial officer)

____________________________ (printed name)

My commission expires: ______________

THE ATTORNEY IN FACT OR AGENT, BY ACCEPTING OR ACTING

UNDER THE APPOINTMENT, ASSUMES THE FIDUCIARY AND OTHER LEGAL

RESPONSIBILITIES OF AN AGENT.

Texas Statutory Durable Power Of Attorney Page 3