Power Of Attorney - New York Statutory Short Form Page 4
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9New York State Bar Association
New York Statutory Short Form Power of Attorney, 8/18/10, Eff. 9/12/10
behalf. If you ALSO wish your agent(s) to be compensated from your assets for services rendered on your
behalf, initial the statement below. If you wish to define "reasonable compensation", you may do so above,
under "Modifications".
(
) My agent(s) shall be entitled to reasonable compensation for services rendered.
(k)
ACCEPTANCE BY THIRD PARTIES:
I agree to indemnify the third party for any claims that may arise against the third party because of
reliance on this Power of Attorney. I understand that any termination of this Power of Attorney, whether the
result of my revocation of the Power of Attorney or otherwise, is not effective as to a third party until the
third party has actual notice or knowledge of the termination.
(l)
TERMINATION:
This 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.
(m)
SIGNATURE AND ACKNOWLEDGMENT:
In Witness Whereof I have hereunto signed my name on the ____ day of ____________, 20__
PRINCIPAL signs 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
(n)
IMPORTANT INFORMATION FOR THE AGENT:
When you accept the authority granted under this Power of Attorney, a special legal relationship is
created between you and the principal. This relationship imposes on you legal responsibilities that continue
until you resign or the Power of Attorney is terminated or revoked. You must:
(1) act according to any instructions from the principal, or, where there are no instructions, in the
principal's best interest;
(2) avoid conflicts that would impair your ability to act in the principal's best interest;
(3) keep the principal's property separate and distinct from any assets you own or control, unless
otherwise permitted by law;
(4) keep a record or all receipts, payments, and transactions conducted for the principal; and
2010 N.Y. Laws ch. 340
Page 4 of 9
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