Durable Power Of Attorney For Finances Page 5
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5I can amend or revoke this power of attorney through a writing delivered to my
agent. Revocation is not effective as to a third party until the third party learns of it.
Photocopies of this document can be relied upon as though they were originals.
S
P
IGNATURE OF
RINCIPAL
I sign this document voluntarily, and I understand its purpose.
Dated: _______________
Signed: ______________________________________
(Your signature)
______________________________________________________________________
(Address)
S
S
W
TATEMENT AND
IGNATURE OF
ITNESSES
We sign below as witnesses. This declaration was signed in our presence. The
declarant appears to be of sound mind, and to be making this designation voluntarily,
without duress, fraud or undue influence. Neither of us is an agent named in this
document.
_____________________
_____________________________________________
(Print name)
(Signature of witness)
______________________________________________________________________
(Address)
____________________
______________________________________________
(Print name)
(Signature of witness)
______________________________________________________________________
(Address)
S
N
IGNATURE OF
OTARY
Sworn to and signed by __________________________ this ___ day of 20__.
____________________________________________
(Signature of notary public)
County _______________________________
My commission expires ______________
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