Statutory Durable Power Of Attorney (Page 2 of 6) in pdf

____ (J)

Personal and family maintenance;

____ (K)

Benefits from social security, Medicare, Medicaid, or other governmental

programs or civil or military service;

____ (L)

Retirement plan transactions;

____ (M)

Tax matters;

____ (N)

Digital assets and the content of an electronic communication.

____ (O)

ALL OF THE POWERS LISTED IN (A) THROUGH (N). YOU DO

NOT HAVE TO INITIAL THE LINE IN FRONT OF ANY OTHER

POWER IF YOU INITIAL LINE (O).

SPECIAL INSTRUCTIONS:

Special instructions applicable to agent compensation (initial in front of one of the following

sentences to have it apply; if no selection is made, each agent will be entitled to compensation

that is reasonable under the circumstances):

____ My agent is entitled to reimbursement of reasonable expenses incurred on my behalf and

to compensation that is reasonable under the circumstances.

____ My agent is entitled to reimbursement of reasonable expenses incurred on my behalf but

shall receive no compensation for serving as my agent.

Special instructions applicable to co-agents (if you have appointed co-agents to act, initial in

front of one of the following sentences to have it apply; if no selection is made, each agent will

be entitled to act independently):

____ Each of my co-agents may act independently for me.

____ My co-agents may act for me only if the co-agents act jointly.

Special instructions applicable to gifts (initial in front of the following sentence to have it

apply):

____ I grant my agent the power to apply my property to make gifts outright to or for the

benefit of a person, including by the exercise of a presently exercisable general power of

appointment held by me, except that the amount of a gift to an individual may not exceed

the amount of annual exclusions allowed from the federal gift tax for the calendar year of

the gift.

ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS

LIMITING OR EXTENDING THE POWERS GRANTED TO YOUR AGENT.

_____________________________________________________________________________

Statutory Durable Power of Attorney

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Statutory Durable Power Of Attorney Page 2