Fillable Florida Durable Power Of Attorney Form (Page 2 of 3) in pdf

MANAGEMENT P OWERS: To vote a t a ll meetings o f s tockholders o f a ny c ompany o r c orporation, a nd o therwise t o a ct

as m y a ttorney o r p roxy i n r espect o f m y s hares o f s tock o r o ther s ecurities o r i nvestments w hich n ow o r h ereafter s hall

belong t o m e, a nd t o a ppoint s ubstitutes o r p roxies w ith r espect t o a ny s uch s hares o f s tock.

TAX POWERS: To sign and execute in my behalf any tax return, state or federal relating to income, gift, ad valorem,

intangible or other taxes, state or federal, and to act for me in any examinations, audits, hearings, conferences or

litigation r elating t o a ny s uch taxes, i ncluding a uthority t o f ile a nd p rosecute r efund c laims, a nd t o e nter into an e ffect

any s ettlements.

TRUST P OWERS:

(a) To e xecute a r evocable o r i rrevocable t rust w hich p rovides t hat a ll i ncome a nd p rincipal s hall b e p aid t o m e o r

the guardian of my estate, or applied for my benefit in such manner as I or my attorney hereunder shall

request o r a s t he t rustee s hall d etermine, a nd t hat o n m y d eath a ny r emaining a ssets, i ncluding i ncome, shall

pass a ccording t o m y w ill o r i ntestate s uccession i f I h ave n o w ill.

(b) To m ake a dditions o f f unds a nd a ssets, r eal a nd p ersonal, t o a ny t rust e stablished b y m e.

BUSINESS I NTERESTS:

(a) To s ell, r ent, l ease f or a ny t erm, o r e xchange, a ny r eal e state o r i nterests t herein, f or s uch c onsiderations and

upon such terms and conditions as my attorney may see fit; specifically including the power and authority to

execute acknowledge and deliver deeds, mortgages, leases and other instruments conveying or encumbering

title t o p roperty o wned b y m e a nd m y s pouse j ointly.

(b) To commence, prosecute, discontinue or defend all actions or other legal proceedings touching my estate or

any p art t hereof, o r t ouching a ny m atter i n w hich I o r m y e state m ay b e i n a ny w ay c oncerned.

(c) The p owers h erein c onferred u pon m y a ttorney s hall e xtend t o a nd i nclude a ll o f m y r ight, t itle a nd i nterest in

and to any real and personal property, tangible or intangible, in which I may have an estate by the entirety,

joint t enancy, t enancy i n c ommon, a s t rustee o r b eneficiary o f a ny t rust, o r i n a ny o ther m anner.

PERSONAL I NTERESTS:

(a) To make gifts, outright or in trust, in an amount not greater than $10,000.00 per donee per year or the

amounts allowed without gift tax consequences under the appropriate Internal Revenue code provisions

(including m y a ttorney h ereunder a ppointed).

(b) To arrange for my entrance to and care at any hospital, nursing home, health center, convalescent home,

retirement h ome o r s imilar i nstitution.

(c) To r enounce o r d isclaim a ny i nterest a cquired b y t estate o r i ntestate s uccession o r b y i nter v ivos t ransfer.

10. HEALTH C ARE P OWERS:

(a) To a uthorize, a rrange f or, c onsent t o, w aive a nd t erminate a ny a nd a ll m edical a nd s urgical p rocedures o n my

behalf ( including any election or election and agreement under the Life-‐Prolonging Procedures Act of Florida

with request to providing, withholding or withdrawing life-‐prolonging procedures should I fail to make a

declaration h ereunder) a nd t o p ay o r a rrange c ompensation f or m y c are.

(b) To m ake h ealth c are d ecisions f or m e a nd t o p rovide i nformed c onsent i f I a m i ncapable o f m aking h ealth care

decisions o r p roviding i nformed c onsent.

(i)

To be the final authority to act for me and to make health care decisions for me in matters

regarding m y h ealth c are d uring a ny p eriod i n w hich I h ave t he i ncapacity t o c onsent.

(ii)

To expeditiously consult with appropriate health care providers to provide informed consent in

my b est i nterest a nd m ake h ealth c are d ecisions f or m e w hich m y s aid S urrogate b elieves I w ould

have m ade u nder t he c ircumstances i f I w ere c apable o f m aking s uch d ecisions.

(iii)

To g ive a ny c onsent i n w riting u sing t he a ppropriate c onsent f orm.

(iv)

To have access to appropriate clinical records regarding me and have authority to authorize the

release of information and clinical records to appropriate persons to insure the continuity of my

health c are.

Florida Durable Power Of Attorney Form Page 2

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