Durable Power Of Attorney And Indemnification Agreement For Power Of Attorney Registration Form

Durable Power of Attorney and

Indemnification Agreement For Power of

Attorney Registration

Questions? Call toll-free 1.888.338.3789

Or write to the Plan at P.O. Box 55189 Boston, MA 02205-5189

Visit

WARNING TO PERSON EXECUTING THIS DOCUMENT: This is an important legal document. It

creates a power of attorney that provides the person you designate as your attorney-in-fact with the

broad powers it sets forth. You have the right to terminate this power of attorney. If there is anything

about this form that you do not understand, you should ask a lawyer to explain it to you.

Account Owner __________________________________________________________

Edvest College Savings Plan Account Number(s): __________________________

Home Phone: (

) _____________________

I, _____________________________________________ of _____________________________

do hereby make, constitute and appoint ______________________________________________

whose specimen signature is _______________________________________________________

and whose address is _____________________________________________________________

my true and lawful Attorney-in-Fact. All references herein to my Attorney-in-Fact shall be to such person or his

or her successors.

THIS IS A DURABLE POWER OF ATTORNEY AND THE AUTHORITY OF MY ATTORNEY-IN-

FACT SHALL NOT TERMINATE IF I LATER BECOME DISABLED OR INCAPACITATED OR IN

THE EVENT OF LATER UNCERTAINTY AS TO WHETHER I AM DEAD OR ALIVE.

I give and grant to my Attorney-in-Fact the power to act on my behalf with respect to the above referenced

Edvest account(s), such power to be used for my benefit and to be exercised by my Attorney-in-Fact only in a

fiduciary capacity. Specifically, my Attorney-in-Fact shall have the power:

To deposit or invest funds owned wholly or partly by me in the above referenced Edvest account(s); to

withdraw, now or in the future, any funds from the above referenced Edvest account(s); to change the

beneficiary of the above-referenced Edvest account(s); and to otherwise manage and enter into all other lawful

transactions with respect to the above referenced Edvest account(s).

I hereby agree to indemnify and hold State Street Bank and Trust Company (State Street), Boston Financial

Data Services, Inc. (Boston Financial), and the Edvest Plan harmless from acting upon instructions, either oral

or in writing, believed to have originated from said Attorney-in-Fact and from any and all acts of said Attorney-

in-Fact with respect to my Edvest account(s).

The authorization and indemnity is a continuing one and shall remain in full force and effect and shall be

binding upon the undersigned’s heirs, executors, successors, beneficiaries, or assigns until revoked by the

undersigned by a written notice addressed to Boston Financial and delivered to its main office, such revocation

shall not effect any liability in any way resulting from transactions initiated prior to Boston Financial’s acting

on such revocation within a reasonable amount of time. In case of the death, disability or incompetence of

the undersigned, this authorization shall continue and State Street, Boston Financial, and Edvest shall not be

responsible for any action taken on the basis of this authorization until Boston Financial has received written

notice thereof addressed to Boston Financial and delivered to its main office.

A13631/WI1210.POA

Durable Power Of Attorney And Indemnification Agreement For Power Of Attorney Registration Form - Wisconsin