Oklahoma Statutory Form For Power Of Attorney Form Page 2

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________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
(Attach additional pages if needed.)
UNLESS YOU DIRECT OTHERWISE ABOVE, THIS POWER OF ATTORNEY IS
EFFECTIVE IMMEDIATELY AND WILL CONTINUE UNTIL IT IS REVOKED.
This power of attorney will continue to be effective even though I become disabled,
incapacitated, or incompetent.
STRIKE THE PRECEDING SENTENCE IF YOU DO NOT WANT THIS POWER OF
ATTORNEY TO CONTINUE IF YOU BECOME DISABLED, INCAPACITATED, OR
INCOMPETENT.
I agree that any third party who receives a copy of this document may act under it.
Revocation of the power of attorney is not effective as to a third party until the third party
learns of the revocation. I agree to indemnify the third party for any claims that arise
against the third party because of reliance on this power of attorney.
Signed this ________ day of ________, 20___
______________________________
(Your Signature)
______________________________
(Your Social Security Number)
State of ____________
(County) of__________
This document was acknowledged before me on _______________(Date)
by____________________________
(Name of principal)
______________________________
(Signature of notarial officer)
______________________________
(Title and Rank)
(Seal, if any)
My commission expires: ___________
BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT
ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN
AGENT.

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