Connecticut Durable Power Of Attorney Form Page 2
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4(Strike out and initial in the opposite box any one or more of the
subdivisions as to which the principal does NOT desire to give the
agent authority. Such elimination of any one or more of subdivisions
(A) to (L), inclusive, shall automatically constitute an elimination of
subdivision (L).)
NOTE:
To strike out any subdivisions the principal must draw a line through the text of that
subdivision AND write his or her initials in the box opposite.
[If you do not draw a line
through and initial, you are giving your agent authority to exercise all of the following
powers.]
(A) real estate transactions;
[
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(B) chattel and goods transactions;
[
]
(C) bond, share and commodity transactions;
[
]
(D) banking transactions
[
]
(E) business operating transactions;
[
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(F) insurance transactions;
[
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(G) estate transactions;
[
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(H) claims and litigation;
[
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(I) personal relationships and affairs;
[
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(J) benefits from military service;
[
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(K) records, reports and statements;
[
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(L) all other matters;
[
]
[NOTE:
You may insert additional powers here]
___________________________________________________________________________________
Second: with full and unqualified authority to delegate any or all
the foregoing powers to any person or persons whom my attorneys-in-fact
shall select.
Third:
hereby ratifying and confirming all that said attorneys or
substitutes do or cause to be done.
This power of attorney shall not be affected by the subsequent
disability or incompetence of the principal.
In Witness Whereof, I have hereunto signed my name and affixed my
seal this
_______ day of _________________, __________.
(date)
(month)
(year)
___________________________
(L.S.)
(SIGNATURE)
WITNESSES (one of whom may be the notary, attorney, etc. taking the
acknowledgment)
Attested and subscribed in the presence of the
principal and subsequent to the principal
subscribing same:
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