Texas General Durable Power Of Attorney Form Page 2

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I am fully informed as to all the contents of this form and understand the full import of this grant of
powers to my Agent.
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]
ACKNOWLEDGMENT OF AGENT
BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT ASSUMES THE
FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT.
Elaine Pennartz
Agent
________________________________________________
[Signature of Agent]
PREPARATION STATEMENT
This document was prepared by the following individual:
________________________________________________
[YOUR NAME Typed or Printed]
________________________________________________
[Signature]

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