General Durable Power Of Attorney Form (Page 5 of 7) in pdf

safeguarding of me against excess or illegal taxation or against penalties imposed

for claimed violation of any law or other governmental regulation; and to pay, to

compromise, or to contest or to apply for refunds in connection with any taxes or

assessments for which I am or may be liable.

_______ (N) ALL OF THE POWERS LISTED ABOVE. YOU NEED NOT

INITIAL ANY OTHER LINES IF YOU INITIAL LINE (N).

SPECIAL INSTRUCTIONS:

ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS

LIMITING OR EXTENDING THE POWERS GRANTED TO YOUR AGENT.

The powers granted above specifically include the authorization for my

agent, ______________________, to withdraw part or all of the funds in my

____________________________________, account #________________, and

to use those funds for my benefit including to pay for my living, medical and

other expenses; as well as to deposit, transfer, or invest, part or all of those

funds in another account or investment vehicle of any type in the same or any

other financial institution for my benefit. These powers, are to be recurring

during the life of this Power of Attorney.

THIS POWER OF ATTORNEY IS EFFECTIVE IMMEDIATELY AND WILL

CONTINUE UNTIL IT IS REVOKED.

THIS POWER OF ATTORNEY SHALL BE CONSTRUED AS A GENERAL

DURABLE POWER OF ATTORNEY AND SHALL CONTINUE TO BE

EFFECTIVE EVEN IF I BECOME DISABLED, INCAPACITATED, OR

INCOMPETENT.

(YOUR AGENT WILL HAVE AUTHORITY TO EMPLOY OTHER PERSONS

AS NECESSARY TO ENABLE THE AGENT TO PROPERLY EXERCISE

THE POWERS GRANTED IN THIS FORM, BUT YOUR AGENT WILL

HAVE TO MAKE ALL DISCRETIONARY DECISIONS. IF YOU WANT TO

GIVE YOUR AGENT THE RIGHT TO DELEGATE DISCRETIONARY

DECISION-MAKING POWERS TO OTHERS, YOU SHOULD KEEP THE

NEXT SENTENCE, OTHERWISE IT SHOULD BE STRICKEN.)

Authority to Delegate. My Agent shall have the right by written instrument to

delegate any or all of the foregoing powers involving discretionary decision-

making to any person or persons whom my Agent may select, but such delegation

may be amended or revoked by any agent (including any successor) named by me

who is acting under this power of attorney at the time of reference.

_________/_________

Agent / Grantor

General Durable Power Of Attorney Form Page 5