General Durable Power Of Attorney Form (Page 6 of 7) in pdf

General Durable Power Of Attorney Form Page 6

Choice of Law. THIS POWER OF ATTORNEY WILL BE GOVERNED BY

THE LAWS OF THE STATE OF ______________ WITHOUT REGARD FOR

CONFLICTS OF LAWS PRINCIPLES. IT WAS EXECUTED IN THE STATE

OF ________________ AND IS INTENDED TO BE VALID IN ALL

JURISDICTIONS OF THE UNITED STATES OF AMERICA AND ALL

FOREIGN NATIONS.

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]

[Notary Seal]:

STATEMENT OF WITNESS

On the date written above, the principal declared to me in my presence that this

instrument is his general durable power of attorney and that he or she had

willingly signed or directed another to sign for him or her, and that he or she

executed it as his or her free and voluntary act for the purposes therein expressed.

_______________________________________ [Signature of Witness #1]

_______________________________________ [Printed or typed name of

Witness #1]

_______________________________________ [Address of Witness #1, Line 1]

_______________________________________ [Address of Witness #1, Line 2]

_______________________________________ [Signature of Witness #2]

_______________________________________ [Printed or typed name of

Witness #2]

_________/_________

Agent / Grantor

General Durable Power Of Attorney Form Page 6