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

Delaware Durable Personal Power Of Attorney Form Page 5

IF YOU HAVE QUESTIONS ABOUT THIS POWER OF ATTORNEY OR THE AUTHORITY

YOU ARE GRANTING TO YOUR AGENT(S), YOU SHOULD SEEK LEGAL ADVICE

BEFORE SIGNING THIS FORM.

IN WITNESS WHEREOF, I have hereunto set my Hand and Seal this ____ day of

____________, 20____ .

_______________________________

Principal’s Signature

_______________________________

Print Principal’s Name

SIGNED, SEALED, AND DECLARED by the Principal, ________________,

as his/her Durable Personal Power of Attorney in the presence of the following

witness, who has signed in the presence of and at the request of the Principal on the

day and year appearing above.

I, the witness, swear that I am not related to the Principal by blood, marriage, civil

union, or adoption; and that I am not entitled to any portion of the estate of the

Principal under the Principal's current will or codicil, or under any current trust

instrument of the Principal.

________________________________ of ________________________________

(Seal) Witness Signature

________________________________

Print name

STATE OF DELAWARE :: SS.

COUNTY OF _________________ :

This Durable Power of Attorney was signed by the Principal, witnessed by the person

aforesaid, and acknowledged before me, the Subscriber, a Notary Public, this

________ day of ______________ 20____.

______________________________

Notary Public

Effective October 1, 2010

Delaware Durable Personal Power Of Attorney Form Page 5