General Durable Power Of Attorney Form Page 6

The authority given my attorney has no expiration date and shall expire only in

the event that I revoke the authority in writing and deliver it to my health care

provider.

24.

Alternate Attorney-In-Fact

In the event _______________ is unable to act for any reason whatsoever, then I appoint

__________________, of ________________, Michigan, as my attorney-in-fact with full power

and authority to act under this Power of Attorney.

25.

Revocations.

I hereby revoke any and all prior General Durable Powers of Attorney executed by me.

Date:

Witnessed by:

Signed by:

_______________________________

____________________________________

_______________________________

Acknowledged before me in Oakland County, Michigan, on ____________________, by

______________________________.

Notary Stamp:

Notary Signature:

____________________________________

1945-7.bus

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