Durable Power Of Attorney - New York (Page 2 of 10) in pdf

Durable Power Of Attorney - New York Page 2

Helpful to Know, continued

• You have the right to modify or revoke this

complete Sections 6 and 7. You must

POA. To do so, submit a new POA form or

sign and date this form in the presence

a letter of instruction (LOI). Should you be

of a notary public.

declared incompetent, you lose the option

• This form appoints an Attorney-in-Fact for

of modifying or revoking this POA.

one person. Joint account owners or other

• You must complete Sections 1 - 5 and 8

individuals must complete a separate form.

yourself, and your Attorney-in-Fact must

1. Account Owner

Name

Phone numbers are for

questions about this

request only; they will

Evening Phone

Daytime Phone

Extension

not update your Fidelity

contact information.

2. Account(s) Included

Account Number

List accounts that you want

this form to apply to. To

appoint a different Attorney-

Account Number

in-Fact for other accounts,

use a copy of this form.

3. Powers to be Granted

Powers granted by the account owner identified in Section 1.

Standard Powers

By completing this

• Access accounts and place trades Buy, sell, sell short, exchange, convert,

form, you grant all of

tender, or otherwise acquire or dispose of all types of securities and other

these powers to the

investments, including the right to borrow on margin and conduct options

Attorney-in-Fact identified

transactions to whatever extent any account is approved for these features.

in Section 6.

• Withdraw money Remove assets from any account — by any means

INITIAL

available for that account type and regardless of any tax consequences.

Account Owner Initials

Withdrawn assets may be distributed to you or to any third party, including

your Attorney-in-Fact.

• Move money among accounts Make rollovers, Roth IRA conversions,

IRA recharacterizations, or other transfers of assets within and between

account(s).

• Modify, close, or open accounts Modify or close any account named on

this form and use your taxpayer ID to open any number or type of new

accounts, including managed accounts, for your benefit.

Powers to be Granted continues on next page.

1.933269.101

027750102

Page 2 of 10

Durable Power Of Attorney - New York Page 2

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