Durable Power Of Attorney - New York (Page 8 of 10) in pdf

Durable Power Of Attorney - New York Page 8

7. Attorney-in-Fact Signature and date, continued

This durable POA shall be governed by New York law, except with respect to its conflict

of laws provisions.

You acknowledge that the account(s) and this durable POA are governed by a pre-

dispute arbitration clause, which appears on the last page of the Fidelity Customer

Agreement, and that you have read the predispute arbitration clause.

Attorney-in-Fact Name

Attorney-in-Fact Signature

Date

mm dd yyyy

Certificate of Acknowledgement of Notary Public must be a U.S. Notary. Foreign notary

or consular seals may NOT be substituted. State of

, in the County of

, subscribed and sworn to before me by the above-named Attorney-

in-Fact who is personally known to me or who has produced

identification, that the foregoing statements were true and accurate and made of his/her

own free act and deed, on

NOTARY SEAL / STAMP

Print Notary Name

Notary Signature

Date

mm dd yyyy

My commission expires

Form continues on next page.

1.933269.101

027750108

Page 8 of 10

Durable Power Of Attorney - New York Page 8