Power Of Attorney Form - Michigan

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Michigan Power of Attorney
NOTICE: THE POWERS GRANTED BY THIS POWER OF ATTORNEY ARE BROAD AND SWEEPING. IF
YOU HAVE ANY QUESTIONS ABOUT THESE POWERS, PLEASE OBTAIN COMPETENT LEGAL
ADVICE. THIS DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL AND OR HEALTH
CARE DECISIONS FOR YOU. YOU MAY REVOKE THIS POWER OF ATTORNEY AT A LATER DATE IF
YOU SO DESIRE.
I, do hereby
[Legal Name], AKA [Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
Here By Appoint:
Name
[Legal Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
If you designate more than one agent above, by default they must act together unless you
initial the statement below.
[___] My agents may act separately.
If every agent that is listed above is unable or unwilling to serve, I hereby appoint as my
successor agent(s):
_____________________________________________________________________________
If you designate more than one successor agent above, by default they must act together
unless you initial the statement below.
[___] My successor agents may act separately.
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