New York Statutory Power Of Attorney Short Form Page 2

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This POWER OF ATTORNEY
shall
not
be
affected
by
my
subsequent
incapacity unless I have stated otherwise below,
under "Modifications".
(e)
This
POWER
OF
ATTORNEY
DOES
NOT
REVOKE any Powers of Attorney
previously executed by me
unless I have stated
otherwise
below,
under
"Modifications."
If
you
do NOT intend to revoke your prior Powers of Attorney,
and if
you have granted the same authority in this Power
of
Attorney
as
you
granted
to
another
agent in a prior Power
of Attorney, each agent can
act separately unless you indicate
under "Modifications" that the agents
with the same authority
are to act together.
(f) GRANT OF AUTHORITY:
To grant
your agent some or all of the authority below, either
(1)
Initial the bracket at each authority you grant, or
(2)
Write or type the letters for each authority you grant on
the
blank line at (P), and initial the bracket at (P). If you initial
(P), you do not need to initial the other lines.
I
grant
authority to my agent(s) with respect to the following
subjects as defined in sections 5-1502A through 5-1502N of the
New
York General Obligations Law:
(
) (A) real
estate transactions;
(
) (B) chattel and goods
transactions;
(
) (C) bond, share, and commodity
transactions;
(
) (D) banking transactions;
(
) (E) business operating transactions;
(
) (F)
insurance transactions;
(
) (G) estate transactions;
(
) (H) claims and litigation;
(
) (I) personal and
family maintenance. If you grant your agent
this authority, it will allow the agent
to
make
gifts
that you customarily have made to individuals, including
the
agent,
and
charitable
organizations.
The
total
amount of all such gifts in any one calendar year cannot
exceed five hundred dollars;
(
) (J) benefits from
governmental programs or civil or military
service;
(
) (K) health
care
billing
and
payment
matters;
records,
reports, and statements;
(
) (L) retirement benefit transactions;
(
) (M) tax
matters;
(
) (N) all other matters;
(
) (O)
full
and
unqualified
authority
to
my
agent(s)
to
delegate any or all
of
the
foregoing
powers
to
any
person or persons whom my agent(s) select;
(
) (P) EACH
of
the
matters
identified
by
the
following
letters______.
You need not initial the other lines if you
initial line (P).
(g) MODIFICATIONS: (OPTIONAL)
In
this
section,
you
may
make
additional
provisions,
including
language to limit or supplement authority granted to your agent.
However, you cannot use this Modifications section to grant your
agent
authority
to
make
gifts or changes to interests in
your property.
If
you wish to grant your agent
such
authority,
you
MUST
complete
the
Statutory Gifts Rider.
(h) CERTAIN GIFT TRANSACTIONS: STATUTORY GIFTS RIDER (OPTIONAL)
In
order to authorize your agent to make gifts in excess of an
annual
total of $500 for all gifts described in (I) of the
grant
of
authority
section
of
this
document (under
personal and family maintenance), you
must initial the

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