Warning to Person Executing This Document
This is an important and powerful document. It creates a durable power of attorney. Before executing this document you should know these facts:
1. This document provides the person you designate as your attorney-in-fact with broad powers to dispose, sell, convey, and encumber your real and personal property.
2. These powers will exist for an indefinite period of time unless you limit their duration in this document. These powers will continue to exist even if you become disabled, incapacitated, or incompetent.
3. You have the right to revoke or terminate this durable power of attorney at any time; however, you must do so in writing.
I, (principal’s name) of (principal’s address) , the Principal, hereby create this General Power of Attorney for the purpose of enabling the Agent named below to act as my agent and attorney-in-fact on all matters at all times, either before or after my disability.
1. Designation of Agent. I hereby designate and appoint (agent’s name) of (agent’s address) to be my agent and attorney-in-fact to act in my name and stead for all purposes.
In the event that my designated agent named above shall, at any time, be unable or unwilling to serve, or continue to serve, as my agent and attorney-in-fact, I hereby designate and appoint (alternative agent’s name) of (alternative agent’s address) to be my agent and attorney-in-fact to act in my name and stead for all purposes.
2. Effective Date. This General Power of Attorney and the powers conferred herein shall be effective as of the date I execute this document as set forth below.
3. Disability or Disappearance of Principal. This General Power of Attorney shall not be affected by my disability. The powers and authority conferred to my agent _____ in this instrument shall be fully exercisable by him/her notwithstanding my subsequent disability or incapacity or any later uncertainty as to whether I am alive or dead. All acts performed by my agent pursuant to this General Power of Attorney during any period of my disability or incompetence or during any period of uncertainty as to whether I am alive or dead shall have the same effect and inure to the benefit of and bind me, my heirs, devisees, and personal representative, to the same extent as if I were alive, competent, and not disabled.
4. Nomination of Guardian of Person and Estate. In the event I become disabled and am unable to manage my own affairs, I hereby nominate _______________ as the Guardian of my person and estate. I nominate him/her as my Guardian because he/she is best suited to carry out my wishes, desires, and intentions concerning my estate. He/She is also the person who has my best interests at heart. I trust him/her completely and ask the Probate Court to honor my selection of my Guardian. I also ask that my nominee serve without bond.
In the event the Probate Court does not name my nominee as the Guardian of my person and estate, I demand that the person selected by the Court be required to post a bond to serve in the capacity of Guardian.
5. Powers of Agent. The Agent acting under this General Power of Attorney shall have the full power and authority to do and perform every act and thing to the same extent as I could do if personally present and under no disability. The Agent shall have all of the powers, rights, discretions, elections, and authority conferred by statute, the common law, or rule of court or governmental agency that are reasonably necessary for the Agent to act on my behalf for any purpose. In addition to these general powers, the Agent shall have the following specific powers:
a. The power to request, ask, demand, sue for, recover, sell, collect, forgive, receive, and hold money, debts, dues, commercial paper, checks, drafts, accounts, deposits, legacies, bequests, devises, notes, interests, stocks, bonds, certificates of deposit, annuities, pension and retirement benefits, insurance proceeds, any and all documents of title, choses in action, personal and real property, intangible and tangible property and property rights, and demands whatsoever, liquidated or unliquidated, as now are, or may become, owned by, or due, owing, payable, or belonging to me, or in which I have or may hereafter acquire an interest; to have, use, and take all lawful means and equitable and legal remedies, procedures, and writs in my name for the collection and recovery thereof, and to adjust, sell, compromise, and agree for the same; and to make, execute, and deliver for me, on my behalf and in my name, all endorsements, acceptances, releases, receipts, or other sufficient discharges for the same.
b. The power to prepare, sign, and file joint or separate income tax returns or declarations or estimated tax returns for any year or years; to prepare, sign, and file gift tax returns with respect to gifts made by me, or by the Agent on my behalf, for any year or years; to consent to any gift and to utilize any gift-splitting provision or other tax election; and to prepare, sign, and file any claim for refund of any tax. This power is in addition to and not in limitation of the tax powers granted in the next paragraph.
c. The power and authority to do, take, and perform each and every act and thing that is required, proper, or necessary to be done, in connection with executing and filing any tax return, receiving and cashing any refund checks with respect to any tax filing, and dealing with the Internal Revenue Service and any state and local tax authority concerning any gift, estate, inheritance, income, or other tax, and any audit or investigation of same. This power shall include the power to do all acts that could be authorized by a properly executed Form 2848, entitled “Power of Attorney and Declaration of Representative,” granting the broadest powers provided therein to the Agent.
d. The power to conduct, engage in, and transact any lawful matter of any nature, on my behalf or in my name, and to maintain, improve, invest, manage, insure, lease, or encumber, and in any manner deal with any real, personal, tangible, or intangible property, or any interest in them, that I now own or may later acquire, in my name and for my benefit, upon such terms and conditions as the Agent shall deem proper.
e. The power to exercise or perform any act, power, duty, right, or obligation that I now have, or may later acquire, including, without limiting the foregoing, the right to enter into a contract of sale and to sell any real, personal, tangible, or intangible property on my behalf and the right to renounce or disclaim any testamentary or nontestamentary transfer intended for me.
f. The power to make, receive, sign, endorse, acknowledge, deliver, and possess insurance policies, documents of title, bonds, debentures, checks, drafts, stocks, proxies, and warrants, relating to accounts or deposits in, or certificates of deposit, other debts and obligations, and such other instruments in writing of any kind or nature as may be necessary or proper in the exercise of the rights and powers herein granted.
g. The power to sell any and all shares of stocks, bonds, or other securities now belonging to or later acquired by me that may be issued by any association, trust, or corporation, whether private or public, and to make, execute, and deliver any assignment or assignments of any such shares of stocks, bonds, or other securities.
h. The power to conduct or participate in any business of any nature for me and in my name; execute partnership agreements and amendments thereto; incorporate, reorganize, merge, consolidate, recapitalize, sell, liquidate, or dissolve any business; elect or employ officers, directors, and agents; carry out the provisions of any agreement for the sale of any business interest or the stock therein; and exercise voting rights with respect to stock, either in person or by proxy, and exercise stock options.
i. The power to enter any safe deposit box rented by me, and to remove all or any part of the contents thereof, and to surrender or relinquish said safe-deposit box. Any institution in which any such safe-deposit box may be located shall not incur any liability to me or my estate as a result of permitting the Agent to exercise the powers herein granted.
j. The power to make outright gifts of cash or property to adults or to minors in custodial form under an applicable Gifts to Minors Act, in amounts not to exceed Eleven Thousand Dollars ($11,000.00) to each adult or minor donee in any calendar year. Permissible donees hereunder shall include my partner, any of my children or stepchildren and their descendants, or any descendant of a brother or sister of mine or of any person to whom I shall have been married, as well as any person who shall be married to any of the foregoing.
k. To make gifts to facilitate my qualifying for the receipt of government benefits for my long-term health care and nursing home care needs (e.g., old age pension and Medicaid benefits). Any gifts made pursuant to this paragraph are to be made unconditionally as determined in the sole discretion of my attorney-in-fact. Such gifts shall be irrevocable. My attorney-in-fact is authorized to make said gifts so long as my long-term care is reasonably provided for by my assets subject to this Power, or otherwise during the time period I would be disqualified from receiving long-term care and/or medical assistance under the State Medicaid program. Any gifts may be made outright or in trust and may include both real and personal property.
l. The power to convey or assign any cash or other property of which I shall be possessed to the trustee or trustees of any trust that I may have created, provided that such trust is subject to revocation by me, which power shall be exercisable hereunder by the Agent.
m. The power to purchase United States Government Bonds known as “Flower Bonds,” which may be used in payment of death taxes from my estate.
n. Subject to the provisions of Section 1 above, the power to appoint a substitute or alternate agent and attorney-in-fact, who shall have all powers and authority of the Agent.
6. Limitation of Power of Agent. Notwithstanding any other provision of this General Power of Attorney, the Agent shall have no rights or powers hereunder with respect to any act, power, duty, right, or obligation relating to any person, matter, transaction, or property held or possessed by me as a trustee, custodian, personal representative, or other fiduciary capacity. In addition, the Agent shall have no power or right to perform any of the following functions:
7. Ratification. I hereby ratify, acknowledge, and declare valid all acts performed by the Agent on my behalf prior to the effective date of this General Power of Attorney.
8. Revocation and Termination. This General Power of Attorney is revocable by me, provided that insofar as any governmental agency, bank, depository, trust company, insurance company, other corporation, transfer agent, investment banking company, or other person who shall rely upon this power, this power may be revoked only by a notice in writing executed by me and delivered to such person or institution.
This General Power of Attorney shall not be revoked or otherwise become ineffective in any way by the mere passage of time, but rather shall remain in full force and effect until revoked by me in writing.
I hereby revoke any and all general powers of attorney previously executed by me, if any, and the same shall be of no further force or effect. However, I do not intend in this General Power of Attorney to affect, modify, or terminate any special, restricted, or limited power or powers of attorney previously granted by me in connection with any banking, borrowing, or commercial transaction.
9. Construction. This General Power of Attorney is executed and delivered in the State of ______________, and the laws of the State of _______________ shall govern all questions as to its validity and as to the construction of its provisions. This instrument is to be construed and interpreted as a general durable power of attorney. The enumeration of specific powers is not intended to limit or restrict the general powers granted to the Agent in this instrument.
10. Reliance. Third parties may rely upon the representations of the Agent as to all matters related to any power granted to the Agent in this instrument, and no person who acts in reliance upon the representation of the Agent shall incur any liability to me or my estate as a result of permitting the Agent to exercise any power. Third parties may rely upon a photocopy of this executed General Power of Attorney to the same extent as if the copy were an original of this instrument. This document consists of [number of] pages of which this is the last.
IN WITNESS WHEREOF, I have executed this Durable Power of Attorney on the ______ day of _______________, 20___.
State of ___________________
County of _________________
____________________________________, the Principal, personally appeared before me and executed and acknowledged this Durable Power of Attorney for Finances before me this ______ day of ____________, 20_____.