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Uniform Statutory Power of Attorney

This document appoints an agent to act on the principal's behalf with respect to various legal matters by initialing the corresponding lines. The principal grants the agent power over all matters listed by initialing line (N). This power of attorney remains valid if the principal becomes incapacitated unless the line is struck. Multiple agents must act jointly unless "separately" is written in the blank space. The principal agrees the document is binding on third parties unless revoked and known to them.

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276 views3 pages

Uniform Statutory Power of Attorney

This document appoints an agent to act on the principal's behalf with respect to various legal matters by initialing the corresponding lines. The principal grants the agent power over all matters listed by initialing line (N). This power of attorney remains valid if the principal becomes incapacitated unless the line is struck. Multiple agents must act jointly unless "separately" is written in the blank space. The principal agrees the document is binding on third parties unless revoked and known to them.

Uploaded by

abrarh
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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UNIFORM STATUTORY FORM POWER OF ATTORNEY [California Probate Code 4401] NOTICE: THE POWERS GRANTED BY THIS DOCUMENT

ARE BROAD AND SWEEPING. THEY ARE EXPLAINED IN THE UNIFORM STATUTORY FORM POWER OF ATTORNEY ACT (CALIFORNIA PROBATE CODE 4400-4465). IF YOU HAVE ANY QUESTIONS ABOUT THESE POWERS, OBTAIN COMPETENT LEGAL ADVICE. THIS DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL AND OTHER HEALTH CARE DECISIONS FOR YOU. YOU MAY REVOKE THIS POWER OF ATTORNEY IF YOU LATER WISH TO DO SO. I, _________________, (address) _____________________, appoint ____________________, (address) ______________________, as my agent (attorney-in-fact) to act for me in any lawful way with respect to the following initialed subjects: TO GRANT ALL OF THE FOLLOWING POWERS, INITIAL THE LINE IN FRONT OF (N) AND IGNORE THE LINES IN FRONT OF THE OTHER POWERS. TO GRANT ONE OR MORE, BUT FEWER THAN ALL, OF THE FOLLOWING POWERS, INITIAL THE LINE IN FRONT OF EACH POWER YOU ARE GRANTING. TO WITHHOLD A POWER, DO NOT INITIAL THE LINE IN FRONT OF IT. YOU MAY, BUT NEED NOT, CROSS OUT EACH POWER WITHHELD. INITIAL (A) Real property transactions. (B) Tangible personal property transactions. (C) Stock and bond transactions. (D) Commodity and option transactions. (E) Banking and other financial institution transactions. (F) Business operating transactions. (G) Insurance and annuity transactions. (H) Estate, trust and other beneficiary transactions. (I) (J) Claims and litigation. Personal and family maintenance.

(K) Benefits from Social Security, Medicare, Medicaid or other governmental programs, or civil or military service.

(L) Retirement plan transactions. (M) Tax matters. (N) ALL OF THE POWERS LISTED ABOVE. YOU NEED NOT INITIAL ANY OTHER LINES IF YOU INITIAL LINE (N). SPECIAL INSTRUCTIONS IN THE SPACE BELOW YOU MAY GIVE SPECIAL INSTRUCTIONS LIMITING OR EXTENDING THE POWERS GRANTED TO YOUR AGENT.

UNLESS YOU DIRECT OTHERWISE ABOVE, THIS POWER OF ATTORNEY IS EFFECTIVE IMMEDIATELY AND WILL CONTINUE UNTIL IT IS REVOKED. This Power of Attorney will continue to be effective even though I become incapacitated. STRIKE THE PRECEDING SENTENCE IF YOU DO NOT WANT THIS POWER OF ATTORNEY TO CONTINUE IF YOU BECOME INCAPACITATED. EXERCISE OF POWER OF ATTORNEY WHERE MORE THAN ONE AGENT DESIGNATED: If I have designated more than one agent, the agents are to act N/A____. IF YOU APPOINTED MORE THAN ONE AGENT AND YOU WANT EACH AGENT TO BE ABLE TO ACT ALONE WITHOUT THE OTHER AGENT JOINING, WRITE THE WORD "SEPARATELY" IN THE BLANK SPACE ABOVE. IF YOU DO NOT INSERT ANY WORD IN THE BLANK SPACE, OR IF YOU INSERT THE WORD "JOINTLY," THEN ALL OF YOUR AGENTS MUST ACT OR SIGN TOGETHER. I agree that any third party who receives a copy of this document may act under it. Revocation of the Power of Attorney is not effective as to a third party until the third party has actual knowledge of the revocation. I agree to indemnify the third party for any claims that arise against the third party because of reliance on this Power of Attorney. I hereby revoke any and all prior durable powers of attorney relating to my property made by me.

PWR OF ATTY /var/www/apps/conversion/current/tmp/scratch10792/98661421.doc

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Signed this

day of ___________________

, 2012.

(your signature)

___________________
(your Social Security number)

State of California Francisco

County of San

BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT. State of California County of San Francisco On , 2012, before me, , Notary Public, personally appeared __________________, personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument; and he acknowledged to me that he executed the same in his authorized capacity and that by his signature on the instrument, the person, or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal.

(signature)

PWR OF ATTY /var/www/apps/conversion/current/tmp/scratch10792/98661421.doc

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