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The following document of "Power Of Attorney is offered
free to the general public and has no warranties claimed or
implied.
NOTICE
THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE YOUR "AGENT" BROAD POWERS TO HANDLE YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO SELL OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU.
THIS POWER OF ATTORNEY DOES NOT IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS, BUT WHEN POWERS ARE EXERCISED, YOUR AGENT MUST USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE WITH THIS POWER OF ATTORNEY.
YOUR AGENT MAY EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU BECOME INCAPACITATED, UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THESE POWERS OR YOU REVOKE THESE POWERS OR A COURT ACTING ON YOUR BEHALF TERMINATES YOUR AGENT'S AUTHORITY.
YOUR AGENT MUST KEEP YOUR FUNDS SEPARATE FROM YOUR AGENT'S FUNDS. A COURT CAN TAKE AWAY THE POWERS OF YOUR AGENT IF IT FINDS YOUR AGENT IS NOT ACTING PROPERLY.
THE POWERS AND DUTIES OF AN AGENT UNDER A POWER OF ATTORNEY ARE EXPLAINED MORE FULLY IN 20 PA. C.S. CH. 56.
IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER OF YOUR OWN CHOOSING TO EXPLAIN IT TO YOU.
I HAVE READ OR HAD EXPLAINED TO ME THIS NOTICE AND I UNDERSTAND ITS CONTENTS.
DATED: ___________________
________________________________
PRINCIPAL
ACKNOWLEDGEMENT
I, ________________________(AGENT), HAVE READ THE ATTACHED POWER OF ATTORNEY AND AM THE PERSON IDENTIFIED AS THE AGENT FOR THE PRINCIPAL. I HEREBY ACKNOWLEDGE THAT IN THE ABSENCE OF A SPECIFIC PROVISION TO THE CONTRARY IN THE POWER OF ATTORNEY OR IN 20 PA. C.S. WHEN I ACT AS AGENT:
I SHALL EXERCISE THE POWERS FOR THE BENEFIT OF THE PRINCIPAL.
I SHALL KEEP THE ASSETS OF THE PRINCIPAL SEPARATE FROM MY ASSETS.
I SHALL EXERCISE REASONABLE CAUTION AND PRUDENCE.
I SHALL KEEP A FULL AND ACCURATE RECORD OF ALL ACTIONS, RECEIPTS AND DISBURSEMENTS ON BEHALF OF THE PRINCIPAL.
DATED:_____________________
___________________________________
AGENT
DURABLE POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that I, __________________________________________(PRINCIPAL), of the Township of _________________, County of
______________ and State of ____________, Social Security Number
_____________, do hereby make, constitute and appoint my beloved
_______________ (relationship to principal),
___________________________________, my true and lawful agent, (as agent is defined under Chapter 56 of the Decedents, Estates and Fiduciaries Code, Section 711, as amended) for me and in my name, place and stead, and in my behalf, and for my use and benefit:
1. To exercise or perform any act, power, duty, right or obligation whatsoever that I now have, or may hereafter acquire the legal right, power or capacity to exercise or perform, in connection with, arising from, or relating to any person, item, transaction, thing, business, property, real or personal, tangible or intangible, or matter whatsoever.
2. To request, ask, demand, sue for, recover, collect, receive, and hold and possess all such sums of money, debts, dues, commercial paper, checks, drafts, accounts, deposits, legacies, bequests, devises, notes, interests, stock certificates, bonds, dividends, certificates of deposit, annuities, pension and retirement benefits, deferred compensation, insurance benefits and proceeds, and any and all documents of title, chooses in action, personal and real property, intangible and tangible property and property rights, and any demands whatsoever, liquidated or unliquidated, as now are, or shall hereafter become, owned by, or due owing, payable, or belonging to me or in which I have or may hereafter acquire any 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, 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 discharge for the same.
3. To maintain, repair, improve, insure, rent, lease, grant, bargain, sell, exchange, option, convey, grant easements or licenses, mortgage, encumber, hypothecate, and contract for all of the foregoing, and in any way or manner deal with all or any part of any real or personal property whatsoever, tangible or intangible or any interest therein, that I now own or may hereafter acquire, for me, in my behalf, and in my name; and to effect any or all the above transactions to any persons, firms or entities for such price or prices, and on such terms and conditions as my agent may deem proper, and in my name to make, execute, acknowledge and deliver a good and sufficient deed or deeds of conveyance or any other instrument or instruments necessary to effect such transactions; and to ask for, demand, sue for, collect, recover and receive all monies which may become due and owing to me by reason of such transaction.
4. To conduct, engage in, and transact any and all lawful business of whatever nature or kind for me, on my behalf and in my name.
5. To receive, deposit, hold or cash all payments which I receive from Social Security, Medicare or any other government program or agency, in addition to all other powers.
6. To do all acts necessary for my maintenance, health, and personal care, which my attorneys may deem necessary under the circumstances.
7. No other person shall be required to inquire as to the circumstances of the issuance or use of this instrument or as to the disposition of any proceeds paid to my agent based on this instrument.
8. To make, receive, sign, endorse, execute, acknowledge, deliver, and possess such applications, contracts, agreements, options, covenants, conveyances, deeds, trust deeds, security agreements, bills of sale, leases, mortgages, assignments, insurance policies, bills of lading, warehouse receipts, documents of title, bonds, debentures, checks, drafts, bills of exchange, letter of credit, notes, stock certificates, proxies, warrants, commercial paper, receipts, withdrawal receipt and deposit instruments relating to accounts or deposits in, or certificates of deposit of, banks, savings and loan or other institutions or associations, proofs of loss, evidence of debts, releases and satisfaction of mortgages, liens,
judgments, security agreements and other debts and obligations and such other instruments in writing of whatever kind and nature as may be necessary or proper in the exercise of the rights and powers herein granted.
9. To enter any safe deposit box, vault or other storage area leased by me alone or in conjunction with any other person or persons, to sign such documents as may be necessary to gain access to the same, and to examine, remove and keep the contents of the same as fully as if I were present.
10. To prepare, or cause to be prepared, tax returns and Internal Revenue Service Powers-of-Attorney; to execute and file tax returns on my behalf and in my name; and to settle any tax disputes.
11. To deal with and elect options under retirement plans including but not limited to pension plans, profit sharing plans, individual retirement accounts, rollovers and voluntary contributions; to fund inter vivos trusts; to borrow funds to avoid forced liquidation of assets; to apply for me and maintain life insurance; to enter into buy-sell agreements; to forgive and
collect debts; to complete charitable contributions; to make statutory elections and
disclaimers; to pay salaries of employees and independent contractors; to settle, pursue or appeal litigation on my behalf and in my name.
12. To admit me into a hospital when I need medical or physical care; to authorize medical and related procedures, to perform surgery, operations and any other treatment upon me, and to do or authorize any other act for my benefit and physical welfare. I intend, by the above authorization, that my attorneys-in-fact, acting individually or jointly, knowing it is not my desire that my life be prolonged or lengthened by the use of any life support systems, be able to make, in situations where my life may be threatened or my illness if of a terminal nature, to decide upon the withholding of the use of any medical treatment, life supporting systems, devices, surgery or whatever other means may be devised for that purpose. Said attorneys-in-fact, acting individually or jointly, shall carry out the intentions of this Paragraph in accordance with a Living Will, which further states and directs my intentions pertaining to medical treatments to be performed to keep me alive, such Living Will dated _____________, a true and correct copy attached hereto as Exhibit "A". Said attorneys-in-fact, acting individually or jointly, shall in no way, be liable for any act or occurrence under this or any other power granted by this Power of Attorney.
13. I grant to said agent full power and authority to do, take and perform all and every act and thing whatsoever requisite, proper, or necessary to be done, in the exercise of any rights and powers herein granted, as fully to all intents and purposes as I might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that said agent, or its substitute or substitutes, shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted.
14. I do further empower my true and lawful agent for me and in my name to
make gifts; THE AUTHORITY TO MAKE GIFTS SHALL BE OF AN UNLIMITED NATURE of either
real, personal and/or mixed property, as defined in Title 20, Pa. C.S.A. §
5601.2 ( c) in that the principal herein authorizes the agent to make gifts,
for no consideration to the agent himself/herself; any trust with agent as
Trustee and/or beneficiary, either solely or with other persons; any donee of
agent's choosing, without consideration of other donee's or spouse, children
or siblings of principal; a minor as defined under §5601.2 (d); or to any
other beneficiary as allowed by Title 20 Pa. C.S.A. § 5601.2; for this
power shall be in no way be considered LIMITED or of a LIMITED NATURE, as defined
in said Act and shall be construed to be as broad as possible under said
Act referred to above; may co-mingle funds of principal and agent; The power to
make gifts herein is intended to be contrary to the LIMITED POWERS as
acknowledged by agent herein, who may create a trust for my benefit; to
withdraw and receive any income or corpus of a trust; to authorize my
admission to a medical, nursing, residential, or similar facility and to
enter into any agreement for my care; and to authorize medical and surgical
procedures.
15. I do hereby expressly authorize and empower any Bank to permit my said
agent to deal with, control, withdraw, transfer to the name of the agent, or
to the name of others, appropriate to its own use or to the use of others,
and the dispose of, any and all monies, funds, accounts, checks, drafts,
promissory notes, bills of exchange, other commercial paper,
certificates of deposit or other orders or instruments for the payment of money, bonds,
stocks and securities, or any and all other property whatsoever, tangible or
intangible, which may belong to me or in which I may have an interest, to the
same and full extent and in the same manner as my said attorneys might or
could do, if the same was their absolute property, hereby expressly authorizing my said attorneys to deposit funds in their personal account, and
I agree that any Bank shall not in any manner or for any cause be liable for
any disposition which my said attorneys may make of the same or any part
thereof.
16. This instrument is a Durable Power of Attorney and shall not be affected
by disability of the principal, except as provided by statute; the enumeration of specific terms, rights, acts or powers herein is not intended
to nor does it limit or restrict, and is not to be construed or interpreted
as limiting or restricting the general powers herein granted to the said
agent.
17. The rights, powers and authority of said agent herein granted shall
commence and be in full force and effect on the date set forth below, and
such rights, powers and authority shall remain in full force and effect thereafter until I,
________________________, the Principal, give written notice to the said agent
that this instrument is no longer in effect, such notice to be given in
person or by registered mail, return receipt requested.
IN WITNESS WHEREOF, I the Principal, have hereto set my hand and seal on this
________ day of _________________, 2000.
____________________________________
(Principle's Name)
Signed, Sealed and Delivered
in the Presence of:
_____________________________
Witness
Before me, personally appeared, _______________, to me well known and known
to me to be the person described in and who executed the foregoing DURABLE
POWER OF ATTORNEY, and acknowledged to and before me that he executed said
instrument for the purposes therein expressed.
Witnessed my hand and official seal this ________ day of
_____________________, 2000.
______________________________
NOTARY
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