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Power Of Attorney Joint Attorney's___________________, the "principal," of _______________, herewith appoints the following persons _________________, and ________________, as his attorney in fact, with the same authority as Principal would have to do the following acts: Such persons shall exercise this power jointly and severally. To conduct any and all business regarding my deposit accounts, loans, safe deposit box, or other banking business at any bank, credit union or other financial institution. This power shall specifically include, but is not limited to the right to deposit, withdraw, sign checks or drafts, make stop payment orders, and to conduct any banking transactions necessary or possible in regard to my banking relationship with any and all banks. To manage any and all real estate which I own, lease or have an interest in and to execute a deeds, leases, contracts for sale and purchase or other instruments in regard to any real estate interests which I hold regardless of where located. To examine and to order copies of any and all of my educational records, including both financial and student loan and health related records, at any colleges, schools or other educational institutions. To manage, sell, lease, repair, borrow on the credit of, or otherwise deal with all of my personal and intangible personal property. To act for me in the regard to the following: This power of attorney shall not become effective until I am determined to be unable to manage my own financial affairs. Such determination shall be made in writing by my primary treating physician at the time, or a board certified neurologist or psychiatrist. Any third party may rely upon the representation of my attorney in fact that this determination has been made. This power of attorney is intended to be a durable power of attorney and the power shall not be revoked or lapse due to my incapacity or disability. NOTICE THIS GENERAL POWER OF ATTORNEY IS A BINDING AND IMPORTANT LEGAL INSTRUMENT AND GIVES BROAD AUTHORITY TO YOUR ATTORNEY IN FACT TO MANAGE, SELL OR DISPOSE OF ALL OF YOUR PROPERTY. THIS POWER WILL GO INTO EFFECT UPON YOUR DISABILITY ONCE CERTIFIED BY YOUR PRIMARY TREATING PHYSICIAN OR A BOARD CERTIFIED NEUROLOGIST OR PSYCHIATRIST AND WILL REMAIN IN EFFECT UNTIL YOU REGAIN CAPACITY. ________________________________ , As Principal STATE OF: ___________. COUNTY OF: __________. personally appeared before me and acknowledged the execution of this power of attorney for the purposes set forth therein. Dated: ____________. ________________________________ Notary Public My comission expires:
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