Appendix C: durable power of attorney for finances.



Recording requested by and when recorded mail to: --

Warning to Person Executing This Document

This is an important document. It creates a durable power of attorney. Before executing this document, you should know these facts:

  1. This document may provide 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 notwithstanding your subsequent disability or incapacity.

  3. You have the right to revoke or terminate this durable power of attorney at any time.


  4. Creation of Durable Power of Attorney

    By signing this document, I, --, intend to create a durable power of attorney. This durable power of attorney shall not be affected by my subsequent disability or incapacity, and shall remain effective until my death, or until revoked by me in writing.

  5. Effective Date

    This durable power of attorney shall become effective only in the event that I become incapacitated or disabled so that I am not able to handle my own financial affairs and decisions. That determination shall be made in writing by a licensed physician and the writing shall be attached to this durable power of attorney.

  6. Designation of Attorney in Fact

    I, --, hereby appoint --, as my attorney in fact, to act for me in my name and for my use and benefit. Should -- for any reason fail to serve or cease to serve as my attorney in fact, I appoint -- of -- to be my attorney in fact.

  7. Authority of Attorney in Fact

    I grant my attorney in fact full power and authority over all my property real and personal, and authorize -- to do and perform all and every act which I as owner of that property could do or perform and hereby ratify and confirm that all that my attorney in fact shall do or cause to be done under the Durable Power of Attorney.

    [Special Provisions or Limitations. Add to this section any specific limitation(s), restriction(s), direction(s), etc. you want.] --

  8. Reliance by Third Parties

    The powers conferred on my attorney in fact by this durable power of attorney may be exercisable by my attorney in fact alone, and my attorney in fact's signature or act under the authority granted in this durable power of attorney may be accepted by any third person or organization as fully authorized by me and with the same force and effect as if I...

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