Fill and Sign the Delaware General Form

Parcel No.: ___________________________________ Prepared by: ___________________________________ Return to: ___________________________________ ___________________________________ ___________________________________ ____________________________________________________ GENERAL DURABLE POWER OF ATTORNEY THE POWERS YOU GRANT BELOW ARE EFFECTIVE EVEN IF YOU BECOME DISABLED OR INCOMPETENT 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, dispose of, or encumber any real or personal property without advance notice to you or approval by you. This power of attorney does not authorize your Agent to make health-care decisions for you. Unless you specify otherwise, your Agent's authority will continue even if you become incapacitated, or until you die or revoke the power of attorney, or until your Agent resigns or is unable to act for you. You should select someone you trust to serve as your Agent. 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 must keep your funds and other property separate from your Agent's funds and other property. 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 durable power of attorney are explained more fully in Delaware Code, Title 12, Chapter 49A, Section 49A-114 and Sections 49A-201 through 49A-217. 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. General Durable Power of Attorney Page 1 of 8 I have read or had explained to me this notice and I understand its contents. ____________________________________ Principal ____________ Date DURABLE PERSONAL POWER OF ATTORNEY FORM INSTRUCTIONS As the person completing this form, you are the Principal. This form gives another person the power to act on your behalf. The other person is your Agent. This form allows you to designate: (1) one Agent at a time and up to two Agents in succession; (2) two or more Agents who may act independently of each other (Concurrent Agents); or (3) two or more Agents who must act together (Joint Agents). If your Agent is unable or unwilling to act for you, your power of attorney will end unless you have named a successor Agent(s). IF YOU HAVE QUESTIONS ABOUT THIS POWER OF ATTORNEY OR THE AUTHORITY YOU ARE GRANTING TO YOUR AGENT(S), YOU SHOULD SEEK LEGAL ADVICE BEFORE COMPLETING AND SIGNING THIS FORM. DESIGNATION OF AGENT I, ______________________________________________________ , (Name of Principal), name the following person(s) as my Agent(s): ______________________________________________________ Name of Agent: ______________________________________________________ Agent's Address: ______________________________________________________ Agent's Telephone Number: ______________________________________________________ DESIGNATION OF ADDITIONAL OR SUCCESSOR AGENTS (OPTIONAL) Name of Agent: ______________________________________________________ Agent's Address: ______________________________________________________ General Durable Power of Attorney Page 2 of 8 Agent's Telephone Number: ______________________________________________________ Name of Agent: ______________________________________________________ Agent's Address: ______________________________________________________ Agent's Telephone Number: ______________________________________________________ If I have named more than one Agent above, I intend for those Agents to: _____ Act successively, one after the other _____ Act concurrently, independent of each other _____ Act jointly, not independent of each other EFFECTIVE DATE You must sign ONE of these two choices: ______________________________________________________ This power of attorney (Sign here if this is your choice) is effective immediately, and shall not be affected by my subsequent incapacity. ______________________________________________________ This power of attorney (Sign here if this is your choice) is effective only if and while I am incapacitated as determined under 12 Del. C. § 49A-109(c). GRANT OF GENERAL AUTHORITY I grant my Agent and any successor Agent general authority to act for me with respect to the following powers described in more detail as defined in the Durable Personal Power of Attorney Act, Delaware Code, Title 12, Chapter 49A. You should READ the terms of each category of power or authority before granting any of them to your Agent. A full explanation of each power or authority is in the Delaware Code. The General Durable Power of Attorney Page 3 of 8 Delaware Code is available online. Search: Delaware Code, Title 12, Chapter 49A, and then go to the number next to the category. Example: Real Property, Section (§) 49A-204. The Delaware Code may also be available at your local library. INITIAL each category you want to include in the Agent's general authority. CROSS OUT each category you do not want to include in the Agent's general authority. If you do not initial a category listed below, powers associated with that category will NOT be included as part of your Agent's general authority. _____ Real Property § 49A-204     _____ Tangible Personal Property § 49A-205      _____ Stocks and Bonds § 49A-206      _____ Commodities and Options § 49A-207      _____ Banks and Other Financial Institutions § 49A-208      _____ Operation of Entity or Business § 49A-209      _____ Insurance and Annuities § 49A-210      _____ Estates, Trusts, and Other Beneficial Interests § 49A-211      _____ Claims and Litigation § 49A-212      _____ Personal and Family Maintenance § 49A-213      _____ Benefits from Governmental Programs or Civil or Military Service § 49A-214      _____ Retirement Plans § 49A-215      _____ Taxes § 49A-216      GRANT OF SPECIFIC AUTHORITY (OPTIONAL) PROCEED WITH CAUTION Giving your Agent any of the following powers will give your Agent the authority to take actions that could significantly reduce your property or change how and to whom your property is distributed at your death. You should READ the terms describing each power before granting any of them to your Agent. INITIAL each power you want to include in the Agent's authority. General Durable Power of Attorney Page 4 of 8 CROSS OUT each power you do not want to include in the Agent's authority. If you do not initial a power listed below, it will NOT be included as part of your Agent's specific authority. _____ Create, amend, revoke, or terminate an inter vivos trust     _____ Make a gift in excess of the limitations in the Durable Personal Power of      Attorney Act, 12 Del. C. § 49A-217 _____ Create or change rights of survivorship      _____ Create or change a beneficiary designation      _____ Delegate authority granted under the power of attorney      when all successor Agents have resigned, died, become incapacitated, are no longer qualified to serve, or have declined to serve _____ Exercise fiduciary powers that the Principal has authority to delegate      _____ Reject, renounce, disclaim, release, or consent to a reduction in or modification      of a share in or payment from estate, trust, or other beneficial interest RELIANCE ON THIS POWER OF ATTORNEY Any person, including my Agent, may rely upon this power of attorney or a copy of it unless that person knows it has terminated or is invalid. SIGNATURE AND ACKNOWLEDGMENT IF YOU HAVE QUESTIONS ABOUT THIS POWER OF ATTORNEY OR THE AUTHORITY YOU ARE GRANTING TO YOUR AGENT(S), YOU SHOULD SEEK LEGAL ADVICE BEFORE SIGNING THIS FORM. IN WITNESS WHEREOF, I have hereunto set my Hand and Seal this _____ day of _______________ , 20 _____ . _______________________ ___________________________              Witness Signature Signature of Principal                  ___________________________ ___________________________            Witness Printed Name Printed Name of Principal Your Name                General Durable Power of Attorney Page 5 of 8 I, the witness, swear that I am not related to the Principal by blood , marriage, or adoption; and that I am not entitled to any portion of the estate of the Principal under the Principal's current will or codicil, or under any current trust instrument of the Principal STATE OF DELAWARE :         : SS.                            COUNTY OF _____________________ :             This Durable Power of Attorney was acknowledged before me by ______________________________________ this _____ day of ___________ , 20 _____ . Notarial Office IMPORTANT INFORMATION FOR AGENT Agent's Duties When you accept the authority granted under this power of attorney, a special legal relationship is created between you and the Principal. This relationship imposes upon your legal duties that continue until you resign or the power of attorney is terminated or revoked. You must: (1) do what you know the Principal reasonably expects you to do with the Principal's    property or, if you do not know the Principal's expectations, act in the Principal's best interest; (2) act in good faith;    (3) do nothing beyond the authority granted in this power of attorney; and    (4) disclose your identity as an Agent whenever you act for the Principal by writing or    printing the name of the Principal and signing your own name as "Agent'' in the following manner: _______________ _______________                      (Principal's Name) by                       (Your Signature) as Agent                      General Durable Power of Attorney Page 6 of 8 Except as otherwise provided in the power of attorney, you must also: (1) not act for your own benefit;  (2) avoid conflicts that would impair your ability to act in the Principal's best interest;   (3) act with care, competence, and diligence;   (4) keep a record of all receipts, disbursements, and transactions made on behalf of the   Principal; (5) cooperate with any person who has authority to make health-care decisions for the Principal;   and (6) not act in a manner inconsistent with the Principal's testamentary plan.   Termination of Agent's Authority You must stop acting on behalf of the Principal if you learn of any event that terminates this power of attorney or your authority under this power of attorney. Events that terminate this power of attorney or your authority to act under it include: (1) death of the Principal;   (2) the Principal's revocation of the power of attorney   or your authority; (3) the occurrence of a termination event stated in the power of attorney;   (4) the purpose of the power of attorney   is fully accomplished; or (5) an action is filed with a court for your separation, annulment, or divorce from the Principal,   unless the Principal otherwise provided in the power of attorney that such action will not terminate your authority. Liability of Agent The meaning of the authority granted to you is defined in the Durable Personal Power of Attorney Act, Delaware Code, Title 12, Chapter 49A. If you violate the Durable Personal Power of Attorney Act, Delaware Code, Title 12, Chapter 49A, or act outside the authority granted, you may be liable for any damages caused by your violation. If there is anything about this document or your powers, authority, or duties as Agent that you do not understand, you should seek legal advice. General Durable Power of Attorney Page 7 of 8 AGENT'S CERTIFICATION I, ________________________________________ (Name of Agent), have read the attached durable personal power of attorney and I am the person identified as the Agent or identified as the Agent for the Principal. To the best of my knowledge this power has not been revoked. I hereby acknowledge that, when I act as Agent, I shall: Act in accordance with the principal's reasonable expectations to the extent actually known to me and, otherwise, in the Principal's best interest; Act in good faith; Act only within the scope of authority granted in the personal power of attorney; and To the extent reasonably practicable under the circumstances, keep in regular contact with the principal and communicate with the principal. In addition, in the absence of a specific provision to the contrary in the durable personal power of attorney, when I act as Agent, I shall: Keep the assets of the Principal separate from my assets;   Exercise reasonable caution and prudence; and    Keep a full and accurate record of all actions, receipts and disbursements on behalf of the    Principal. _____________________________ ___________                 Agent Signature Date                         General Durable Power of Attorney Page 8 of 8