Fill and Sign the Durable Power Attorney 481377098 Form

General Durable Power of Attorney Page 1 of 8 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 g ive 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 a ct 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 accor dance 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 o f 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 2 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 comp leting 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 w ho 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 3 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 s uccessor 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 powe r 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 4 of 8 Delaware Code is available online. Search: Delaware Code, Title 12, Chapter 49A, and then go to the number next to the cate gory. 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 Othe r 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 _____ Ta xes § 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 5 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 r ights 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, o r 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 Print ed Name of Principal Your Name General Durable Power of Attorney Page 6 of 8 I, the witness, swear that I am not related to the Principal by blood , marriage, or adoption; and that I am not entitl ed 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 FO R 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 you r 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 g ood 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 th e following manner: _______________ _______________ (Principal's Name) by (Your Signature) as Agent General Durable Power of Attorney Page 7 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 i f 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 revocati on 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 8 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, whe n 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 Prin cipal. ________ ______________ _______ ___________ Agent Signature Date