Recording requested by:
___________________________________
After Recorded, return to:
___________________________________
(Full Name of Party)
___________________________________
(Company, if applicable)
___________________________________
(Street Address)
___________________________________
(City, State and Zip Code)
___________________________________________________
_
LIMITED POWER OF ATTORNEY
CAUTION: A DURABLE POWER OF ATTORNEY IS AN IMPORTANT LEGAL
DOCUMENT. BY SIGNING THE DURABLE POWER OF ATTORNEY, YOU ARE
AUTHORIZING ANOTHER PERSON TO ACT FOR YOU, THE PRINCIPAL.
BEFORE YOU SIGN THIS DURABLE POWER OF ATTORNEY, YOU SHOULD
KNOW THESE IMPORTANT FACTS: YOUR AGENT (ATTORNEY-IN-FACT) HAS
NO DUTY TO ACT UNLESS YOU AND YOUR AGENT AGREE OTHERWISE IN
WRITING. THIS DOCUMENT GIVES YOUR AGENT THE POWERS TO MANAGE,
DISPOSE OF, SELL, AND CONVEY YOUR REAL AND PERSONAL PROPERTY,
AND TO USE YOUR PROPERTY AS SECURITY IF YOUR AGENT BORROWS
MONEY ON YOUR BEHALF. THIS DOCUMENT DOES NOT GIVE YOUR AGENT
THE POWER TO ACCEPT OR RECEIVE ANY OF YOUR PROPERTY, IN TRUST OR
OTHERWISE, AS A GIFT, UNLESS YOU SPECIFICALLY AUTHORIZE THE AGENT
TO ACCEPT OR RECEIVE A GIFT. YOUR AGENT WILL HAVE THE RIGHT TO
RECEIVE REASONABLE PAYMENT FOR SERVICES PROVIDED UNDER THIS
DURABLE POWER OF ATTORNEY UNLESS YOU PROVIDE OTHERWISE IN THIS
POWER OF ATTORNEY. THE POWERS YOU GIVE YOUR AGENT WILL
CONTINUE TO EXIST FOR YOUR ENTIRE LIFETIME, UNLESS YOU STATE THAT
THE DURABLE POWER OF ATTORNEY WILL LAST FOR A SHORTER PERIOD OF
TIME OR UNLESS YOU OTHERWISE TERMINATE THE DURABLE POWER OF
ATTORNEY.
THE POWERS YOU GIVE YOUR AGENT IN THIS DURABLE POWER OF
ATTORNEY WILL CONTINUE TO EXIST EVEN IF YOU CAN NO LONGER MAKE
YOUR OWN DECISIONS RESPECTING THE MANAGEMENT OF YOUR
PROPERTY. YOU CAN AMEND OR CHANGE THIS DURABLE POWER OF
ATTORNEY ONLY BY EXECUTING A NEW DURABLE POWER OF ATTORNEY OR
BY EXECUTING AN AMENDMENT THROUGH THE SAME FORMALITIES AS AN
ORIGINAL. YOU HAVE THE RIGHT TO REVOKE OR TERMINATE THIS
DURABLE POWER OF ATTORNEY AT ANY TIME, SO LONG AS YOU ARE
COMPETENT.
THIS DURABLE POWER OF ATTORNEY MUST BE DATED AND MUST BE
ACKNOWLEDGED BEFORE A NOTARY PUBLIC OR SIGNED BY TWO
WITNESSES. IF IT IS SIGNED BY TWO WITNESSES, THEY MUST WITNESS
EITHER (1) THE SIGNING OF THE POWER OF ATTORNEY OR (2) THE
PRINCIPAL'S SIGNING OR ACKNOWLEDGMENT OF HIS OR HER SIGNATURE. A
DURABLE POWER OF ATTORNEY THAT MAY AFFECT REAL PROPERTY
SHOULD BE ACKNOWLEDGED BEFORE A NOTARY PUBLIC SO THAT IT MAY
EASILY BE RECORDED.
YOU SHOULD READ THIS DURABLE POWER OF ATTORNEY CAREFULLY.
WHEN EFFECTIVE, THIS DURABLE POWER OF ATTORNEY WILL GIVE YOUR
AGENT THE RIGHT TO DEAL WITH PROPERTY THAT YOU NOW HAVE OR
MIGHT ACQUIRE IN THE FUTURE. THE DURABLE POWER OF ATTORNEY IS
IMPORTANT TO YOU. IF YOU DO NOT UNDERSTAND THE DURABLE POWER
OF ATTORNEY, OR ANY PROVISION OF IT, THEN YOU SHOULD OBTAIN THE
ASSISTANCE OF AN ATTORNEY OR OTHER QUALIFIED PERSON.
NOTICE TO PERSON ACCEPTING THE APPOINTMENT AS ATTORNEY-IN-FACT
BY ACTING OR AGREEING TO ACT AS THE AGENT (ATTORNEY-IN-FACT)
UNDER THIS POWER OF ATTORNEY YOU ASSUME THE FIDUCIARY AND
OTHER LEGAL RESPONSIBILITIES OF AN AGENT. THESE RESPONSIBILITIES
INCLUDE:
1. THE LEGAL DUTY TO ACT SOLELY IN THE INTEREST OF THE PRINCIPAL
AND TO AVOID CONFLICTS OF INTEREST.
2. THE LEGAL DUTY TO KEEP THE PRINCIPAL'S PROPERTY SEPARATE AND
DISTINCT FROM ANY OTHER PROPERTY OWNED OR CONTROLLED BY YOU.
YOU MAY NOT TRANSFER THE PRINCIPAL'S PROPERTY TO YOURSELF
WITHOUT FULL AND ADEQUATE CONSIDERATION OR ACCEPT A GIFT OF THE
PRINCIPAL'S PROPERTY UNLESS THIS POWER OF ATTORNEY SPECIFICALLY
AUTHORIZES YOU TO TRANSFER PROPERTY TO YOURSELF OR ACCEPT A
GIFT OF THE PRINCIPAL'S PROPERTY. IF YOU TRANSFER THE PRINCIPAL'S
PROPERTY TO YOURSELF WITHOUT SPECIFIC AUTHORIZATION IN THE
POWER OF ATTORNEY, YOU MAY BE PROSECUTED FOR FRAUD AND/OR
EMBEZZLEMENT. IF THE PRINCIPAL IS 65 YEARS OF AGE OR OLDER AT THE
TIME THAT THE PROPERTY IS TRANSFERRED TO YOU WITHOUT AUTHORITY,
YOU MAY ALSO BE PROSECUTED FOR ELDER ABUSE UNDER PENAL CODE
SECTION 368. IN ADDITION TO CRIMINAL PROSECUTION, YOU MAY ALSO BE
SUED IN CIVIL COURT. I HAVE READ THE FOREGOING NOTICE AND I
UNDERSTAND THE LEGAL AND FIDUCIARY DUTIES THAT I ASSUME BY
ACTING OR AGREEING TO ACT AS THE AGENT (ATTORNEY-IN-FACT) UNDER
THE TERMS OF THIS POWER OF ATTORNEY.
DATE:
____________________________
(Signature of Agent)
___________________________________
(Print Name of agent)
STATE OF CALIFORNIA
COUNTY OF ______________
KNOW ALL MEN BY THESE PRESENT, THAT I
___________________________________ ,
whose address is ___________________________________ , __________________________
(City), __________ (State), __________ _ (Zip), “Principal”, have made, constituted and
appointed, and by these presents do make, constitute and appoint,
___________________________________ my true and lawful attorney in fact to act with the
following limited powers, to wit:
Insert powers here. See examples at the end of this form
____________________________________________________________
____________________________________________________________
____________________________________________________________
FURTHER, I do authorize my aforesaid attorney-in-fact to execute, acknowledge and
deliver any instrument under seal or otherwise, and to do all things necessary to carry out the
intent hereof, hereby granting unto my said attorney-in-fact full power and authority to act in
and concerning the premises as fully and effectually as I may do if personally present, limited,
however, to the purpose for which this limited power of attorney is executed.
PROVIDED, however, that all business transacted hereunder for me or for my account
shall be transacted in my name, and that all endorsements and instruments executed by my said
attorney-in-fact for the purpose of carrying out the foregoing powers shall contain my name,
followed by that of my said attorney and the designation "attorney-in-fact".
I further declare that any act or thing lawfully done hereunder and within the powers
herein stated by my said attorney shall be binding on myself and my heirs, legal and personal
representatives and assigns, whether the same shall have been done either before or after my
death, or other revocation of this instrument, unless and until reliable intelligence or notice
thereof shall have been received by my said attorney.
This Power of Attorney shall be:
Non-Durable.
Durable and shall not be affected by any subsequent disability or incompetence.
Third parties may rely upon the representations of the agents as to all matters relating to
any power granted to them hereunder, and no person who may act in reliance upon the
representations of the agent or the authority granted to it shall incur any liability to the principal
or his estate as result of permitting the agent to exercise any power.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this the __________
day of __________ , 20 __________ .
______________________________________________
PRINCIPAL
ATTESTATION
The hereinafter named Witnesses, each declare under penalty of perjury under the laws
of the State of California, that the principal is personally known to us, that the principal signed
and acknowledged this limited power of attorney in our presence, that the principal appears to be
of sound mind and under no duress, fraud or undue influence, that we are not the person
appointed as attorney-in-fact by this document and that we witnessed this power of attorney in
the presence of the principal. We are not related to the principal by blood, marriage or adoption,
and to the best of our knowledge, are not entitled to any part of the estate of the principal upon
the death of the principal under a will now existing or by operation of law.
WITNESSES:
______________________________
Signature
Print Name: __________________________
Address: _____________________________
City: ________________ State: ___________
Zip: __________ WITNESSES:
______________________________
Signature
Print Name: ___________________________
Address: ______________________________
City: ________________ State: ___________
Zip: __________
State of California
County of
On before me, (here
insert name and title of the officer), personally appeared
, who proved to me on the basis of satisfactory evidence to be the
person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that
he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s)
acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the
State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature (Seal)
Principal Name and Address Attorney-in-Fact Name and Address
Name: Name:
Address: Address:
City: City:
State: Zip: State: Zip:
Phone: Phone:
NOTICE: THESE ARE SAMPLE POWERS.
Collection of Debts . To demand, collect, recover, sue for, receive and give receipt or
release for any monies, debts, dividends, interests, royalties, legacies, annuities,
demands, discounts, income, rents, profits, securities or other property of any sort, now
or hereafter due or becoming due to me or to which I may be or hereafter become
entitled.
Endorsements .
a) To endorse and negotiate for any and all purposes all promissory notes,
bills of exchange, checks, drafts or other negotiable or non-negotiable
paper payable to me or to my order;
b) To endorse for transfer all certificates of stock, bond or other securities;
c) To endorse and cash United States Savings Bonds and notes.
Executing Government Vouchers . To execute vouchers in my behalf for any and all
allowances, compensation and reimbursements properly payable to me by the
Government of the United States or any agency or department thereof.
Depositing Money and Other Property . To deposit in my attorney's or my name, or
jointly in both our names, in any banking institution, funds or property, and to withdraw
any part or all of my deposits at any time made by me in my behalf.
Borrowing Money. To borrow money in my name when deemed necessary to my said
attorney upon such terms as to my said attorney appear proper and to execute such
instruments as may be requisite for such purpose.
Acquisition of Property. To buy, receive, lease, accept or otherwise acquire in my name
and for my account property, real, personal or mixed, upon such terms, considerations
and conditions as my said attorney shall think proper.
Recovering Possession of Property. To eject, remove or relieve tenants or other persons
from, and recover possession of, any property, real, personal or mixed in which I now or
hereafter may have an interest.
Litigation . To institute, maintain, defend, compromise, arbitrate or otherwise dispose of,
any and all actions, suits, attachments or other legal proceedings for or against me.
Tax Returns . To prepare and execute any tax returns, including, but not limited to,
Federal income tax returns, State income tax returns, Social Security tax returns, and
Federal and State information and estimated returns; to execute any claims for refund,
protests, applications for abatement, petitions to the United States Board of Tax Appeals
or any other Board or Court, Federal or State, consents and waivers to determination and
assessment of taxes and consents and waivers agreeing to a later determination and
assessment of taxes than is provided by statute of limitations; to receive and endorse and
collect any checks in settlement of any refund of taxes; to examine and to request and
receive copies of any tax returns, reports and other information from the United States
Treasury Department or any other taxing authority, Federal or State, in connection with
any of the foregoing matters.
Automobiles . To execute and deliver to the proper persons and authority any and all
documents, instruments and papers necessary to effect proper registration of any
automobile in which I now or may hereafter have an interest, or the sale thereof and
transfer of legal title thereto as required by law, and to collect and receipt for all monies
paid in consideration of such sale and transfer.
Disposition of Property . To sell, assign, transfer, convey, exchange, deed, mortgage,
pledge, lease, let, license, demise, remise, quitclaim, bargain or otherwise dispose of any
or all of my real estate, stocks, bonds, evidences of indebtedness and other securities and
other personal tangible and intangible or mixed property, or any custody, possession,
interest or right therein at public or private sale, upon such terms, consideration, and
conditions as my said attorney shall deem advisable and to execute, acknowledge and
deliver such instruments and writings of whatsoever kind and nature as may be
necessary, convenient or proper in the premises.