Fill and Sign the Sec 1326332 Statutory Form Power of Attorney 2015

STATUTORY FORM POWER OF ATTORNEY: General, Limited, or Durable (AS 13.26.332) THE POWERS GRANTED FROM THE PRINCIPAL TO THE AGENT OR AGENTS IN THE FOLLOWING DOCUMENT ARE VERY BROAD. THEY MAY INCLUDE THE POWER TO DISPOSE, SELL, CONVEY, AND ENCUMBER YOUR REAL AND PERSONAL PROPERTY. ACCORDINGLY, THE FOLLOWING DOCUMENT SHOULD ONLY BE USED AFTER CAREFUL CONSIDERATION. IF YOU HAVE ANY QUESTIONS ABOUT THIS DOCUMENT, YOU SHOULD SEEK COMPETENT ADVICE. YOU MAY REVOKE THIS POWER OF ATTORNEY AT ANY TIME. Pursuant to AS 13.26.338 - 13.26.353, I, ___________________________ (Name of principal), of ___________________________ (Address of principal), do hereby appoint ___________________________ ___________________________ (Name and address of agent or agents), my attorney(s) -in-fact to act as I have checked below in my name, place, and stead in any way which I myself could do, if I were personally present, with respect to the following matters, as each of them is defined in AS 13.26.344 , to the full extent that I am permitted by law to act through an agent: THE AGENT OR AGENTS YOU HAVE APPOINTED WILL HAVE ALL THE POWERS LISTED BELOW UNLESS YOU DRAW A LINE THROUGH A CATEGORY; AND INITIAL THE BOX OPPOSITE THAT CATEGORY (A) real estate transactions ( ) (B) transactions involving tangible personal property, chattels, and goods ( ) (C) bonds, shares, and commodities transactions () (D) banking transactions () (E) business operating transactions () (F) insurance transactions () (G) estate transactions ( ) (H) gift transactions () (I) claims and litigation ( ) (J) personal relationships and affairs ( ) (K) benefits from government programs and military service ( ) (L) records, reports, and statements ( ) (M) delegation ( ) (N) voter registration and absentee ballot requests ( ) (O) all other matters, including those specified as follows: ( )________________________________________________________________________________________________________________________________________ IF YOU HAVE APPOINTED MORE THAN ONE AGENT, CHECK ONE OF THE FOLLOWING: ( ) Each agent may exercise the powers conferred separately, without the consent of any other agent. ( ) All agents shall exercise the powers conferred jointly, with the consent of all other agents. TO INDICATE WHEN THIS DOCUMENT SHALL BECOME EFFECTIVE, CHECK ONE OF THE FOLLOWING: ( ) This document shall become effective upon the date of my signature. () This document shall become effective upon the date of my disability and shall not otherwise be affected by my disability. IF YOU HAVE INDICATED THAT THIS DOCUMENT SHALL BECOME EFFECTIVE ON THE DATE OF YOUR SIGNATURE, CHECK ONE OF THE FOLLOWING: () This document shall not be affected by my subsequent disability. () This document shall be revoked by my subsequent disability. IF YOU HAVE INDICATED THAT THIS DOCUMENT SHALL BECOME EFFECTIVE UPON THE DATE OF YOUR SIGNATURE AND WANT TO LIMIT THE TERM OF THIS DOCUMENT, COMPLETE THE FOLLOWING: This document shall only continue in effect for ________ ( ) years from the date of my signature. NOTICE OF REVOCATION OF THE POWERS GRANTED IN THIS DOCUMENT: You may revoke one or more of the powers granted in this document. Unless otherwise provided in this document, you may revoke a specific power granted in this power of attorney by completing a special power of attorney that includes the specific power in this document that youwant to revoke. Unless otherwise provided in this document, you may revoke all the powers granted in this power of attorney by completing a subsequent power of attorney. NOTICE TO THIRD PARTIES A third party who relies on the reasonable representations of an attorney -in-fact as to a matter relating to a power granted by a properly executed statutory power of attorney does not incur any liability to the principal or to the principal's heirs, assigns, or estate as a result of permitting the attorney-in-fact to exercise the authority granted by the power of attorney. A third party who fails to honor a properly executed statutory form power of attorney may be liable to the principal, the attorney -in-fact, the principal's heirs, assigns, or estate for a civil penalty, plus damages, costs, and fees associated with the failure to comply with the statutory form power of attorney. If the power of attorney is one which becomes effective upon the disability of the principal, the disability of the principal is established by an affidavit, as required by law. IN WITNESS WHEREOF, I have hereunto signed my name this _______________ day of _______________, 20___________. ___________________________________Signature of Principal Acknowledged before me at_______________________________________________________ __________________________ on ______________________________. ___________________________________ Signature of Officer or Notary Additional optional provisions to statutory form power of attorney Each of the following provisions may be included in a statutory form power of attorney: (1) YOU MAY DESIGNATE AN ALTERNATE ATTORNEY-IN-FACT. ANY ALTERNATE YOU DESIGNATE WILL BE ABLE TO EXERCISE THE SAME POWERS AS THE AGENT(S) YOU NAMED AT THE BEGINNING OF THIS DOCUMENT. IF YOU WISH TO DESIGNATE AN ALTERNATE OR ALTERNATES, COMPLETE THE FOLLOWING: If the agent(s) named at the beginning of this document is unable or unwilling to serve or continue to serve, then I appoint the following agent to serve with the same powers: First alternate or successor attorney-in-fact ______________________________________________________(Name and address of alternate) Second alternate or successor attorney-in-fact ______________________________________________________(Name and address of alternate) (2) YOU MAY NOMINATE A GUARDIAN OR CONSERVATOR. IF YOU WISH TO NOMINATE A GUARDIAN OR CONSERVATOR, COMPLETE THE FOLLOWING:In the event that a court decides that it is necessary to appoint a guardian or conservator for me, I hereby nominate ___________________________ ___________________________ ( Name and address of person nominated ) to be considered by the court for appointment to serve as my guardian or conservator, or in any similar representative capacity.