Signed Power of Attorney

Signed Power of Attorney

This Durable Power of Attorney is executed on this date by Principal Name: of Principal Address: (the "Principal"), who hereby appoints Agent Name: of Agent Address: (the "Agent") to act as Attorney-in-Fact for the Principal commencing on .

RECITALS

WHEREAS, the Principal is the owner of certain property and rights for which the Principal desires representation and management; and

WHEREAS, the Principal desires to appoint the Agent to make decisions and take actions on the Principal's behalf as set forth in this instrument; and

WHEREAS, the Principal intends that this Power of Attorney include broad and continuing authority, unless expressly limited below.

Check applicable options:

Durable Power of Attorney (this Power of Attorney shall not be affected by subsequent incapacity of the Principal)
Springing Power of Attorney (this instrument becomes effective upon the occurrence of the incapacity of the Principal as certified below)

NOW THEREFORE, in consideration of the foregoing recitals and the mutual covenants contained herein, the Principal hereby grants the Agent the authority and powers set forth below.

1. APPOINTMENT AND GENERAL GRANT OF AUTHORITY

1.1 The Principal appoints the Agent as the Principal's true and lawful attorney-in-fact with full power and authority to act in the Principal's name, place and stead to manage, conduct, transact and do all lawful acts concerning the Principal's property and affairs, whether now owned or hereafter acquired, including but not limited to the powers enumerated in Section 2 of this instrument.

1.2 The Agent may exercise powers on the Principal's behalf with the same effect as if the Principal personally performed the acts, and the acts of the Agent shall bind the Principal to third parties who rely on the Agent's representations made within the scope of the authority granted.

2. SPECIFIC POWERS

Without limiting the generality of the foregoing, the Agent is specifically authorized to exercise the following powers on behalf of the Principal. Each power is granted to the fullest extent permitted by law.

Real property: to buy, sell, lease, encumber, manage, and convey real property; to execute deeds, mortgages, releases, and related instruments.

Personal property: to acquire, sell, transfer, insure, and manage tangible and intangible personal property.

Banking and financial: to open, close, and operate accounts; endorse checks; borrow and repay funds; enter into agreements; and exercise rights with respect to investments and securities.

Business interests: to operate, continue, modify, or terminate any business in which the Principal has an interest; to execute contracts and bind the Principal in ordinary and extraordinary business affairs.

Tax matters: to prepare, sign, and file tax returns and to represent the Principal before tax authorities; to receive confidential tax information.

Claims and litigation: to commence, defend, prosecute, settle, and otherwise manage claims or litigation affecting the Principal's interests.

Benefits and insurance: to apply for, receive, and manage social security, Medicare, Medicaid, pensions, insurance proceeds, and other governmental or private benefits.

3. LIMITATIONS AND SPECIAL INSTRUCTIONS

4. EFFECTIVE DATE; DURATION; TERMINATION

4.1 This Power of Attorney shall become effective on the effective date stated above unless the springing option is selected. If the springing option is selected, this Power of Attorney shall become effective upon the occurrence of the Principal's incapacity as determined by a written certification of the Principal's physician or other qualified health professional.

4.2 This Power of Attorney shall continue in effect until revoked by the Principal in writing, or as otherwise provided by law. If the Principal has specified a termination date, indicate termination on: .

5. REVOCATION

The Principal may revoke this Power of Attorney at any time by providing written notice to the Agent and any third parties reasonably relied upon. Revocation shall not affect any actions taken by the Agent in good faith prior to actual receipt of written notice of revocation by a third party.

6. AGENT'S DUTIES AND STANDARD OF CARE

The Agent shall act in the Principal's best interests, avoid conflicts of interest, keep accurate records of all transactions made on behalf of the Principal, and provide an accounting of actions and expenses upon reasonable request. The Agent shall exercise reasonable care, diligence and prudence in the performance of the Agent's duties.

7. THIRD-PARTY RELIANCE

Third parties may rely upon a copy of this Power of Attorney and shall be indemnified by the Principal and the Agent when they act in good faith reliance on this document. No third party who acts in reliance on the authority granted hereunder shall incur liability to the Principal or the Principal's estate for permitting the Agent to exercise powers.

8. COMPENSATION AND EXPENSES

The Agent shall be entitled to reimbursement for reasonable expenses incurred on behalf of the Principal. The Agent shall be compensated at the rate of for services rendered, if compensation is provided for by the Principal.

9. NOTICES

10. GOVERNING LAW

This Power of Attorney shall be governed by and construed in accordance with the laws of the State of .

11. ENTIRE AGREEMENT; AMENDMENT; SEVERABILITY; WAIVER

This instrument constitutes the entire Power of Attorney executed by the Principal and supersedes all prior powers of attorney executed by the Principal relating to the matters addressed herein, unless expressly provided otherwise. Any amendment or revocation must be in writing signed by the Principal. If any provision of this Power of Attorney is held invalid, illegal or unenforceable, the remaining provisions shall remain in full force and effect. No waiver of any provision is effective unless in writing and signed by the party granting the waiver.

12. INDEMNIFICATION

The Principal agrees to indemnify and hold the Agent harmless from all claims, liabilities, losses, and expenses (including reasonable attorneys' fees) arising from the Agent's actions taken in good faith pursuant to this Power of Attorney.

ACKNOWLEDGMENT

The Principal and Agent each acknowledge that they have read and understand the terms of this Power of Attorney, that the Principal is signing this document voluntarily, and that the Agent accepts the appointment and agrees to act in accordance with the terms hereof.

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