Fill and Sign the Special Durable Power of Attorney for Bank Account Matters Michigan Form

SPECIAL DURABLE POWER OF ATTORNEY FOR BANK ACCOUNT MATTERS STATE OF MICHIGAN COUNTY OF __________ KNOW ALL MEN BY THESE PRESENTS: That I, ____________________________ of ____________________________ County, Michigan, being of sound mind and memory, do hereby make, constitute and appoint ___________________________________as my true and lawful agent and attorney in fact (hereinafter sometimes called "my agent"), with full power and authority to act for me, individually, and in my name, place and stead, with reference to the transaction of any and all business related to or connected with my bank accounts at ____________________________ Bank, __________________________________________________________ (City), Michigan, __________ (Zip Code) hereinafter “Bank”, including, but not limited to, the following: 1. Making deposits, transfers and withdrawals to or from any of my bank accounts at Bank. 2. Writing, making and endorsing checks, drafts and other instruments in connection with my bank accounts at Bank. 3. Opening new checking, savings, money market, certificates of deposit, IRA’s or other accounts in my name and maintaining same. 4. Approving and authorizing automatic withdrawals from my accounts. 5. Executing signature cards for accounts maintained or opened by my agent in my name. 6. Performing any and all other matters relating to, or in connection with, my bank accounts at Bank. I direct that the above-related powers and authority of my said agent shall be so exercisable and effective regardless of the fact that I may be mentally or physically incapacitated or incapable of understanding or unable to express myself or act in my own behalf at the time of any action on my behalf by said agent. Such incapacity, whether mental or physical, that I may exhibit shall not in any way interfere with the authority of my agent herein to act fully on my behalf according to the terms hereof. In other words, this Power of Attorney shall not be affected by the subsequent disability, incompetence or incapacity of the principal. And I do hereby undertake to ratify and confirm, all and singular, the acts heretofore performed and to be hereinafter performed by my said agents, acting in my name and on my behalf. Bank shall honor this Power of Attorney until and unless Bank receives written notice of revocation of same signed by me. Bank is hereby indemnified and shall be held harmless by the undersigned for any and all actions taken by my agent regarding my accounts at Bank, regardless of whether within the intended scope of this Power of Attorney or not; therefore, Bank shall have no liability for the actions of my agent or for following the directions of my agent in connection with my bank accounts at Bank. IN WITNESS WHEREFORE, I have executed this Special Power of Attorney on this the ____ day of ________________, 20___. __________________________________________ (Principal's Signature) ______________________________ Principal's Name __________________________________________ Witness Signature ______________________________ Witness Name __________________________________________ Witness Signature ______________________________ Witness Name AGENT'S ACKNOWLEDGEMENT I, ______________________________ , have been appointed as attorney-in-fact for ______________________________ , the principal, under a durable power of attorney dated ______________________________ . By signing this document, I acknowledge that if and when I act as attorney-in-fact, all of the following apply: (a) Except as provided in the durable power of attorney, I must act in accordance with the standards of care applicable to fiduciaries acting under durable powers of attorney. (b) I must take reasonable steps to follow the instructions of the principal. (c) Upon request of the principal, I must keep the principal informed of my actions. I must provide an accounting to the principal upon request of the principal, to a guardian or conservator appointed on behalf of the principal upon the request of that guardian or conservator, or pursuant to judicial order. (d) I cannot make a gift from the principal's property, unless provided for in the durable power of attorney or by judicial order. (e) Unless provided in the durable power of attorney or by judicial order, I, while acting as attorney-in-fact, shall not create an account or other asset in joint tenancy between the principal and me. (f) I must maintain records of my transactions as attorney-in-fact, including receipts, disbursements, and investments. (g) I may be liable for any damage or loss to the principal, and may be subject to any other available remedy, for breach of fiduciary duty owed to the principal. In the durable power of attorney, the principal may exonerate me of any liability to the principal for breach of fiduciary duty except for actions committed by me in bad faith or with reckless indifference. An exoneration clause is not enforceable if inserted as the result of my abuse of a fiduciary or confidential relationship to the principal. (h) I may be subject to civil or criminal penalties if I violate my duties to the principal. Signature: _________________________________ Date: ______________________ Principal Name and Address Attorney-in-Fact Name and Address Name: Name: Address: Address: City: City: State: Zip: State: Zip: Phone: Phone: State of ________________________ County of ______________________ The foregoing instrument was acknowledged before me this _______________________ _____________________(date) by ___________________________________________ ____________________________(name of person acknowledged). _____________________________________ (Signature of person taking acknowledgment) _________________________________ (Title or rank) _________________________________ (Serial number, if any)