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Sample durable power of attorn... Reset Show Field Borders 1930-- Florida general durable power of attorney, 2-12. Purchase - Click Here 2012 by BlumbergExcelsior, Inc., Publisher, NYC 10013 www.blumberg.com FLORIDA GENERAL DURABLE

Certificate of incapacity 8 20... CERTIFICATE OF INCAPACITY AND REGARDING THE NEED FOR GUARDIANSHIP In accordance with NRS 159.044(2)(j): I, (your name), am: A physician licensed to practice in the State of Nevada A physician employed

Power of attorney childpdffill... GRANDPARENT POWER OF ATTORNEY FOR THE CARE OF A MINOR CHILD NOTICE: (1) THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE GRANDPARENT THAT YOU DESIGNATE (THE AGENT GRANDPARENT) POWERS TO CARE FOR

Power health care form THIS POWER OF ATTORNEY MAY BE AMENDED OR REVOKED BY YOU IN THE MANNER PROVIDED IN SECTION 4-6 OF THE ILLINOIS POWERS OF ATTORNEY FOR HEALTH CARE LAW SEE THE BACK OF THIS FORM. A COURT CAN TAKE AWAY THE POWERS OF YOUR AGENT IF IT FINDS THE AGENT IS NOT ACTING PROPERLY. YOU MAY NAME SUCCESSOR AGENTS UNDER THIS FORM BUT NOT CO-AGENTS AND NO HEALTH CARE PROVIDER MAY BE NAMED. UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THIS POWER IN THE MANNER PROVIDED BELOW UNTIL YOU REVOKE THIS POWER OR A COURT ACTING ON YOUR BEHALF TERMINATES IT YOUR AGENT MAY EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME EVEN AFTER YOU BECOME DISABLED. THE POWERS YOU GIVE YOUR AGENT YOUR RIGHT TO REVOKE THOSE POWERS AND THE PENALTIES FOR VIOLATING THE LAW ARE EXPLAINED MORE FULLY IN SECTIONS 4-5 4-6 4-9 AND 4-10 b OF THE ILLINOIS POWERS OF ATTORNEY FOR HEALTH CARE LAW OF WHICH THIS FORM IS A PART SEE THE BACK OF THIS FORM. THAT LAW EXPRESSLY PERMITS THE USE OF ANY DIFFERENT FORM OF POWER OF ATTORNEY YOU MAY DESIRE. IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND YOU SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU. UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THIS POWER IN THE MANNER PROVIDED BELOW UNTIL YOU REVOKE THIS POWER OR A COURT ACTING ON YOUR BEHALF TERMINATES IT YOUR AGENT MAY EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME EVEN AFTER YOU BECOME DISABLED. THE POWERS YOU GIVE YOUR AGENT YOUR RIGHT TO REVOKE THOSE POWERS AND THE PENALTIES FOR VIOLATING THE LAW ARE EXPLAINED MORE FULLY IN SECTIONS 4-5 4-6 4-9 AND 4-10 b OF THE ILLINOIS POWERS OF ATTORNEY FOR HEALTH CARE LAW OF WHICH THIS FORM IS A PART SEE THE BACK OF THIS FORM. THAT LAW EXPRESSLY PERMITS THE USE OF ANY DIFFERENT FORM OF POWER OF ATTORNEY YOU MAY DESIRE. IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND YOU SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU. month year 1. I. insert name and address of principal hereby appoint. as my attorney-in-fact my agent to act for me and in my name in any way I could act in person to make any and all decisions for me concerning my personal care medical treatment hospitalization and health care and to require withhold or withdraw any type of medical treatment or procedure even though my death may ensue. POWER OF ATTORNEY FOR HEALTH CARE ILLINOIS STATUTORY SHORT FORM POWER OF ATTORNEY FOR HEALTH CARE NOTICE THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE YOUR AGENT BROAD POWERS TO MAKE HEALTH CARE DECISIONS FOR YOU INCLUDING POWER TO REQUIRE CONSENT TO OR WITHDRAW ANY TYPE OF PERSONAL CARE OR MEDICAL TREATMENT FOR ANY PHYSICAL OR MENTAL CONDITION AND TO ADMIT YOU TO OR DISCHARGE YOU FROM ANY HOSPITAL HOME OR OTHER INSTITUTION. THIS FORM DOES NOT IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS BUT WHEN POWERS ARE EXERCISED YOUR AGENT WILL HAVE TO USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE WITH THIS FORM AND KEEP A RECORD OF RECEIPTS DISBURSEMENTS AND SIGNIFICANT ACTIONS TAKEN AS AGENT. Any organ.. Specific organs. THE ABOVE GRANT OF POWER IS INTENDED TO BE AS BROAD AS POSSIBLE SO THAT YOUR AGENT WILL HAVE AUTHORITY TO MAKE ANY DECISION YOU COULD MAKE TO OBTAIN OR TERMINATE ANY TYPE OF HEALTH CARE INCLUDING WITHDRAWAL OF FOOD AND WATER AND OTHER LIFE-SUSTAINING MEASURES IF YOUR AGENT BELIEVES SUCH ACTION WOULD BE CONSISTENT WITH YOUR INTENT AND DESIRES. IF YOU WISH TO LIMIT THE SCOPE OF YOUR AGENT S POWERS OR PRESCRIBE SPECIAL RULES OR LIMIT THE POWER TO MAKE AN ANATOMICAL GIFT AUTHORIZE AUTOPSY OR DISPOSE OF REMAINS YOU MAY DO SO IN THE FOLLOWING PARAGRAPHS. 2. Month year 1. I. insert name and address of principal hereby appoint. as my attorney-in-fact my agent to act for me and in my name in any way I could act in person to make any and all decisions for me concerning my personal care medical treatment hospitalization and health care and to require withhold or withdraw any type of medical treatment or procedure even though my death may ensue. My agent shall have the same access to my medical records that I have including the right to disclose the contents to others. My agent shall also have full power to authorize an autopsy and direct the disposition of my remains.

Power of attorney safe deposit... FOR BANKING TRANSACTIONS AND SAFE DEPOSIT BOX ACCESS ... THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU ...

Oklahoma durable power attorne... DURABLE POWER OF ATTORNEY WITH HEALTH CARE POWERS ONLY NOTICE The powers granted by this document are broad and sweeping. They are explained in the Uniform Statutory Form Power of Attorney Act. If you have any questions about these powers obtain competent legal advice. Free legal information regarding construction of the powers granted by this document and completion of this form may be obtained by calling the Legal Services Developer Aging Services Division of the Oklahoma Department of Human Services 405 522 3069 or your local legal aid or legal services office. DURABLE POWER OF ATTORNEY WITH HEALTH CARE POWERS ONLY NOTICE The powers granted by this document are broad and sweeping. They are explained in the Uniform Statutory Form Power of Attorney Act. If you have any questions about these powers obtain competent legal advice. Free legal information regarding construction of the powers granted by this document and completion of this form may be obtained by calling the Legal Services Developer Aging Services Division of the Oklahoma Department of Human Services 405 522 3069 or your local legal aid or legal services office. This document authorizes your agent to make medical and other health care decisions for you. You may revoke this power of attorney if you later wish to do so. I insert name and address appoint as my agent attorney in fact to act for me in any lawful way with respect to the following initialed subjects. If my agent is unable or unwilling to serve I appoint as my alternate agent with the same authority. Once effective pursuant to section III on the back of this form this power of attorney will continue to be effective even though I become disabled incapacitated or incompetent and shall not be affected by lapse of time. To grant all of the following powers initial the line in front of f and ignore the lines in front of the other powers. To grant one or more but fewer than all of the following powers initial the line in front of each power you are granting. To withhold a power do not initial the line in front of it. You may but need not cross out each power with held. 1. If I am unable to decide or speak for myself my agent has the power to Initial a* Make health and medical care decisions for me including serving as my representative under the Oklahoma Do Not Resuscitate Act but excluding signing an advance directive making decisions reserved to a health care proxy under an advance directive or other life sustaining treatment decisions. Choose my health care providers. Choose where I live and receive care and support when these choices relate to my health care needs. Review my medical records and have the same rights that I would have to give my medical records to other people. Elect hospice treatment. All of the powers listed above. I. Grant of Health Care Powers You need not initial any other lines if you initial line f* 2. It is my intention that my agent s acts on my behalf are to be honored by my family members and health care providers as an expression of my legal right to manage my health care.

Uniform statutory CALIFORNIA UNIFORM STATUTORY POWER OF ATTORNEY California Probate Code Section 4401 NOTICE THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING. THEY ARE EXPLAINED IN THE UNIFORM STATUTORY FORM POWER OF ATTORNEY ACT CALIFORNIA PROBATE CODE SECTIONS 4400-4465. IF YOU HAVE ANY QUESTIONS ABOUT THESE POWERS OBTAIN COMPETENT LEGAL ADVICE* THIS DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL AND OTHER HEALTH-CARE DECISIONS FOR YOU. YOU MAY REVOKE THIS POWER OF ATTORNEY IF YOU LATER WISH TO DO SO. I of Principal s Name Principal s Address appoint of Agent s Name Agent s Address as my agent attorney-in-fact to act for me in any lawful way with respect to the following initialed subjects TO GRANT ALL OF THE FOLLOWING POWERS INITIAL THE LINE IN FRONT OF N AND IGNORE THE LINES IN FRONT OF THE OTHER POWERS* TO GRANT ONE OR MORE BUT FEWER THAN ALL OF THE FOLLOWING POWERS INITIAL THE LINE IN FRONT OF EACH POWER YOU ARE GRANTING* TO WITHHOLD A POWER DO NOT INITIAL THE LINE IN FRONT OF IT. YOU MAY BUT NEED NOT CROSS OUT EACH POWER WITHHELD. INITIAL A Real property transactions. B Tangible personal property transactions. C Stock and bond transactions. D Commodity and option transactions. E Banking and other financial institution transactions. F Business operating transactions. G Insurance and annuity transactions. H Estate trust and other beneficiary transactions. I Claims and litigation* J Personal and family maintenance. K Benefits from social security medicare medicaid or other governmental programs or civil or military service. L Retirement plan transactions. M Tax matters. N ALL OF THE POWERS LISTED ABOVE* YOU NEED NOT INITIAL ANY OTHER LINES IF YOU INITIAL LINE N. Statutory Form Power of Attorney Page 1 SPECIAL INSTRUCTIONS ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS LIMITING OR EXTENDING THE POWERS GRANTED TO YOUR AGENT. UNLESS YOU DIRECT OTHERWISE ABOVE THIS POWER OF ATTORNEY IS EFFECTIVE IMMEDIATELY AND WILL CONTINUE UNTIL IT IS REVOKED. This power of attorney will continue to be effective even though I become incapacitated* STRIKE THE PRECEDING SENTENCE IF YOU DO NOT WANT THIS POWER OF ATTORNEY TO CONTINUE IF YOU BECOME INCAPACITATED. EXERCISE OF POWER OF ATTORNEY WHERE MORE THAN ONE AGENT DESIGNATED If I have designated more than one agent the agents are to act. IF YOU APPOINTED MORE THAN ONE AGENT AND YOU WANT EACH AGENT TO BE ABLE TO ACT ALONE WITHOUT THE OTHER AGENT JOINING WRITE THE WORD SEPARATELY IN THE BLANK SPACE ABOVE* IF YOU DO NOT INSERT ANY WORD IN THE BLANK SPACE OR IF YOU INSERT THE WORD JOINTLY THEN ALL OF YOUR AGENTS MUST ACT OR SIGN TOGETHER* I agree that any third party who receives a copy of this document may act under it. Revocation of the power of attorney is not effective as to a third party until the third party has actual knowledge of the revocation* I agree to indemnify the third party for any claims that arise against the third party because of reliance on this power of attorney. Signed this day of 20. Signature of Principal Principal s Social Security Number BY ACCEPTING OR ACTING UNDER THE APPOINTMENT THE AGENT ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT.

Kaiser healt care directives f... CALIFORNIA ADVANCE HEALTH CARE DIRECTIVE Including Power of Attorney for Health Care Imprint / MRN NOTE: The document meets legal requirements for most Californians, but might not be appropriate in

Marine corps power of attorney... SPECIAL POWER OF ATTORNEY THIS IS A MILITARY POWER OF ATTORNEY PREPARED PURSUANT TO TITLE 10, UNITED STATES CODE, SECTION 1044A, AND EXECUTED BY A PERSON AUTHORIZED TO RECEIVE LEGAL ASSISTANCE FROM

Ftc identity theft form Average time to complete 10 minutes Identity Theft Victim s Complaint and Affidavit A voluntary form for filing a report with law enforcement and disputes with credit reporting agencies and creditors about identity theft-related problems. Visit ftc.gov/idtheft to use a secure online version that you can print for your records. Before completing this form 1. Date Signed mm/dd/yyyy Your Affidavit If you do not choose to file a report with law enforcement you may use this form as an Identity Theft Affidavit to prove to each of the companies where the thief misused your information that you are not responsible for the fraud. Visit ftc*gov/idtheft to use a secure online version that you can print for your records. Before completing this form 1. Place a fraud alert on your credit reports and review the reports for signs of fraud. 2. Close the accounts that you know or believe have been tampered with or opened fraudulently. About You the victim Now My full legal name My date of birth My Social Security number -- My driver s license My current street address First Middle Last Suffix mm/dd/yyyy State Number Number Street Name Apartment Suite etc* I have lived at this address since Leave 3 blank until you provide this form to someone with a legitimate business need like when you are filing your report at the police station or sending the form to a credit reporting agency to correct your credit report. My daytime phone My evening phone My email City Zip Code Country At the Time of the Fraud Skip 8 - 10 if your information has not changed since the fraud. My address was The Paperwork Reduction Act requires the FTC to display a valid control number in this case OMB control 3084-0047 before we can collect or sponsor the collection of your information or require you to provide it. Victim s Name Phone number Page 2 Declarations 11 I did OR did not authorize anyone to use my name or personal information to obtain money credit loans goods or services or for any other purpose as described in this report. 12 I receive any money goods services or other benefit as a result of the events described in this report. 13 I am OR am not willing to work with law enforcement if charges are brought against the person s who committed the fraud. About the Fraud I believe the following person used my information or identification documents to open new accounts use my existing accounts or commit other fraud. Name Address Enter what you know about anyone you believe was involved even if you don t have complete Phone Numbers Additional information about this person 14 and 15 gained access to your information or which documents or information were Attach additional used sheets as needed* Documentation I can verify my identity with these documents A valid government-issued photo identification card for example my driver s license state-issued ID card or my passport. If you are under 16 and don t have a photo-ID a copy of your birth certificate or a copy of your official school record showing your enrollment and legal address is acceptable.

Affidavit domicile form AFFIDAVIT OF DOMICILE STATE OF ) )SS: COUNTY OF ) , being duly sworn deposes and says that he/she resides at , State of and is executor/administrator of the estate of deceased, who died on the day

Hi form divorce INSTRUCTIONS UNCONTESTED DIVORCE PACKET WITH CHILDREN (for the Island of Kaua i) WHO CAN FILE FOR DIVORCE? In order to file a divorce action in the Family Court of the Fifth Circuit (on Kaua i), you

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