I, __________________(“Declarant”), residing at __________________________, hereby appoint _____________________ (“Agent”) of _______________________, as my attorney-in-fact (“Agent”) to exercise the powers and discretions described below.
If the Agent is unable or unwilling to serve for any reason, I appoint ________________ (“Alternate Agent”), of _______________________________, as my alternate or successor Agent, as the case may be to serve with the same powers and discretions.
I hereby revoke any and all general powers of attorney and special powers of attorney that previously have been signed by me. However, the preceding sentence shall not have the effect of revoking any powers of attorney that are directly related to my health care that previously have been signed by me.
My Agent shall have full power and authority to act on my behalf.This power and authority shall authorize my Agent to manage and conduct all of my affairs and to exercise all of my legal rights and powers, including all rights and powers that I may acquire in the future. My Agent’s powers shall include, but not be limited to, the power to:….
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