Uniform Statutory Power of Attorney 2015

CALIFORNIA UNIFORM STATUTORY FORM POWER OF ATTORNEY
THE POWERS YOU GRANT BELOW ARE EFFECTIVE
EVEN IF YOU BECOME DISABLED OR INCOMPETENT
CAUTION: A DURABLE POWER OF ATTORNEY IS AN IMPORTANT LEGAL DOCUMENT.
BY SIGNING THE DURABLE POWER OF ATTORNEY, YOU ARE AUTHORIZING ANOTHER
PERSON TO ACT FOR YOU, THE PRINCIPAL. BEFORE YOU SIGN THIS DURABLE
POWER OF ATTORNEY, YOU SHOULD KNOW THESE IMPORTANT FACTS: YOUR
AGENT (ATTORNEY-IN-FACT) HAS NO DUTY TO ACT UNLESS YOU AND YOUR AGENT
AGREE OTHERWISE IN WRITING. THIS DOCUMENT GIVES YOUR AGENT THE POWERS
TO MANAGE, DISPOSE OF, SELL, AND CONVEY YOUR REAL AND PERSONAL
PROPERTY, AND TO USE YOUR PROPERTY AS SECURITY IF YOUR AGENT BORROWS
MONEY ON YOUR BEHALF. THIS DOCUMENT DOES NOT GIVE YOUR AGENT THE
POWER TO ACCEPT OR RECEIVE ANY OF YOUR PROPERTY, IN TRUST OR
OTHERWISE, AS A GIFT, UNLESS YOU SPECIFICALLY AUTHORIZE THE AGENT TO
ACCEPT OR RECEIVE A GIFT. YOUR AGENT WILL HAVE THE RIGHT TO RECEIVE
REASONABLE PAYMENT FOR SERVICES PROVIDED UNDER THIS DURABLE POWER
OF ATTORNEY UNLESS YOU PROVIDE OTHERWISE IN THIS POWER OF ATTORNEY.
THE POWERS YOU GIVE YOUR AGENT WILL CONTINUE TO EXIST FOR YOUR ENTIRE
LIFETIME, UNLESS YOU STATE THAT THE DURABLE POWER OF ATTORNEY WILL
LAST FOR A SHORTER PERIOD OF TIME OR UNLESS YOU OTHERWISE TERMINATE
THE DURABLE POWER OF ATTORNEY.
THE POWERS YOU GIVE YOUR AGENT IN THIS DURABLE POWER OF ATTORNEY WILL
CONTINUE TO EXIST EVEN IF YOU CAN NO LONGER MAKE YOUR OWN DECISIONS
RESPECTING THE MANAGEMENT OF YOUR PROPERTY. YOU CAN AMEND OR CHANGE
THIS DURABLE POWER OF ATTORNEY ONLY BY EXECUTING A NEW DURABLE
POWER OF ATTORNEY OR BY EXECUTING AN AMENDMENT THROUGH THE SAME
FORMALITIES AS AN ORIGINAL. YOU HAVE THE RIGHT TO REVOKE OR TERMINATE
THIS DURABLE POWER OF ATTORNEY AT ANY TIME, SO LONG AS YOU ARE
COMPETENT.
THIS DURABLE POWER OF ATTORNEY MUST BE DATED AND MUST BE
ACKNOWLEDGED BEFORE A NOTARY PUBLIC OR SIGNED BY TWO WITNESSES. IF IT
IS SIGNED BY TWO WITNESSES, THEY MUST WITNESS EITHER (1) THE SIGNING OF
THE POWER OF ATTORNEY OR (2) THE PRINCIPAL'S SIGNING OR ACKNOWLEDGMENT
OF HIS OR HER SIGNATURE. A DURABLE POWER OF ATTORNEY THAT MAY AFFECT
REAL PROPERTY SHOULD BE ACKNOWLEDGED BEFORE A NOTARY PUBLIC SO THAT
IT MAY EASILY BE RECORDED.
YOU SHOULD READ THIS DURABLE POWER OF ATTORNEY CAREFULLY. WHEN
EFFECTIVE, THIS DURABLE POWER OF ATTORNEY WILL GIVE YOUR AGENT THE
RIGHT TO DEAL WITH PROPERTY THAT YOU NOW HAVE OR MIGHT ACQUIRE IN THE
FUTURE. THE DURABLE POWER OF ATTORNEY IS IMPORTANT TO YOU. IF YOU DO
NOT UNDERSTAND THE DURABLE POWER OF ATTORNEY, OR ANY PROVISION OF IT,
THEN YOU SHOULD OBTAIN THE ASSISTANCE OF AN ATTORNEY OR OTHER
QUALIFIED PERSON.
NOTICE TO PERSON ACCEPTING THE APPOINTMENT AS ATTORNEY-IN-FACT BY
ACTING OR AGREEING TO ACT AS THE AGENT (ATTORNEY-IN-FACT) UNDER THIS
POWER OF ATTORNEY YOU ASSUME THE FIDUCIARY AND OTHER LEGAL
RESPONSIBILITIES OF AN AGENT. THESE RESPONSIBILITIES INCLUDE:
1. THE LEGAL DUTY TO ACT SOLELY IN THE INTEREST OF THE PRINCIPAL AND TO
AVOID CONFLICTS OF INTEREST.
2. THE LEGAL DUTY TO KEEP THE PRINCIPAL'S PROPERTY SEPARATE AND DISTINCT
FROM ANY OTHER PROPERTY OWNED OR CONTROLLED BY YOU. YOU MAY NOT
TRANSFER THE PRINCIPAL'S PROPERTY TO YOURSELF WITHOUT FULL AND
ADEQUATE CONSIDERATION OR ACCEPT A GIFT OF THE PRINCIPAL'S PROPERTY
UNLESS THIS POWER OF ATTORNEY SPECIFICALLY AUTHORIZES YOU TO TRANSFER
PROPERTY TO YOURSELF OR ACCEPT A GIFT OF THE PRINCIPAL'S PROPERTY. IF
YOU TRANSFER THE PRINCIPAL'S PROPERTY TO YOURSELF WITHOUT SPECIFIC
AUTHORIZATION IN THE POWER OF ATTORNEY, YOU MAY BE PROSECUTED FOR
FRAUD AND/OR EMBEZZLEMENT. IF THE PRINCIPAL IS 65 YEARS OF AGE OR OLDER
AT THE TIME THAT THE PROPERTY IS TRANSFERRED TO YOU WITHOUT AUTHORITY,
YOU MAY ALSO BE PROSECUTED FOR ELDER ABUSE UNDER PENAL CODE SECTION
368. IN ADDITION TO CRIMINAL PROSECUTION, YOU MAY ALSO BE SUED IN CIVIL
COURT. I HAVE READ THE FOREGOING NOTICE AND I UNDERSTAND THE LEGAL AND
FIDUCIARY DUTIES THAT I ASSUME BY ACTING OR AGREEING TO ACT AS THE AGENT
(ATTORNEY-IN-FACT) UNDER THE TERMS OF THIS POWER OF ATTORNEY.
DATE: __________________
______________________________________
(SIGNATURE OF AGENT)
______________________________________
(PRINT NAME OF AGENT)
UNIFORM STATUTORY FORM POWER OF ATTORNEY
(California Probate Code Section 4401 Prob.)
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 Prob. - 4465
Prob.).
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 HIS POWER OF
ATTORNEY IF YOU LATER WISH TO DO SO.
I, ________________________________________________________________
_________________________________________________________________
(your name and address) appoint
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
(name and address of the person appointed, or of each person appointed if you want to
designate more than one) 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).
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___.
_________________________________________
(your signature)
_________________________________________
(your social security number)
A notary public or other officer completing this certificate verifies only the identity of the individual who signed
the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC
STATE OF CALIFORNIA
COUNTY OF ________________
)
)
On __________________ before me,
__________________________________________________________________________
(here insert name and title of the officer), personally appeared
__________________________________________________________________________
__________________________________________________________________________,
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s)
is/are subscribed to the within instrument and acknowledged to me that he/she/they executed
the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the
instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the
instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
_______________________________
Signature
(Seal)
ACKNOWLEDGMENT OF AGENT
BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT ASSUMES THE
FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT.
________________________________________________
[Typed or Printed Name of Agent]
________________________________________________
[Signature of Agent]