RECORDING REQUESTED BY: WHEN RECORDED MAIL TO:
SPACE ABOVE THIS LINE FOR RECORDER’S USE
UNIFORM STATUTORY FORM 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 LEGA L 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, ____________________________________________________________________________________________
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.
Tangible personal property transactions.
Banking and other financial institution transactions.
Estate, trust, and other beneficiary transactions.
Benefits from social security, medicare, medicaid, or other governmental programs, or civil or military service.
YOU NEED NOT INITIAL ANY OTHER LINES IF YOU INITIAL LINE (N).
Uniform Statutory Form Power of Attorney
SPECIAL INSTRUCTIONS: ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS LIMITING OR EXTENDING THE POWERS GRANTED TO YOUR AGENT.
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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 TOGET HER. 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 _____________________, ________
BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT.
personally known to me (or 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.
Uniform Statutory Form Power of Attorney
COMMISSION ACTIVITES PHYSIQUES ET SPORTIVES S E C T I O N V O I L E H A B I T A B L E Le mal de mer est une réaction naturel e de l’organisme face à une situation particulière que le cerveau peine à assimiler. Le mal de mer est donc normal et touche tout le monde, chacun ayant seulement un seuil de sensibilité différent. Dans la majorité des cas, au bout de 2 ou 3 jours, le cer
LES ETATS GENERAUX POUR UNE MARTINIQUE PERFORMANTE Richard SAMUEL, Préfet, Coordonnateur national des États généraux de l'Outre-mer Bertrand de SAINT GERMAIN, Administrateur civil hors classe, Coordonnateur des États généraux de la Martinique Victor-Emmanuel VAUGIRARD, Professeur des Universités en Finances à l'Université de Strasbourg, Rapporteur général des États