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THE GENERAL (FINANCIAL)
POWER OF ATTORNEY
OF
__________________________
(Principal)


I, _________________________, the Principal, with the mailing address of
_________________________, City of _________________________,
State of _________________________, hereby designate _________________________
as my attorney-in-fact (hereinafter “attorney-in-fact”), with the mailing address of
_________________________, City of _________________________,
State of _________________________, to act as set forth below, in my name, in my
stead and for my benefit, hereby revoking any and all powers of attorney I may have
executed in the past.

1. Powers of Attorney-in-Fact

I confer upon my attorney-in-fact the power to act on my behalf and in my stead, as if I
were present, and to exercise or perform the acts or powers I have designated with my
initials as set forth below.

My attorney-in-fact shall NOT have the power to act on my behalf if I have not so
designated with my initials.

_____ Banking Powers: To open and close accounts, make, receive, and endorse
checks and drafts, deposit and withdraw funds, acquire and redeem certificates of deposit,
in banks, savings and loan associations, and other institutions, execute or release such
deeds of trust or other security agreements as may be necessary or proper in the exercise
of the rights and powers herein granted;


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_____ Power to Make Payments or Collect Monies Owed: My attorney-in-fact has the
power to make any payments on any accounts I may owe and to hold, collect and request
any sums that may be due, owing or payable to me or in which I may hereinafter acquire
an interest, in whatever form, whether liquidated or un-liquidated, to have, use, and take
all lawful means in my name for the collection and recovery thereof, and to adjust, sell,
compromise, and agree for the same and to execute and deliver for me, on my behalf, and
in my name, all endorsements, releases, receipts, or other sufficient discharges for the
same;

_____ Power to Acquire, Lease and Sell Personal Property: To acquire, purchase,
exchange, lease, grant options to sell, and sell and convey personal property, or any
interests therein, on such terms and conditions, including credit arrangements, as my
attorney-in-fact shall deem proper; to execute, acknowledge and deliver, under seal or
otherwise, any and all assignments, transfers, titles, papers, documents or instruments
which my attorney-in-fact shall deem necessary in connection therewith; to purchase, sell
or otherwise dispose of, assign, transfer and convey shares of stock, bonds, securities and
other personal property now or hereafter belonging to me, whether standing in my name or
otherwise, and wherever situated;

_____ Power to Acquire, Lease and Sell Real Property: To acquire, purchase,
exchange, lease, grant options to sell, and sell and convey real property, or any interests
therein, on such terms and conditions, including credit arrangements, as my attorney-in-
fact shall deem proper; to execute, acknowledge and deliver, under seal or otherwise, any
and all assignments, transfers, deeds, papers, documents or instruments which my
attorney-in-fact shall deem necessary in connection therewith;

_____ Management Powers: To maintain, repair, improve, invest, manage, insure, rent,
lease, encumber, and in any manner deal with any real or personal property, tangible or
intangible, or any interests therein, that I now own or may hereafter acquire, in my name
and for my benefit, upon such terms and conditions as my attorney-in-fact shall deem
proper;



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_____ Motor Vehicles: To apply for a Certificate of Title upon, and endorse and transfer
title thereto, for any automobile, truck, pickup truck, van, motorcycle, or other motor
vehicle, and to represent in such transfer or assignment that the title to said motor vehicle
is free and clear of all liens and encumbrances except those specifically set forth in such
transfer or assignment;

_____ Tax Powers: To act without limitation on my behalf with regard to federal income
taxes (Forms 1040, 1040EZ, 1040X, etc.), state and local income taxes, estate, gift (Form
709) and other tax returns of all sorts, whether federal or state and local, including where
appropriate joint returns, FICA returns, payroll tax returns, claims for refunds, requests for
extensions of time to file returns or pay taxes, extensions and waivers of applicable
periods of limitation, protests and petitions to administrative agencies or courts, including
the tax court, regarding tax matters, and any and all other tax related documents, including
but not limited to consents and agreements under Section 2032A of the Internal Revenue
Code or any successor section thereto and consents to split gifts and closing agreements,
for all tax periods from 1980 through 2050, and for all jurisdictions; to complete Internal
Revenue Service Form 2848, Power of Attorney and Declaration of Representative (or
other prescribed form) on my behalf as well as to perform all other functions contemplated
by that form whether they are required or merely permissible; to consent to any gift and to
utilize any gift-splitting provisions or other tax election; and to prepare, sign, and file any
claims for refund of any tax; to post bonds, receive confidential information and contest
deficiencies determined by the Internal Revenue Service or any state or local taxing
authority; to exercise any and all elections that I may have under federal, state or local tax
laws including without limitation the allocation of any generation-skipping tax exemption to
which I may be entitled; to the extent that I may have omitted some power or discretion,
some tax period, some form or some jurisdiction, I hereby grant to my attorney-in-fact the
power to amend the Internal Revenue Service form power of attorney (presently Form
2848 or Form 2848-D) in my name;





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_____ Safe-Deposit Boxes: To have access at any time or times to any safe-deposit box
rented by me or to which I may have access, where so ever located, including drilling, if
necessary, and to remove all or any part of the contents thereof, and to surrender or
relinquish said safe-deposit box; and any institution in which any such safe-deposit box
may be located shall not incur any liability to me or my estate as a result of permitting my
attorney-in-fact to exercise this power;

_____ Gift Making Powers: To make gifts, grants, or other transfers (including the
forgiveness of indebtedness and the completion of any charitable pledges I may have
made) without consideration, either outright or in trust to such person(s) (including my
attorney-in-fact hereunder) or organizations as my attorney-in-fact shall select, including,
without limitation, the following actions: (a) transfer by gift in advancement of a bequest or
devise to beneficiaries under my will or in the absence of a will to my spouse and
descendants in whatever degree; and (b) release of any life interest, or waiver,
renunciation, disclaimer, or declination of any gift to me by will, deed, or trust;

_____ Lending and Borrowing: To make loans in my name; to borrow money in my
name, individually or jointly with others; to give promissory notes or other obligations
therefor; and to deposit or mortgage as collateral or for security for the payment thereof
any or all of my securities, real estate, personal property, or other property of whatever
nature and wherever situated, held by me personally or in trust for my benefit;

_____ Contracts: To enter into contracts of whatever nature or kind in my name;

_____ Health Care: To take any and all steps necessary to arrange for my admission to
any type of health care facility, including, without limitation, a hospital, rehabilitation facility,
skilled nursing facility, or hospice, and to authorize the release of my medical records in
the discretion of my attorney-in-fact;

_____ HIPAA: To have the power and authority as my personal representative for all
purposes of the Health Insurance Portability and Accountability Act of 1996 (Pub. L. No.
104-191);


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_____ Power to Hire and Pay for Services: To retain such accountants, attorneys, social
workers, consultants, clerks, employees, workers, or other persons as my agent shall
deem appropriate in connection with the management of my property and affairs and to
make payments from my assets for the fees of such persons so employed;

_____ Reimbursement of Attorney-in-Fact: To reimburse my attorney-in-fact for any
reasonable expenses incurred in connection with such services; and

_____ Power to Sue Third Parties Who Fail to Act Pursuant to Power of Attorney: If
any third party (including stock transfer agents, title insurance companies, banks, credit
unions, and savings and loan associations) with whom my attorney-in-fact seeks to
transact refuses to recognize my attorney-in-fact’s authority to act on my behalf pursuant
to this Power of Attorney, I authorize my attorney-in-fact to sue and recover from such
third party all resulting damages, costs, expenses, and attorney’s fees incurred because of
such failure to act. The costs, expenses, and attorney’s fees incurred in bringing such
action shall be charged against my general assets, to the extent that they are not
recovered from said third party.

_____ Other: Power to conduct the following: ______________________________
___________________________________________________________________
___________________________________________________________________

2. Interpretation & Governing Law

This instrument is to be construed and interpreted as a general non-durable power of
attorney. The enumeration of specific powers herein is not intended to, nor does it, limit or
restrict the general powers herein granted to my attorney-in-fact. For a third party to
construe otherwise would be contrary to my intent. This instrument is executed and
delivered in the State of __________________________ and the laws of such state shall
govern all questions as to the validity of this power and the construction of its provisions.
Nevertheless, I intend that this instrument be given full force and effect in any state or
country in which I may find myself or in which I may own property, whether real or


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personal. I direct that my attorney-in-fact not be required to give bond and, if any bond is
required, that no sureties be required. I direct that photocopies of this instrument shall
have the same power and effect as the original.

3. Effective Date & Termination

To indicate when this document shall become effective, initial one of the following:

_____ Upon the date of this document with my authorization.

_____ The following date _____________________, 20_____.

To indicate when this document shall become terminated, initial all of the following that
apply (termination is effective at which of the following occurs first):

_____ On the following date _____________________, 20____.

_____ When I have made a written revocation.

_____ When and if I become incapacitated and unable to make decisions as determined
by a physician.

4. Third (3rd) Party Reliance

Any party dealing with my attorney-in-fact hereunder may rely absolutely on the authority
granted herein and need not look to the application of any proceeds nor the authority of
my attorney-in-fact as to any action taken hereunder. In this regard, no person who may in
good faith act in reliance upon the representations of my attorney-in-fact or the authority
granted hereunder shall incur any liability to me or my estate as a result of such act. I
hereby ratify and confirm whatever my attorney-in-fact shall lawfully do under this
instrument. Any gift of property made by my attorney-in-fact in the proper exercise of the


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gift-making powers specifically granted in Section 1 (under “Gift Making Powers”) herein
shall be a full and complete delivery of title upon which third-party purchasers for value
may rely. My attorney-in-fact is authorized as he or she deems necessary to bring an
action in court so that this instrument shall be given the full power and effect that I intend
on by executing it.


IN WITNESS WHEREOF, I have executed this General Non-Durable Power of Attorney on
_____________________, 20____,

__________________________


Principal Signature






__________________________


Print Name

ACCEPTANCE OF APPOINTMENT

I, __________________________, the attorney-in-fact named above, hereby accept
appointment as attorney-in-fact in accordance with the foregoing instrument.

__________________________


Attorney-in-Fact Signature






__________________________


Print Name












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WITNESSES

We, the witnesses, each do hereby declare in the presence of the Principal that the
Principal signed and executed this instrument as his Power of Attorney in the presence of
each of us, that he signed it willingly, that each of us hereby signs this Power of Attorney
as witness at the request of the Principal and in his presence, and that, to the best of our
knowledge, the Principal is eighteen (18) years of age or over, of sound mind, and under
no constraint or undue influence.

__________________________

__________________________
Witness Signature



Address

__________________________

__________________________
Print Name

__________________________

__________________________
Witness Signature



Address

__________________________

__________________________
Print Name

ACKNOWLEDGMENT OF NOTARY PUBLIC

STATE OF _______________________
COUNTY OF _______________________, ss.

On this ____ day of _______________________, 20____, before me appeared
_______________________, as Principal of this Power of Attorney who proved to me
through government issued photo identification to be the above-named person, in my
presence executed foregoing instrument and acknowledged that he executed the same as
his free act and deed.






__________________________






Notary Public



(seal)




My Commission Expires: ______