FLORIDA GENERAL DURABLE POWER OF ATTORNEY
THE POWERS YOU GRANT BELOW ARE EFFECTIVE
EVEN IF YOU BECOME DISABLED OR INCOMPETENT
This durable power of attorney is not affected by subsequent incapacity of the principal
except as provided in §709.08, Florida Statutes.
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. 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 ____________________________________________________________________________
_____________________________________________ [insert your name and address] appoint
_____________________________________________ [insert the name and address of the person
appointed] 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.
Note: If you initial Item A or Item B, which follow, a notarized signature will be required on behalf of
the Principal.
INITIAL

_______ (A) Real property transactions. To lease, sell, mortgage, purchase, exchange, and acquire, and
to agree, bargain, and contract for the lease, sale, purchase, exchange, and acquisition of, and to accept,
take, receive, and possess any interest in real property whatsoever, on such terms and conditions, and
under such covenants, as my Agent shall deem proper; and to maintain, repair, tear down, alter, rebuild,
improve manage, insure, move, rent, lease, sell, convey, subject to liens, mortgages, and security deeds,
and in any way or manner deal with all or any part of any interest in real property whatsoever, including
specifically, but without limitation, real property lying and being situated in the State of Florida, under such
terms and conditions, and under such covenants, as my Agent shall deem proper and may for all deferred
payments accept purchase money notes payable to me and secured by mortgages or deeds to secure debt,
and may from time to time collect and cancel any of said notes, mortgages, security interests, or deeds to
secure debt.

_______ (B) Tangible personal property transactions. To lease, sell, mortgage, purchase, exchange,
and acquire, and to agree, bargain, and contract for the lease, sale, purchase, exchange, and acquisition of,
and to accept, take, receive, and possess any personal property whatsoever, tangible or intangible, or
interest thereto, on such terms and conditions, and under such covenants, as my Agent shall deem proper;
and to maintain, repair, improve, manage, insure, rent, lease, sell, convey, subject to liens or mortgages, or
to take any other security interests in said property which are recognized under the Uniform Commercial
Code as adopted at that time under the laws of the State of Florida or any applicable state, or otherwise
hypothecate (pledge), and in any way or manner deal with all or any part of any real or personal property
whatsoever, tangible or intangible, or any interest therein, that I own at the time of execution or may
thereafter acquire, under such terms and conditions, and under such covenants, as my Agent shall deem
proper.
_______ (C) Stock and bond transactions. To purchase, sell, exchange, surrender, assign, redeem, vote
at any meeting, or otherwise transfer any and all shares of stock, bonds, or other securities in any business,
association, corporation, partnership, or other legal entity, whether private or public, now or hereafter
belonging to me.
_______ (D) Commodity and option transactions. To buy, sell, exchange, assign, convey, settle and
exercise commodities futures contracts and call and put options on stocks and stock indices traded on a
regulated options exchange and collect and receipt for all proceeds of any such transactions; establish or
continue option accounts for the principal with any securities or futures broker; and, in general, exercise all
powers with respect to commodities and options which the principal could if present and under no disability.

_______ (E) Banking and other financial institution transactions. To make, receive, sign, endorse,
execute, acknowledge, deliver and possess checks, drafts, bills of exchange, letters of credit, notes, stock
certificates, withdrawal receipts and deposit instruments relating to accounts or deposits in, or certificates of
deposit of banks, savings and loans, credit unions, or other institutions or associations. To pay all sums of
money, at any time or times, that may hereafter be owing by me upon any account, bill of exchange, check,
draft, purchase, contract, note, or trade acceptance made, executed, endorsed, accepted, and delivered by
me or for me in my name, by my Agent. To borrow from time to time such sums of money as my Agent may
deem proper and execute promissory notes, security deeds or agreements, financing statements, or other
security instruments in such form as the lender may request and renew said notes and security instruments
from time to time in whole or in part. To have free access at any time or times to any safe deposit box or
vault to which I might have access.

_______ (F) Business operating transactions. To conduct, engage in, and otherwise transact the affairs
of any and all lawful business ventures of whatever nature or kind that I may now or hereafter be involved in.
To organize or continue and conduct any business which term includes, without limitation, any farming,
manufacturing, service, mining, retailing or other type of business operation in any form, whether as a
proprietorship, joint venture, partnership, corporation, trust or other legal entity; operate, buy, sell, expand,
contract, terminate or liquidate any business; direct, control, supervise, manage or participate in the
operation of any business and engage, compensate and discharge business managers, employees, agents,
attorneys, accountants and consultants; and, in general, exercise all powers with respect to business
interests and operations which the principal could if present and under no disability.

_______ (G) Insurance and annuity transactions. To exercise or perform any act, power, duty, right, or
obligation, in regard to any contract of life, accident, health, disability, liability, or other type of insurance or
any combination of insurance; and to procure new or additional contracts of insurance for me and to
designate the beneficiary of same; provided, however, that my Agent cannot designate himself or herself as
beneficiary of any such insurance contracts.

_______ (H) Estate, trust, and other beneficiary transactions. To accept, receipt for, exercise, release,
reject, renounce, assign, disclaim, demand, sue for, claim and recover any legacy, bequest, devise, gift or
other property interest or payment due or payable to or for the principal; assert any interest in and exercise
any power over any trust, estate or property subject to fiduciary control; establish a revocable trust solely for
the benefit of the principal that terminates at the death of the principal and is then distributable to the legal
representative of the estate of the principal; and, in general, exercise all powers with respect to estates and
trusts which the principal could exercise if present and under no disability; provided, however, that the Agent
may not make or change a will and may not revoke or amend a trust revocable or amendable by the
principal or require the trustee of any trust for the benefit of the principal to pay income or principal to the
Agent unless specific authority to that end is given.

_______ (I) Claims and litigation. To commence, prosecute, discontinue, or defend all actions or other
legal proceedings touching my property, real or personal, or any part thereof, or touching any matter in
which I or my property, real or personal, may be in any way concerned. To defend, settle, adjust, make
allowances, compound, submit to arbitration, and compromise all accounts, reckonings, claims, and
demands whatsoever that now are, or hereafter shall be, pending between me and any person, firm,
corporation, or other legal entity, in such manner and in all respects as my Agent shall deem proper.

_______ (J) Personal and family maintenance. To hire accountants, attorneys at law, consultants, clerks,
physicians, nurses, agents, servants, workmen, and others and to remove them, and to appoint others in
their place, and to pay and allow the persons so employed such salaries, wages, or other remunerations, as
my Agent shall deem proper.

_______ (K) Benefits from Social Security, Medicare, Medicaid, or other governmental programs, or
military service. To prepare, sign and file any claim or application for Social Security, unemployment or
military service benefits; sue for, settle or abandon any claims to any benefit or assistance under any
federal, state, local or foreign statute or regulation; control, deposit to any account, collect, receipt for, and
take title to and hold all benefits under any Social Security, unemployment, military service or other state,
federal, local or foreign statute or regulation; and, in general, exercise all powers with respect to Social
Security, unemployment, military service, and governmental benefits, including but not limited to Medicare
and Medicaid, which the principal could exercise if present and under no disability.

_______ (L) Retirement plan transactions. To contribute to, withdraw from and deposit funds in any type
of retirement plan (which term includes, without limitation, any tax qualified or nonqualified pension, profit
sharing, stock bonus, employee savings and other retirement plan, individual retirement account, deferred
compensation plan and any other type of employee benefit plan); select and change payment options for the
principal under any retirement plan; make rollover contributions from any retirement plan to other retirement
plans or individual retirement accounts; exercise all investment powers available under any type of self-
directed retirement plan; and, in general, exercise all powers with respect to retirement plans and retirement
plan account balances which the principal could if present and under no disability.

_______ (M) Tax matters. To prepare, to make elections, to execute and to file all tax, social security,
unemployment insurance, and informational returns required by the laws of the United States, or of any state
or subdivision thereof, or of any foreign government; to prepare, to execute, and to file all other papers and
instruments which the Agent shall think to be desirable or necessary for safeguarding of me against excess
or illegal taxation or against penalties imposed for claimed violation of any law or other governmental
regulation; and to pay, to compromise, or to contest or to apply for refunds in connection with any taxes or
assessments for which I am or may be liable.

_______ (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.

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________
THIS POWER OF ATTORNEY IS EFFECTIVE IMMEDIATELY AND WILL CONTINUE UNTIL IT IS
REVOKED.

THIS POWER OF ATTORNEY SHALL BE CONSTRUED AS A GENERAL DURABLE POWER OF
ATTORNEY AND SHALL CONTINUE TO BE EFFECTIVE EVEN IF I BECOME DISABLED,
INCAPACITATED, OR INCOMPETENT.
(YOUR AGENT WILL HAVE AUTHORITY TO EMPLOY OTHER PERSONS AS NECESSARY TO ENABLE
THE AGENT TO PROPERLY EXERCISE THE POWERS GRANTED IN THIS FORM, BUT YOUR AGENT
WILL HAVE TO MAKE ALL DISCRETIONARY DECISIONS. IF YOU WANT TO GIVE YOUR AGENT THE
RIGHT TO DELEGATE DISCRETIONARY DECISION-MAKING POWERS TO OTHERS, YOU SHOULD
KEEP THE NEXT SENTENCE, OTHERWISE IT SHOULD BE STRICKEN.)

Authority to Delegate. My Agent shall have the right by written instrument to delegate any or all of the
foregoing powers involving discretionary decision-making to any person or persons whom my Agent may
select, but such delegation may be amended or revoked by any agent (including any successor) named by
me who is acting under this power of attorney at the time of reference.

(YOUR AGENT WILL BE ENTITLED TO REIMBURSEMENT FOR ALL REASONABLE EXPENSES
INCURRED IN ACTING UNDER THIS POWER OF ATTORNEY. STRIKE OUT THE NEXT SENTENCE IF
YOU DO NOT WANT YOUR AGENT TO ALSO BE ENTITLED TO REASONABLE COMPENSATION FOR
SERVICES AS AGENT.)

Right to Compensation. My Agent shall be entitled to reasonable compensation for services rendered as
agent under this power of attorney.

(IF YOU WISH TO NAME SUCCESSOR AGENTS, INSERT THE NAME(S) AND ADDRESS(ES) OF SUCH
SUCCESSOR(S) IN THE FOLLOWING PARAGRAPH.)

Successor Agent. If any Agent named by me shall die, become incompetent, resign or refuse to accept the
office of Agent, I name the following (each to act alone and successively, in the order named) as
successor(s) to such Agent:

________________________________________________________________________

________________________________________________________________________
Choice of Law. THIS POWER OF ATTORNEY WILL BE GOVERNED BY THE LAWS OF THE STATE OF
FLORIDA WITHOUT REGARD FOR CONFLICTS OF LAWS PRINCIPLES. IT WAS EXECUTED IN THE
STATE OF FLORIDA AND IS INTENDED TO BE VALID IN ALL JURISDICTIONS OF THE UNITED
STATES OF AMERICA AND ALL FOREIGN NATIONS.
I am fully informed as to all the contents of this form and understand the full import of this grant of powers to
my Agent.

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 learns 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]


STATEMENT OF WITNESS
On the date written above, the principal declared to me in my presence that this instrument is his general
durable power of attorney and that he or she had willingly signed or directed another to sign for him or her,
and that he or she executed it as his or her free and voluntary act for the purposes therein expressed.
_______________________________________ [Signature of Witness #1]
_______________________________________ [Printed or typed name of Witness #1]
_______________________________________ [Address of Witness #1, Line 1]
_______________________________________ [Address of Witness #1, Line 2]



_______________________________________ [Signature of Witness #2]
_______________________________________ [Printed or typed name of Witness #2]
_______________________________________ [Address of Witness #2, Line 1]
_______________________________________ [Address of Witness #2, Line 2]
A Note About Selecting Witnesses: The agent (attorney-in-fact) may not also serve as a
witness. Each witness must be present at the time that principal signs the Power of Attorney in
front of the notary. Each witness must be a mentally competent adult. Witnesses should ideally
reside close by, so that they will be easily accessible in the event they are one day needed to
affirm this document's validity.



CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC
STATE OF FLORIDA
COUNTY OF ________________

Sworn to (or affirmed) and subscribed before me this ______day of _____________ [month],
_________ [year] by ______________________________ [name of principal]. The affiant is
[choose one:] ____ personally known to me, or ____ produced the following identification:
________________________________.

[Notary Seal, if any]:


_______________________________
(Signature of Notarial Officer)

Notary Public for the State of Florida

My commission expires: ___________________



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]









PREPARATION STATEMENT
This document was prepared by the following individual:
________________________________________________
[Typed or Printed Name]

________________________________________________
[Signature]


AFFIDAVIT OF AGENT (ATTORNEY IN FACT)
STATE OF FLORIDA
COUNTY OF ________________
Before me, the undersigned authority, personally appeared ______________________________
_________________________________ (attorney in fact), ("Affiant"), who swore or affirmed
that:
1. Affiant is the attorney in fact named in the Florida General Durable Power of Attorney executed
by __________________________________ (principal) ("Principal") on _______________
(date).
2. This Florida General Durable Power of Attorney is currently exercisable by Affiant. The
principal is domiciled in _____________________________________________ (insert name of
state, territory, or foreign country).
3. To the best of the Affiant's knowledge after diligent search and inquiry:
a. The Principal is not deceased; and
b. There has been no revocation, partial or complete termination by adjudication of incapacity or
by the occurrence of an event referenced in the durable power of attorney, or suspension by
initiation of proceedings to determine incapacity or to appoint a guardian.
4. Affiant agrees not to exercise any powers granted by the Florida General Durable Power of
Attorney if Affiant attains knowledge that it has been revoked, partially or completely terminated,
suspended, or is no longer valid because of the death or adjudication of incapacity of the
Principal.

________________________________________________
[Signature of Affiant]

CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC
Sworn to (or affirmed) and subscribed before me this ______day of _____________ [month],
_________ [year] by ______________________________ [name of agent]. The affiant is
[choose one:] ____ personally known to me, or ____ produced the following identification:
________________________________.
[Notary Seal, if any]:




________________________________________
(Signature of Notarial Officer)

Notary Public for the State of Florida

My commission expires: ___________________