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1、N.Y. Statutory Short Form Power of Attorney Effective 09-01-09 POWER OF ATTORNEY NEW YORK STATUTORY SHORT FORM (a) CAUTION TO THE PRINCIPAL: Your Power of Attorney is an important document. As the “principal,” you give the person whom you choose (your “agent”) authority to spend your money and sell
2、or dispose of your property during your lifetime without telling you. You do not lose your authority to act even though you have given your agent similar authority. When your agent exercises this authority, he or she must act according to any instructions you have provided or, where there are no spe
3、cific instructions, in your best interest. “Important Information for the Agent” at the end of this document describes your agents responsibilities. Your agent can act on your behalf only after signing the Power of Attorney before a notary public. You can request information from your agent at any t
4、ime. If you are revoking a prior Power of Attorney by executing this Power of Attorney, you should provide written notice of the revocation to your prior agent(s) and to the financial institutions where your accounts are located. You can revoke or terminate your Power of Attorney at any time for any
5、 reason as long as you are of sound mind. If you are no longer of sound mind, a court can remove an agent for acting improperly. Your agent cannot make health care decisions for you. You may execute a “Health Care Proxy” to do this. The law governing Powers of Attorney is contained in the New York G
6、eneral Obligations Law, Article 5, Title 15. This law is available at a law library, or online through the New York State Senate or Assembly websites, www.senate.state.ny.us or www.assembly.state.ny.us. If there is anything about this document that you do not understand, you should ask a lawyer of y
7、our own choosing to explain it to you. (b) DESIGNATION OF AGENT(S): I, , hereby appoint:name and address of principalas my agent(s)name(s) and address(es) of agent(s)If you designate more than one agent above, they must act together unless you initial the statement below. () My agents may act SEPARA
8、TELY. (c) DESIGNATION OF SUCCESSOR AGENT(S): (OPTIONAL) If every agent designated above is unable or unwilling to serve, I appoint as my successor agent(s): name(s) and address(es) of successor agent(s) Successor agents designated above must act together unless you initial the statement below. () My
9、 successor agents may act SEPARATELY. (d) This POWER OF ATTORNEY shall not be affected by my subsequent incapacity unless I have stated otherwise below, under Modifications”. (e) This POWER OF ATTORNEY REVOKES any and all prior Powers of Attorney executed by me unless I have stated otherwise below,
10、under “Modifications.” If you are NOT revoking your prior Powers of Attorney, and if you are granting the same authority in two or more Powers of Attorney, you must also indicate under “Modifications” whether the agents given these powers are to act together or separately. (f) GRANT OF AUTHORITY: To
11、 grant your agent some or all of the authority below, either (1) Initial the bracket at each authority you grant, or (2) Write or type the letters for each authority you grant on the blank line at (P), and initial the bracket at (P). If you initial (P), you do not need to initial the other lines.I g
12、rant authority to my agent(s) with respect to the following subjects as defined in sections 51502A through 5-l502N of the New York General Obligations Law: () (A) real estate transactions; () (B) chattel and goods transactions; () (C) bond, share, and commodity transactions; () (D) banking transacti
13、ons; () (E) business operating transactions; () (F) insurance transactions; () (G) estate transactions; () (H) claims and litigation; () (I) personal and family maintenance; () (J) benefits from governmental programs or civil or military service; () (K) health care billing and payment matters; recor
14、ds, reports, and statements; () (L) retirement benefit transactions; () (M) tax matters; () (N) all other matters; () (O) full and unqualified authority to my agent(s) to delegate any or all of the foregoing powers to any person or persons whom my agent(s) select; () (P) EACH of the matters identifi
15、ed by the following letters . You need not initial the other lines if you initial line (P). (g) MODIFICATIONS: (OPTIONAL) In this section, you may make additional provisions, including language to limit or supplement authority granted to your agent. However, you cannot use this Modifications section
16、 to grant your agent authority to make major gifts or changes to interests in your property. If you wish to grant your agent such authority, you MUST complete the Statutory Major Gifts Rider. (h) MAJOR GIFTS AND OTHER TRANSFERS: STATUTORY MAJOR GIFTS RIDER: (OPTIONAL) In order to authorize your agent to make major
