1

CA Power of Attorney, Uniform Statutory Form 1

RECORDING REQUESTED BY

AND WHEN RECORDED MAIL TO:

Name

Street

Address

City, State

Zip

Order No. ________________

SPACE ABOVE THIS LINE FOR RECORDER'S USE

UNIFORM STATUTORY FORM POWER OF ATTORNEY

(California Probate Code Section 4401)

NOTICE: THE POWERS CRANGED BY THIS DOCUMENT ARE BROAD AND SWEEPING. THEY ARE EXPLAINED IN THE INIFORM STATUTORY FORM POWER OF ATTORNEY ACT (CALIFORNIA CIVIL CODE SECTIONS 2475-2499.5, INCLUSIVE). 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, _______________________

appoint _____________________

as my agent (attorney-in-fact) to act for me in any lawful way with respect to the following subjects indicated by signature:

TO GRANT ALL OF THE FOLLOWING POWERS, SIGN THE LINE IN FRONT OF (N) AND IGNORE THE LINES IN FORN OF THE OTHER POWERS.

TO GRANT ONE OR MORE, BUT FEWER THAN ALL, OF THE FOLLOWING POWERS, SIGN THE LINE IN FRONT OF EACH POWER YOU ARE GRANTING.

TO WITHHOLD A POWER, DO NOT SIGN THE LINE IN FRONT OF IT. YOU MAY, BUT NEED NOT, CROSS OUT EACH POWER WITHHELD.

SIGN

___________________________(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 THE POWERS LISTED ABOVE.

YOU NEED NOT SIGN ANY OTHER LINES IF YOU SIGN LIN (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 INCAPCITATED.

EXERCISE OF POWER OF ATTORNEY WHERE
MORE THAN ONE AGENT DESGNATED

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 WORKD ?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 until a 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 attorney.

Signed this _________ day of __________, 20 ______________

____________________________________

BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT.

CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC

STATE OF CALIFORNIA

COUNTY OF _______________________S.S.

On _____________________ before me, ___________________________

a Notary Public in and for said County and State, personally appeared _______________

________________________________________________________________________

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.

WITNESS my hand and official seal.

Signature ___________________________________________

(This area for official notorial seal)

No guidelines are available for this form at this time.

All content on Virtual Underwriter is subject to the terms shown here.