Durable Power of Attorney for Finances

5
I can amend or revoke this power of attorney through a writing delivered to my
agent. Revocation is not effective as to a third party until the third party learns of it.
Photocopies of this document can be relied upon as though they were originals.
SIGNATURE OF PRINCIPAL
I sign this document voluntarily, and I understand its purpose.
Dated: _______________ Signed: ______________________________________
(Your signature)
______________________________________________________________________
(Address)
STATEMENT AND SIGNATURE OF WITNESSES
We sign below as witnesses. This declaration was signed in our presence. The
declarant appears to be of sound mind, and to be making this designation voluntarily,
without duress, fraud or undue influence. Neither of us is an agent named in this
document.
_____________________ _____________________________________________
(Print name) (Signature of witness)
______________________________________________________________________
(Address)
____________________ ______________________________________________
(Print name) (Signature of witness)
______________________________________________________________________
(Address)
SIGNATURE OF NOTARY
Sworn to and signed by __________________________ this ___ day of 20__.
____________________________________________
(Signature of notary public)
County _______________________________
My commission expires ______________
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