For official use onl y:
FS Form 5188
Department of the Treasury
Bureau of the Fiscal Service
(Revised July 2015)
DURABLE POWER OF ATTORNEY FOR SECURITIES
AND SAVI NGS BONDS TRANSACTIONS
OMB No. 1530-0042
IMPORT ANT: F ollow instructio ns in filling out this form. You should be aw are that the making of an y false, fictitious, or fraudul ent claim o r
statement to the United States is a crime that is punishable by fine and/or imprisonment.
PRINT IN INK OR TYPE ALL INFORMATION
, hereby appoint
(Name of Grantor)
as my attorney-in-fact.
(Name of Attorney-in-Fact)
(Check as ma ny boxes as you choose.)
Relating to my Treasury securities and United States Savings Bonds and Notes, I authorize my
attorney-in-fact named above to perform any and all transactions that Treasury regulations permit an
attorney-in-fact to make. This authority includes the right to execute tax documents related to these
securities. This does not include the authority to make transfers to the attorney-in-fact or to make gifts
I authorize my attorney-in-fact named above to exercise any powers and duties, whether or not
discretionary, that I am authorized to perform regarding securities belonging to any trust, probate
estate, guardianship, conservatorship, custodianship, or other similar estate for which I am now, or
may later be, appointed as fiduciary.
In addition to one or both of the above, I authorize my attorney-in-fact to make gifts to others. I further
authorize my attorney-in-fact to make transfers (either for consideration or as a gift) to the attorney-in-
Authorized transactions may include, but are not limited to, changes of payment information, collection of
interest, redemptions, transfers, assignments, purchases by ACH (PayDirect
) or any other authorized
payment method, or reinvestments. The Bureau of the Fiscal Service will not be liable for any loss, cost, or
expense that you may incur as a result of transactions made by the attorney-in-fact appointed.
3. TERM AND DURABILIT Y
This power is effective until it is revoked in writing. (See Item 3 in the instructions for revocation
procedures.) This is a durable power of attorney that will not be affected by the grantor's subsequent
disability or incapacity.