Form 5188 - Durable Power of Attorney for Securities and Savings Bonds Transactions

For official use onl y:
Customer Name
Customer No.
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
1. APPOINTMENT
I,
, hereby appoint
(Name of Grantor)
as my attorney-in-fact.
(Name of Attorney-in-Fact)
2. AUTHORITY
(Check as ma ny boxes as you choose.)
A.
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
to others.
B.
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.
C.
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-
fact.
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.
Page 1/3
Free Download

Form 5188 - Durable Power of Attorney for Securities and Savings Bonds Transactions PDF

Favor this template? Just fancy it by voting!
  •  
  •  
  •  
  •  
  •  
(1 Votes)
3.0
Related Forms
  •  
  •  
  •  
  •  
  •  
1 Page(s) | 772 Views | 3 Downloads
  •  
  •  
  •  
  •  
  •  
3 Page(s) | 1161 Views | 0 Downloads
  •  
  •  
  •  
  •  
  •  
1 Page(s) | 1021 Views | 7 Downloads
  •  
  •  
  •  
  •  
  •  
1 Page(s) | 914 Views | 3 Downloads
  •  
  •  
  •  
  •  
  •  
9 Page(s) | 3014 Views | 23 Downloads