Power of Attorney: How Important Is It?

Defining Power of Attorney
A legal document that gives an individual (the agent) authority to act in behalf of the other person  (the principal). This is about legal representation, trust and assurance during transactions and decisions on crucial matters such as health, medical directives on proxy, organ donations upon death, consent for child care, consent for bank transactions, right to sell of properties, and declaration of living wills.

Persons involved in a Power of Attorney agreement:

Principal
An individual who signs the Power of Attorney, and thereby gives the appointed individual the authority to act on his or her behalf.

Agent
An person given authority by a Power of Attorney.

Attorney-in- Fact
Refers to the agent. An individual who is given authority by a Power of Attorney.

Types of Power of Attorney

General Power of Attorney
A Power of Attorney that gives the agent very broad powers to oversee, transact and conduct business on behalf of the principal.

Special Power of Attorney
A Power of Attorney that limits the agent's authority to certain specific areas or actions.

Durable Power of Attorney
A Power of Attorney that continues after the principal has been incapacitated.

Springing Power of Attorney
A Power of Attorney that does not become effective until a certain event occurs, such as the incapacity of the principal.

Sample Statutory Short Form Durable Power of Attorney

Connecticut Statutory Short Form Durable Power of Attorney


NOTICE: The powers granted by this document are broad and sweeping. They are defined in Connecticut Statutory Short Form Power of Attorney Act, sections 1-42 to 1-56, inclusive, of the general statutes, which expressly permits the use of any other or different form of power of attorney desired by the parties concerned. The grantor of any power of attorney or the attorney-in-fact may make application to a court of probate for an accounting as provided in subsection (b) of section 45a-175. 

Know All Men by These Presents, which are intended to constitute a GENERAL POWER OF ATTORNEY pursuant to Connecticut Statutory Short Form Power of Attorney Act: 


That I ________________________________________________________________ (insert name and address of the principal) do hereby appoint _____________________________________________________________________ (insert name and address of the agent, or each agent, if more than one is designated) my attorney(s)- in-fact TO ACT _________________ 


If more than one agent is designated and the principal wishes each agent alone to be able to exercise the power conferred, insert in this blank the word "severally". Failure to make any insertion or the insertion of the word "jointly" shall require the agents to act jointly. 


First: In my name, place and stead in any way which I myself could do, if I were personally present, with respect to the following matters as each of them is defined in the Connecticut Statutory Short Form Power of Attorney Act to the extent that I am permitted by law to act through an agent: 


(Strike out and initial in the opposite box any one or more of the subdivisions as to which the principal does NOT desire to give the agent authority. Such elimination of any one or more of subdivisions (A) to (L), inclusive, shall automatically constitute an elimination also of subdivision (M).) 

To strike out any subdivision the principal must draw a line through the text of that subdivision AND write his initials in the box opposite. 


(A) real estate transactions; (_____) 

(B) chattel and goods transactions; (______) 

(C) bond, share and commodity transactions; (______) 

(D) banking transactions; (______) 

(E) business operating transactions; (______) 

(F) insurance transactions; (______) 

(G) estate transactions; (______) 

(H) claims and litigation; (______) 

(I) personal relationships and affairs; (______) 

(J) benefits from military service; (______) 

(K) records, reports and statements; (______) 

(L) health care decisions; (______) 

(M) all other matters; (_____) 


___________________________________________________________________ 

___________________________________________________________________ 

___________________________________________________________________ 

___________________________________________________________________ 


(Special provisions and limitations may be included in the statutory short form power of attorney only if they conform to the requirements of the Connecticut Statutory Short Form Power of Attorney Act.) 


Second: With full and unqualified authority to delegate any or all of the foregoing powers to any person or persons whom my attorney(s)-in-fact shall select; 


Third: Hereby ratifying and confirming all that said attorney(s) or substitute(s) do or cause to be done. 


In Witness Whereof I have hereunto signed my name and affixed my seal this ______ day of ______________, 20_____. 

________________________ (Signature of Principal) (Seal)

On the date written above, ________________________________________________

declared to us that this instrument was [his/her] durable power of attorney, and request us to act as witnesses to it. [He/She] signed it in our presence, all of us being present at the same time. We now sign this instrument as witnesses.

________________________, Witness ________________________

________________________, Witness ________________________

ACKNOWLEDGMENT

STATE OF ____________________

COUNTY OF _______________ 

The foregoing instrument was acknowledged before me this ______ ____________________ by  ____________________.

_________________________ (Signature)

Title or Rank  _________________________ 

Serial No. if any  _________________________ 

Sample Statutory Power of Attorney for Property

You are allowing a trusted legal authority to represent transactions involving your property or real-estate.

COLORADO STATUTORY POWER OF ATTORNEY FOR PROPERTY

NOTICE: UNLESS YOU LIMIT THE POWER IN THIS DOCUMENT, THIS DOCUMENT GIVES YOUR AGENT THE POWER TO ACT FOR YOU, WITHOUT YOUR CONSENT, IN ANY WAY THAT YOU COULD ACT FOR YOURSELF. THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING. THEY ARE EXPLAINED IN THE "UNIFORM STATUTORY FORM POWER OF ATTORNEY ACT", PART 13 OF ARTICLE 1 OF TITLE 15, COLORADO REVISED STATUTES, AND PART 6 OF ARTICLE 14 OF TITLE 15, COLORADO REVISED STATUTES. 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. 

 

THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO HANDLE YOUR PROPERTY AND AFFAIRS, WHICH MAY INCLUDE POWERS TO PLEDGE, SELL, OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. THIS FORM DOES NOT IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS; BUT WHEN POWERS ARE EXERCISED, YOUR AGENT MUST USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE WITH THE PROVISIONS OF THIS FORM AND MUST KEEP A RECORD OF RECEIPTS, DISBURSEMENTS, AND SIGNIFICANT ACTIONS TAKEN AS AGENT. YOU MAY NAME SUCCESSOR AGENTS UNDER THIS FORM BUT NOT CO-AGENTS. UNTIL YOU REVOKE THIS POWER OF ATTORNEY OR A COURT ACTING ON YOUR BEHALF TERMINATES IT, YOUR AGENT MAY EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU MAY BECOME DISABLED, UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THIS POWER IN THE MANNER PROVIDED BELOW.

 

YOU MAY HAVE OTHER RIGHTS OR POWERS UNDER COLORADO LAW NOT SPECIFIED IN THIS FORM.

 

  I, _________________________________________________________, (insert your full name and address) appoint _____________________________________________________ (insert the full name and address of the person appointed) as my agent (attorney-in-fact) to act for me in any lawful way with respect to the following initialed subjects:

 

  TO GRANT ONE OR MORE OF THE FOLLOWING POWERS, INITIAL THE LINE IN FRONT OF EACH POWER YOU ARE GRANTING. TO WITHHOLD A POWER, DO NOT INITIAL THE LINE IN FRONT OF IT. YOU MAY, BUT NEED NOT, CROSS OUT EACH POWER WITHHELD.

 

  __________ (A) Real estate transactions (when property recorded).

  __________ (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 military service.

  __________ (L) Retirement plan transactions.

  __________ (M) Tax matters.

 

  UNLESS YOU DIRECT OTHERWISE ABOVE, THIS POWER OF ATTORNEY IS EFFECTIVE IMMEDIATELY AND WILL CONTINUE UNTIL IT IS REVOKED OR TERMINATED AS SPECIFIED BELOW. STRIKE THROUGH AND WRITE YOUR INITIALS TO THE LEFT OF THE FOLLOWING SENTENCE IF YOU DO NOT WANT THIS POWER OF ATTORNEY TO CONTINUE IF YOU BECOME DISABLED, INCAPACITATED, OR INCOMPETENT.

  1. ( ) This power of attorney will continue to be effective even though I become disabled, incapacitated, or incompetent.

  YOU MAY INCLUDE ADDITIONS TO AND LIMITATIONS ON THE AGENT’S POWERS IN THIS POWER OF ATTORNEY IF THEY ARE SPECIFICALLY DESCRIBED BELOW.

  2. The powers granted above shall not include the following powers or shall be modified or limited in the following manner (here you may include any specific limitations you deem appropriate, such as a prohibition of or conditions on the sale of particular stock or real estate or special rules regarding borrowing by the agent):

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

  3. In addition to the powers granted above, I grant my agent the following powers (here you may add any other delegable powers, such as the power to make gifts, exercise powers of appointment, name or change beneficiaries or joint tenants, or revoke or amend any trust specifically referred to below):

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

  4. SPECIAL INSTRUCTIONS. ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS TO YOUR AGENT:

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

  YOUR AGENT WILL BE ENTITLED TO REIMBURSEMENT FOR ALL REASONABLE EXPENSES INCURRED IN ACTING UNDER THIS POWER OF ATTORNEY. STRIKE THROUGH AND INITIAL THE NEXT SENTENCE IF YOU DO NOT WANT YOUR AGENT TO ALSO BE ENTITLED TO REASONABLE COMPENSATION FOR SERVICES AS AGENT.

  5. ( ) My agent is entitled to reasonable compensation for services rendered as agent under this power of attorney.

  THIS POWER OF ATTORNEY MAY BE AMENDED IN ANY MANNER OR REVOKED BY YOU AT ANY TIME. ABSENT AMENDMENT OR REVOCATION, THE AUTHORITY GRANTED IN THIS POWER OF ATTORNEY IS EFFECTIVE WHEN THIS POWER OF ATTORNEY IS SIGNED AND CONTINUES IN EFFECT UNTIL YOUR DEATH, UNLESS YOU MAKE A LIMITATION ON DURATION BY COMPLETING THE FOLLOWING:

  6. This power of attorney terminates on ___________________________________________ (Insert a future date or event, such as court determination of your disability, when you want this power to terminate prior to your death).

  BY RETAINING THE FOLLOWING PARAGRAPH, YOU MAY, BUT ARE NOT REQUIRED TO, NAME YOUR AGENT AS GUARDIAN OF YOUR PERSON OR CONSERVATOR OF YOUR PROPERTY, OR BOTH, IF A COURT PROCEEDING IS BEGUN TO APPOINT A GUARDIAN OR CONSERVATOR, OR BOTH, FOR YOU. THE COURT WILL APPOINT YOUR AGENT AS GUARDIAN OR CONSERVATOR, OR BOTH, IF THE COURT FINDS THAT SUCH APPOINTMENT WILL SERVE YOUR BEST INTERESTS AND WELFARE. STRIKE THROUGH AND INITIAL PARAGRAPH 7 IF YOU DO NOT WANT YOUR AGENT TO ACT AS GUARDIAN OR CONSERVATOR, OR BOTH.

  7. ( ) If a guardian of my person or a conservator for my property, or both, are to be appointed, I nominate the agent acting under this power of attorney as such guardian or conservator, or both, to serve without bond or security.

  IF YOU WISH TO NAME SUCCESSOR AGENTS, INSERT THE NAME AND ADDRESS OF ANY SUCCESSOR AGENT IN THE FOLLOWING PARAGRAPH:

  8. If any agent named by me shall die, become incapacitated, resign, or refuse to accept the office of agent, I name the following each to act alone and successively, in the order named, as successor to such agent:

___________________________________________________________________

___________________________________________________________________

For purposes of this paragraph 8, a person is considered to be incapacitated if and while the person is a minor or a person adjudicated incapacitated or if the person is unable to give prompt and intelligent consideration to business matters, as certified by a licensed physician.


  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 as to a third party until the third party learns 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 of attorney.

 

  Signed on _____________________________, __________.

 

  IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, IT MAY BE IN YOUR BEST INTEREST TO CONSULT A COLORADO LAWYER RATHER THAN SIGN THIS FORM.

 

  _____________________________________________

  (Your signature)

 

  _____________________________________________

  (Your Social Security number)

 

  YOU MAY, BUT ARE NOT REQUIRED TO, REQUEST YOUR AGENT AND SUCCESSOR AGENTS TO PROVIDE SPECIMEN SIGNATURES BELOW. IF YOU INCLUDE SPECIMEN SIGNATURES IN THIS POWER OF ATTORNEY, YOU MUST COMPLETE THE CERTIFICATION OPPOSITE THE SIGNATURES OF THE AGENTS.


NOTICE TO AGENTS: BY EXERCISING POWERS UNDER THIS DOCUMENT, THE AGENT ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT UNDER COLORADO LAW.

 

Specimen signatures of agent I certify that the signatures of my agent 

(and successors) (and successors) are correct.

 

______________________________________ ______________________________________

Agent Principal

 

______________________________________ ______________________________________

Successor Agent Principal

 

______________________________________ ______________________________________

Successor Agent Principal

 

 

STATE OF COLORADO )

  ) ss.

COUNTY OF ______________________________ )


This document was acknowledged before me on __________________ (date) by ____________

_________________________________ (name of principal) (who certifies the correctness of the signature(s) of the agent(s).) My commission expires: __________________________________

 

  _________________________________________

  Notary public

Sample Uniform Statutory Form Power of Attorney

A sample legal Uniform Statutory Form Power of Attorney from the State of California complete with certificate of acknowledgment of notary public and acknowledgment of agent

UNIFORM STATUTORY FORM POWER OF ATTORNEY

NOTICE: THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING. THEY ARE EXPLAINED IN THE UNIFORM STATUTORY FORM POWER OF ATTORNEY ACT (CALIFORNIA PROBATE CODE SECTIONS 4400 Prob. - 4465 Prob.).

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 HIS POWER OF ATTORNEY IF YOU LATER WISH TO DO SO.

I, [Your name and address] appoint [Name and address of the person appointed, or of each person appointed if you want to designate more than one] as my agent (attorney-in-fact) to act for me in any lawful way with respect to the following initialed subjects:

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

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

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

INITIAL
______ (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 OF THE POWERS LISTED ABOVE. YOU NEED NOT INITIAL ANY OTHER LINES IF YOU INITIAL LINE (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 INCAPACITATED. EXERCISE OF POWER OF ATTORNEY WHERE MORE THAN ONE AGENT DESIGNATED.

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 WORD "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 as to a third party until the 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 of attorney.

Signed this ____ day of ________________, 20___.


_________________________________________
(your signature)


_________________________________________
(your social security number)
 

CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC

STATE OF CALIFORNIA )
COUNTY OF ________________ )  

On __________________ before me, __________________________________________________________________________ (here insert name and title of the officer), personally appeared __________________________________________________________________________ __________________________________________________________________________, who 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. 

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. 

WITNESS my hand and official seal. 




_______________________________ (Seal)
Signature 

ACKNOWLEDGMENT OF AGENT

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

________________________________________________
[Typed or Printed Name of Agent]


________________________________________________
[Signature of Agent]


PREPARATION STATEMENT

This document was prepared by the following individual: 

________________________________________________
[Typed or Printed Name]
 

________________________________________________

[Signature]

Sample Statutory Short Form of General Power of Attorney

A special Statutory Short Form of General Power of Attorney from the State of North Carolina. This affidavit gives your lawyer the legal authority to represent your real estate, financial and business transactions.

Statutory Short Form of General Power of Attorney

NOTICE 

THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING. THEY ARE DEFINED IN CHAPTER 32A OF THE NORTH CAROLINA GENERAL STATUTES WHICH EXPRESSLY PERMITS THE USE OF ANY OTHER OR DIFFERENT FORM OF POWER OF ATTORNEY DESIRED BY THE PARTIES CONCERNED. 


State of ______________ 

County of ____________ 


I ____________________________, appoint __________________ to be my attorney in fact, to act in my name in any way which I could act for myself, with respect to the following matters as each of them is defined in Chapter 32A of the North Carolina General Statutes. (DIRECTIONS: Initial the line opposite any one or more of the subdivisions as to which the principal desires to give the attorney in fact authority.) 


______ (1) Real property transactions 

______ (2) Personal property transactions 

______ (3) Bond, share, stock, securities and commodity transactions 

______ (4) Banking transactions 

______ (5) Safe deposits 

______ (6) Business operating transactions 

______ (7) Insurance transactions 

______ (8) Estate transactions 

______ (9) Personal relationships and affairs 

______ (10) Social security and unemployment 

______ (11) Benefits from military service 

______ (12) Tax matters 

______ (13) Employment of agents 

______ (14) Gifts to charities, and to individuals other than the attorney in fact 

______ (15) Gifts to the named attorney in fact 


(If power of substitution and revocation is to be given, add: 'I also give to such person full power to appoint another to act as my attorney in fact and full power to revoke such appointment.') 

(If period of power of attorney is to be limited, add: 'This power terminates______________, ________') 

(If power of attorney is to be a durable power of attorney under the provision of Article 2 of Chapter 32A and is to continue in effect after the incapacity or mental incompetence of the principal, add: 'This power of attorney shall not be affected by my subsequent incapacity or mental incompetence.') 

(If power of attorney is to take effect only after the incapacity or mental incompetence of the principal, add: 'This power of attorney shall become effective after I become incapacitated or mentally incompetent.') 

(If power of attorney is to be effective to terminate or direct the administration of a custodial trust created under the Uniform Custodial Trust Act, add: 'In the event of my subsequent incapacity or mental incompetence, the attorney in fact of this power of attorney shall have the power to terminate or to direct the administration of any custodial trust of which I am the beneficiary.') 

(If power of attorney is to be effective to determine whether a beneficiary under the Uniform Custodial Trust Act is incapacitated or ceases to be incapacitated, add: 'The attorney in fact of this power of attorney shall have the power to determine whether I am incapacitated or whether my incapacity has ceased for the purposes of any custodial trust of which I am the beneficiary.') 


Dated___________, _______. 

  (Seal)

Signature __________________ 



STATE OF ____________________ COUNTY OF _______________ 

On this ______ day of___________, ______, personally appeared before me, the said named ______________________________ to me known and known to me to be the person described in and who executed the foregoing instrument and he (or she) acknowledged that he (or she) executed the same and being duly sworn by me, made oath that the statements in the foregoing instrument are true. 



My Commission Expires ______________________. 



__________________________ (Signature of Notary Public) 

Notary Public (Official Seal)

Sample Right To Sell Contract

EXCLUSIVE RIGHT TO SELL

For and in consideration of your services to be rendered in listing for sale and in undertaking to sell or find a purchaser for the property hereinafter described, the parties understand and agree that this is an exclusive listing to sell the real estate located at:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

together with the following improvements and fixtures:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________


The minimum selling price of the property shall be $______________ to be payable on the following terms:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________


You are authorized to accept and hold a deposit in the amount of $______________ as a deposit and to apply such deposit on the purchase price.

If said property is sold, traded or in any other way disposed of either by us or by anyone else within the time specified in this listing, it is agreed to and understood that you shall receive from the sale or trade of said property as your commission _____% of the purchase price. Should said property be sold or traded within _____ days after expiration of this listing agreement to a purchaser with whom you have been negotiating for the sale or trade of the property, the said commission shall be due and payable on demand.

We agree to furnish a certificate of title showing a good and merchantable title of record, and further agree to convey by good and sufficient warranty deed or guaranteed title on payment in full.

The listing contract shall continue until midnight of _________________, 20____.


Date: _________________


_______________________________
Owner


_______________________________
Owner



I accept this listing and agree to act promptly and diligently to procure a buyer for said property.



Date: _________________


_______________________________
Agent/Broker

Sample Health Care Proxy Affidavit

I, [Name]hereby appoint [Name, home address and telephone number] as my health care agent to make any and all health care decisions for me, except to the extent that I state otherwise. This proxy shall take effect only when and if I become unable to make my own health care decisions.

(2) Optional: Alternate Agent

If the person I appoint is unable, unwilling or unavailable to act as my health care agent, I hereby appoint [Name, home address and telephone number] as my health care agent to make any and all health care decisions for me, except to the extent that I state otherwise.

(3) Unless I revoke it or state an expiration date or circumstances under which it will expire, this proxy shall remain in effect indefinitely. (Optional: If you want this proxy to expire, state the date or conditions here.) This proxy shall expire (specify date or conditions): _____________________________________

_____________________________________

_____________________________________

(4) I direct my health care agent to make health care decisions according to my wishes and limitations, as he or she knows or as stated below. (If you want to limit your agent’s authority to make health care decisions for you or to give specific instructions, you may state your wishes or limitations here.) I direct my health care agent to make health care decisions in accordance with the following limitations and/or instructions (attach additional pages as necessary):

_____________________________________

_____________________________________

_____________________________________

Please note that in order for your agent to make health care decisions for you about artificial nutrition and hydration (nourishment and water provided by feeding tube and intravenous line), your agent must reasonably know your wishes. You can either tell your agent what your wishes are or include them in the above section. See instructions for sample language that you could use if you choose to include your wishes on this form, including your wishes about artificial nutrition and hydration.

Health Care Proxy, 2

(5) I also grant authority and power to my agent(s) to serve as my personal representative for purposes of the Health Insurance Portability and Accountability Act (HIPAA). My agent is authorized to execute any and all releases and other documents necessary in order to obtain disclosure of my patient records and other medical information subject to and protected by HIPAA.
(6) Your Identification (please print)
Name_____________________________________
Signature ______________Date ________________
Address___________________________________
(7) Witnesses: Two witnesses must be 18 years of age or older and cannot be the health care agent or alternate.
I declare that the person who signed this document appeared to execute the Health Care Proxy willinglyand free from duress. He or she signed (or asked another to sign for him or her) this document in my presence.
Witness 1:
Witness 2:
Signature:_________________  Signature: __________________
Print Name: ________________________________
Print Name: _______________________________
Address: __________________________________
Address: _________________________________
Tel. No.: __________________________________
Tel. No.: _________________________________
Optional: Organ and/or Tissue Donation
You may state wishes or instructions about organ and/or tissue donation on this form. A health care agent cannot make a decision about organ and/or tissue donation because the agent's authority ends upon your death. The law does provide for certain individuals in order of priority to consent to an organ and/or tissue donation on your behalf: your spouse, a son or daughter 18 years of age or older, either of your parents, a brother or sister 18 years of age or older, a guardian appointed by a court prior to the donor's death, or any other legally authorized person.
I hereby make an anatomical gift, to be effective upon my death, of (write your initials next to the statement of your choice):
Any organs and/or tissues
The following organs and/or tissues:
__________________________________
__________________________________
Limitations:
__________________________________
__________________________________

If you do not state your wishes or instructions regarding organ and/or tissue donation on this form, it will not mean that you do not wish to make a donation or prevent a person, who is otherwise authorized by law, to consent to a donation on your behalf.
Signed ___________________________ Date: ____________________________
Address:__________________________

Sample Statutory Form of Power of Attorney

Statutory form of power of attorney

A. The following statutory form of power of attorney is legally sufficient:

STATUTORY POWER OF ATTORNEY

NOTICE: THIS IS AN IMPORTANT DOCUMENT. THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING. THEY ARE EXPLAINED IN THE UNIFORM STATUTORY FORM POWER OF ATTORNEY ACT, CHAPTER 45, ARTICLE 5, PART 6 NMSA 1978. IF YOU HAVE ANY QUESTIONS ABOUT THESE POWERS, YOU SHOULD ASK A LAWYER TO EXPLAIN THEM TO YOU. THIS FORM DOES NOT PROHIBIT THE USE OF ANY OTHER FORM. YOU MAY REVOKE THIS POWER OF ATTORNEY IF YOU LATER WISH TO DO SO.

I, _________________________________________, (Name) reside at
___________________________________________,(Address).

I appoint _______________________________________________ (Name(s)) and address(es)) to serve as my attorney(s)-in-fact. If any attorney-in-fact appointed above is unable to serve, then I appoint _________________________________ to serve as successor attorney-in-fact in place of the person who is unable to serve. This power of attorney shall not be affected by my incapacity but will terminate upon my death unless I have revoked it prior to my death. I intend by this power of attorney to avoid a court-supervised guardianship or conservatorship. Should my attempt be defeated, I ask that my agent be appointed as guardian or conservator of my person or estate.

STRIKE THROUGH THE SENTENCE ABOVE IF YOU DO NOT WANT TO NOMINATE YOUR AGENT AS YOUR GUARDIAN OR CONSERVATOR.

CHECK AND INITIAL THE FOLLOWING PARAGRAPH ONLY IF YOU WANT YOUR ATTORNEY(S)-IN-FACT TO BE ABLE TO ACT ALONE AND INDEPENDENTLY OF EACH OTHER. IF YOU DO NOT CHECK AND INITIAL THE FOLLOWING PARAGRAPH AND MORE THAN ON PERSON IS NAMED TO ACT ON YOUR BEHALF THEN THEY MUST ACT JOINTLY.

(___ ) (initials) If more than one person is appointed to serve as my attorney-in-fact then they (initials) may act severally, alone and independently of each other.

My attorney(s)-in fact shall have the power to act in my name, place and stead in any way which I myself could do with respect to the following matters to the extent permitted by law:

INITIAL IN THE BOX IN FRONT OF EACH AUTHORIZATION WHICH YOU DESIRE TO GIVE TO YOUR ATTORNEY(S)-IN-FACT. YOUR ATTORNEY(S)-IN-FACT SHALL BE AUTHORIZED TO ENGAGE ONLY IN THOSE ACTIVITIES WHICH ARE INITIALED.

(initials)
(___) 1. real estate transactions.
(___) 2. stock and bond transactions.
(___) 3. commodity and option transactions.
(___) 4. tangible personal property transactions.
(___) 5. banking and other financial institution transactions.
(___) 6. business operating transactions.
(___) 7. insurance and annuity transactions.
(___) 8. estate, trust and other beneficiary transactions.
(___) 9. claims and litigation.
(___) 10. personal and family maintenance.
(___) 11. benefits from social security, Medicare, Medicaid or other government programs or civil or military service.
(___) 12. retirement plan transactions.
(___) 13. tax matters, including any transactions with the Internal Revenue Service.
(___) 14. decisions regarding lifesaving and life prolonging medical treatment.
(___) 15. decisions relating to medical treatment, surgical treatment, nursing care, medication, hospitalization, institutionalization in a nursing home or other facility and home health care.
(___) 16. transfer of property or income as a gift to the principal's spouse for the purpose of qualifying the principal for governmental medical assistance.
(___) 17. ALL OF THE ABOVE POWERS, INCLUDING FINANCIAL AND HEALTH CARE DECISIONS. IF YOU INITIAL THE BOX IN FRONT OF LINE 17, YOU NEED NOT INITIAL ANY OTHER LINES.

SPECIAL INSTRUCTIONS:

ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS
LIMITING OR EXTENDING THE POWERS YOU HAVE GRANTED TO YOUR AGENT.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
________________________________

CHECK AND INITIAL THE FOLLOWING PARAGRAPH IF YOU INTEND FOR THIS POWER OF ATTORNEY TO BECOME EFFECTIVE ONLY IF YOU BECOME INCAPACITATED. YOUR FAILURE TO DO SO WILL MEAN THAT YOUR ATTORNEY(S)-IN FACT ARE EMPOWERED TO ACT ON YOUR BEHALF FROM THE TIME YOU SIGN THIS DOCUMENT UNTIL YOUR DEATH UNLESS YOU REVOKE THE POWER BEFORE YOUR DEATH.


(___ ) (initials) This power of attorney shall become effective only if I become incapacitated. My attorney(s)-in-fact shall be entitled to rely on initials notarized statements from two qualified health care professionals, one of whom shall be a physician, as to my incapacity. By incapacity I mean that among other things, I am unable to effectively manage my personal care, property or financial affairs.

This power of attorney will not be affected by lapse of time. I agree that any third party who receives a copy of this power of attorney may act under it.

____________________________________ (Signature)

____________________________________ (Optional, but preferred: social security number)

Dated: ____________________,19______

ACKNOWLEDGEMENT

NOTICE: IF THIS POWER OF ATTORNEY AFFECTS REAL ESTATE, IT MUST BE RECORDED IN THE OFFICE OF THE COUNTY CLERK IN EACH COUNTY WHERE THE REAL ESTATE IS LOCATED.

STATE OF __________ )
) ss.
COUNTY OF__________ )

The foregoing instrument was acknowledged before me on
______________, 19______, by ___________________________________
_____________________________________________________________
(seal)

___________________________________
Notary Public

My commission expires:
_____________________________

BY ACCEPTING OR ACTING UNDER THE POWER OF ATTORNEY, YOUR AGENT ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT ACTING ON YOUR BEHALF and

THIS AFFIDAVIT IS FOR THE USE OF YOUR ATTORNEY(S)-IN FACT IF EVER YOUR ATTORNEY(S)-IN-FACT ACTS ON YOUR BEHALF UNDER YOUR WRITTEN POWER OF ATTORNEY.

AFFIDAVIT AS TO POWER OF ATTORNEY BEING IN FULL FORCE

STATE OF __________ )
) ss.
COUNTY OF__________ )

I/WE_________________________________ being duly sworn, state:

1. ___________________________________________ ("Principal") of __________________ County, New Mexico, signed a written Power of Attorney on ____________________,19_____, appointing the undersigned as his/her attorney(s)-in-fact.

2. As attorney(s)-in-fact and under and by virtue of the Power of Attorney, I/we have this date executed the following described instrument:________________________________________.

3. At the time of executing the above described instrument I/we had no actual knowledge or actual notice of revocation or termination of the Power of Attorney by death or otherwise, or notice of any facts indicating the same.

4. I/we represent that the principal is now alive; has not, at any time, revoked or repudiated the power of attorney; and the power of attorney still is in full force and effect.

5. I/we make this affidavit for the purpose of inducing _______________ to accept delivery of the above described instrument, as executed by me/us in my/our capacity of attorney(s)-in-fact for the Principal. ______________________________, Attorney-in-fact ________________________, Attorney-in-fact

Sworn to before me ____________________________ this ________ day
of_________________,19______.

___________________________________ Notary Public
My commission expires: ___________________________.

B. A statutory power of attorney is legally sufficient under the Uniform Statutory Form Power of Attorney Act, if the wording of the form complies substantially with Subsection A of this section, the form is properly completed, and the signature of the principal is acknowledged in any form permitted by law.
C. If the line in front of line 17 of the form under Subsection A of this section is initialed, an initial on the line in front of any other power does not limit the powers granted by line 17.
D. By accepting or acting under a power of attorney, statutory or otherwise, an attorney-in-fact assumes fiduciary and other legal responsibilities of an agent acting for the principal.