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Oklahoma Public) _________________________________ Name typed, printed, or stamped -6- r of them is related to the principal by blood or marriage, or related to the attorney-in-fact by blood or marriage. _________________________________ Signature of person taking acknowledgment (Notaryecuted it as the free act and deed of the principal for the purposes expressed in the document, and the witnesses declared to me that they were each eighteen (18) years of age or over, and that neitheduly sworn, the principal declared to me and to the witnesses in my presence that the -5- instrument is his or her power of attorney, and that the principal has willingly and voluntarily made and ex_________________ (Witness), and ___________________________________ (Witness), whose names are signed to the foregoing instrument in their respective capacities, and all of these persons being by me f ________________________ ) Before me, the undersigned authority, on this ______day of _________________, ______, personally appeared _________________________________ (principal), ___________________________________________________ State: ___________________________________ * witnesses may not be under 18 or related by blood or marriage to the Principal or Agent State of OKLAHOMA ) ) ss County o__________ City: __________________________________ State: ___________________________________ Witness Signature*: ___________________________________ Name: ___________________________________ City: _willingly made and executed it as his or her free and voluntary act for the purposes expressed in this document. Witness Signature*: ___________________________________ Name: _________________________The principal has declared to me that this instrument is his or her power of attorney granting to the named attorney-in-fact the power and authority specified in this document, and that he or she has I believe the principal to be of sound mind. I am eighteen (18) years of age or older. I am not related to the principal by blood or marriage, or related to the attorney-in-fact by blood or marriage. notice to my Agent. Signed on ________________ (date), at _______________________ (city), Oklahoma. ________________________________ Signature of Principal The principal is personally known to me and iduciary duty, failure to act in good faith and/or willful misconduct, while acting under the authority of this Power of Attorney. I may revoke this Power of Attorney at any time by providing written without notice of such termination, shall be held harmless. -4- Agent shall not be liable for losses resulting from judgment errors made in good faith. However, Agent will be liable for breach of f the third party because of reliance on this power of attorney. If this Durable Power of Attorney is terminated by operation of law, any person relying in good faith on the authority of this document,ation 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 againstlicies I may own on the life of my Agent; and/or (c) my assets to be subject to a general power of appointment by my Agent. Any third party who receives a copy of this document may act under it. Revocent by this power-of-attorney are limited to the extent necessary to prevent (a) my income to be taxable to my Agent; (b) my Agent to have any rights or ownership with respect to any life insurance poperson needs to inquire as to the reasons for the use or issuance of this power-ofattorney or as to the disposition of any proceeds paid to my Agent based on this document. The powers granted to my Agvalid, illegal or unenforceable under applicable law, then the remaining unaffected parts of the document shall still remain in full force and effect and not be affected by any partial invalidity. No he listing of specific terms, rights, acts or powers are not intended to restrict or limit the definition or scope of powers granted herein in any manner. If any part of this document is held to be inting on my behalf, my Agent shall provide an accounting for all funds handled and all acts performed as my Agent. This Power of Attorney shall be construed as broadly as a General Power of Attorney. Ttorney. If desired, my Agent shall also be entitled to reasonable compensation for any services provided as my Agent If so requested by myself or any authorized personal representative or fiduciary ac/or to manage my financial resources and affairs properly. My Agent shall be entitled to reimbursement of all reasonable expenses incurred as a result of carrying out any provision of this Power of Atexcept as provided by any applicable statute). As used herein, "disability" or "incapacity" shall mean a lack of capacity to receive and evaluate information effectively, to communicate decisions, andrity of this document shall remain in full force and effect thereafter until my death. This Power of Attorney shall not terminate on my subsequent disability, incapacity or lack of mental competence (ent's estate. -3- This Durable Power of Attorney and the rights, powers, and authority of my Agent shall become effective immediately upon execution of this instrument. The rights, powers, and autho other entity, as may be appropriate. However, Agent may not disclaim assets, to which I would be entitled, if the result is that the disclaimed assets pass directly or indirectly to my Agent or my Agists at the time of such transfer. 17. To disclaim any interest (subject to other provisions of this document), which might be transferred or distributed to me from any other person, estate, trust, orsupport which my Agent may owe to others, excluding those whom I am legally obligated to support. 16. To transfer any of my assets to the trustee of any revocable trust created by me, if such trust exof my Agent, my Agent's estate, my Agent's creditors, or the creditors of my Agent's estate, or (c) use any of my assets to discharge any of my Agent's legal obligations, including any obligations of s, interests or rights, directly or indirectly, to my Agent, my Agent's estate, my Agent's creditors, or the creditors of my Agent's estate, (b) exercise any powers of appointment I may hold in favor l be non-cumulative and shall lapse at the end of each calendar year. However, my Agent may not, unless specifically authorized by this document, (a) gift, appoint, assign or designate any of my asset be limited to gifts that qualify for the federal gift tax annual exclusion, shall not exceed in value the federal gift tax annual exclusion amount in any one calendar year, and this annual right shalto minors may be made to the minor directly or parent, guardian or close friend of the minor or pursuant to the Uniform Gifts to Minors Act or the Uniform Transfers To Minors Act. Any gifts made shallsuch persons or organizations without regard to whether such gifts are a part of my estate planning or otherwise, and if necessary, to file any state and federal gift tax returns and documents. Gifts s, relating to tax matters and to negotiate, compromise or settle any matter with such agency. 15. To make gifts and charitable contributions of my real, personal, tangible or intangible property, to ut not limited to, federal, state, local or other income and tax returns and necessary and/or related documents; to obtain or provide information to and from any agency, including governmental agencievestment professionals, brokers and real estate agents. 14. To prepare, or cause to be prepared, sign, and/or file any documents with any federal, state, local or other governmental body, including, b interest in or may own or have an interest in, in the future. 13. To employ any professional and/or business assistance as may be appropriate, including but not limited to, attorneys, accountants, inhts, including proxy rights, with respect to stocks, bonds, debentures, commodities, options or any other investments. -2- 12. To maintain and/or operate any business that I currently own or have aned or leased by me alone or in conjunction with any other person, including access to their contents, and to examine, remove, keep or otherwise dispose of the contents. 11. To exercise any and all rigegotiate, sell or transfer any note, security, or draft of the United States of America, including U.S. Treasury Securities. 10. To have access to any safe deposit box, vault or other storage area ownpassbooks, drafts, warrants, money orders, certificates, cashier checks, cash or vouchers payable to me by any person, firm, corporation or political entity; to perform any act necessary to deposit, nal institution with respect to any of my accounts, including, but not limited to, making deposits and withdrawals, negotiating or endorsing any checks or other instruments, obtaining bank statements, certificates of deposit, investment accounts, brokerage accounts, retirement plan accounts, and other similar accounts with financial institutions; to conduct any business with any banking or financias my "Representative Payee" for the purpose of receiving Social Security benefits. 9. To open, maintain and/or close bank accounts, including, but not limited to, checking accounts, savings accounts,y government or its agencies in connection with governmental benefits (including but not limited to, medical, military and social security benefits), and to appoint anyone, including my Agent, to act ans, insurance benefits and government program including, but not limited to, Social Security and Medicare; to prepare applications, provide information, and perform any other reasonable request by anlections and disclaimers under such policies. 8. To receive, deposit, hold, demand, deal with and/or sue to recover all payments I receive from any annuity, pension, retirement benefits, retirement pl apply for, purchase, maintain and/or deal with insurance and annuity contracts, insurance policies, including life insurance upon my life or the life of any other appropriate person and to make any eo remove tenants and to recover possession; and the right to ask for, demand, sue for, collect, recover and receive all monies which may become due and owing to me by reason of such transaction. 7. Toe by me) and to execute any necessary document, instrument or deed for such transactions. This includes the right to sell or encumber any homestead that I now own or may own in the future; the right th terms and at prices my Agent may deem proper) deal with all, any part or any interest in any real or personal property or asset whatsoever, tangible or intangible (now owned or acquired in the futur I have or may hereafter acquire any interest, to have, or use. 6. To maintain, manage, insure, lease, rent, sell, mortgage, improve, repair, exchange, invest, reinvest and in any other manner (on sucates of deposit, any and all documents of title and demands whatsoever, whether agreed to or disputed, now due or due -1- in the future, owned by, due, owing payable, or belonging to, me or in whicho receive, hold, possess and/or invest any and all sums of money, accounts, debts, bonds, commercial papers, checks, drafts, causes of action, bequests, deposits, notes, interests, dividends, certific legal steps necessary to recover and collect any amount or debt owed to me. 4. To adjust, compromise and settle any claim, against me or asserted on my behalf against any other person or entity. 5. T, lien, judgments, security agreements and other debts and obligations and such other instruments in writing of whatever kind and nature as may be. 3. To request, ask, demand, sue and take any and allof deposit of, or investments with or through banks, savings and loan, brokers, mutual fund companies or other institutions, proofs of loss, evidences of debts, releases, and satisfaction of mortgagesortgages, notes, insurance policies, receipts, title documents, checks, drafts, letters of credit, stock certificates, proxies, warrants, commercial papers, withdrawal and deposit slips, certificates and/or agreement, including but not limited to applications, assignments, bills of sale or lading, bonds, contracts, covenants, conveyances, deeds, options, trust deeds, security agreements, leases, md or nature, on my behalf and in my name. 2. To enter into binding contracts on my behalf and to sign, endorse and execute any written agreement and document necessary to enter into any such contract ower of attorney and the rights hereby granted. My Agent's powers and authority shall include, but not be limited to: 1. To conduct, engage in, and transact any and all lawful business of whatever kinr whatsoever as I could do if personally present. I hereby ratify and confirm all acts that my Agent, or my Agent's substitute or substitutes, shall lawfully do or cause to be done by virtue of this pbligation whatsoever that I now have or may later acquire in connection with or relating to any person, item, transaction, thing, business, property, real or personal, tangible or intangible, or matte____________________________ my true and lawful attorney-in-fact for me and in my name, and in my behalf. My Agent shall have full power and authority to perform any act, power, duty, legal right or otaining an address at _______________________________________________ do hereby make and appoint ________________________________________ ("Agent") maintaining an address at: _________________________ other legal responsibilities of an agent. -3- OKLAHOMA DURABLE POWER OF ATTORNEY Effective Immediately KNOW ALL PERSONS BY THESE PRESENTS: I, ____________________________________ ("Principal") mainical and other health-care decisions for you. You may revoke this power of attorney if you later wish to do so. AGENT: By accepting or acting under the appointment, the agent assumes the fiduciary and scope of this power of attorney document, is legally binding upon you. If you have any questions about these powers, obtain competent legal advice. This document does not authorize anyone to make medon ("agent") with the power to handle business and legal matters on your behalf, including the power to sell, mortgage or dispose of your property. Any such action undertaken by your agent, within the CAUTION! PRINCIPAL: The Powers granted by this power of attorney document are broad and sweeping. Before signing this document, consider its consequences. You ("principal") are providing another persmation is general information that is not state specific. Whenever appropriate, the instructions included with the forms packages offered for sale, generally include state specific instructions. -2- a Durable Power of Attorney be witnessed, it is always a very good idea to do so. Please note that this information is not intended as and is not a substitute for legal advice. Furthermore, this infory third party to challenge the validity of the Power of Attorney and will allow the Durable Power of Attorney to be recorded as a public record, if necessary. Although, some states don't require that le Power of Attorney should always be notarized, even if your state does not require it, especially if the Agent will be dealing with any real property. Notarization will make it more difficult for anny action undertaken by the Agent, within the scope of the Power of Attorney document, will be legally binding upon the Grantor. The Grantor can revoke a Durable Power of Attorney at any time. A Durabyer. Almost anyone can be appointed an Attorney-In-Fact by a power of attorney. The Agent should be a competent adult. A Power of Attorney is a "powerful" instrument and should be granted with care. Al (i.e. the Grantor) later becomes incapacitated. Note that the word "attorney" is not used here to mean "lawyer". The person acting as the Attorney-In-Fact for the Principal does not need to be a lawey-InFact") to act on his or her behalf, even if the Principal later becomes incapacitated. This particular Form becomes effective immediately and remains in full force and effect even if the Principaf Attorney Effective Immediately A Durable Power of Attorney allows a natural "mentally" competent person (called the "Principal" or "Grantor") to authorize someone else (called the "Agent" or "Attornefore negotiating any document with another party. [_] The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com. -1- Information Durable Power oended and are not a substitute for legal advice. These forms should only be a starting point for you and should not be used without consulting with an attorney first. An Attorney should be consulted bon of the Agent. The powers granted by this document are very broad and sweeping, as the Agent has the power to handle business and legal matters on the Principal's behalf. [_] These forms are not intdocument as needed. [_] The Principal should be careful in instructing the Agent (or attorney-in-fact) as to the tasks the Agent should complete. The Grantor should also be very careful in the selectises may not be under 18 or related by blood or marriage to the Principal or Agent. [_] The Principal should keep the original document, as well as a copy. The Agent should have access to the original l allow the Durable Power of Attorney to be recorded as a public record, if necessary. [_] In Oklahoma, two witnesses also need to sign the Power of Attorney at the same time as the Notary. The witnesen if the Principal (i.e. the Grantor) becomes subsequently incapacitated. [_] The Principal (i.e. the person granting the power of Attorney) should sign the document before a Notary. Notarization wilation for Durable Power of Attorney Effective Immediately; (3) Durable Power of Attorney Effective Immediately [_] This Durable Power of Attorney becomes effective immediately and remains effective evInstructions & Checklist Oklahoma Durable Power of Attorney Effective Immediately [_] This package contains (1) Instructions & Checklist for Durable Power of Attorney Effective Immediately; (2) Inform OklahomaOklahoma ic) _________________________________ Name typed, printed, or stamped -6- them is related to the principal by blood or marriage, or related to the attorney-in-fact by blood or marriage. _________________________________ Signature of person taking acknowledgment (Notary Publd it as the free act and deed of the principal for the purposes expressed in the document, and the witnesses declared to me that they were each eighteen (18) years of age or over, and that neither of duly sworn, the principal declared to me and to the witnesses in my presence that the instrument is his or her power of attorney, and that the principal has willingly and voluntarily made and execute____________ (Witness), and ___________________________________ (Witness), whose names are signed to the foregoing instrument in their respective capacities, and all of these persons being by me -5- _____________________ ) Before me, the undersigned authority, on this ______day of _________________, ______, personally appeared _________________________________ (principal), ___________________________________________________ State: ___________________________________ * witnesses may not be under 18 or related by blood or marriage to the Principal or Agent State of OKLAHOMA ) ) ss County of ________ City: __________________________________ State: ___________________________________ Witness Signature*: ___________________________________ Name: ___________________________________ City: ______ngly made and executed it as his or her free and voluntary act for the purposes expressed in this document. Witness Signature*: ___________________________________ Name: ______________________________rincipal has declared to me that this instrument is his or her power of attorney granting to the named attorney-in-fact the power and authority specified in this document, and that he or she has williieve the principal to be of sound mind. I am eighteen (18) years of age or older. I am not related to the principal by blood or marriage, or related to the attorney-in-fact by blood or marriage. The pe to my Agent. Signed on ________________ (date), at _______________________ (city), Oklahoma. ________________________________ Signature of Principal The principal is personally known to me and I belary duty, failure to act in good faith and/or willful misconduct, while acting under the authority of this Power of Attorney. I may revoke this Power of Attorney at any time by providing written noticout notice of such termination, shall be held harmless. -4- Agent shall not be liable for losses resulting from judgment errors made in good faith. However, Agent will be liable for breach of fiducithird party because of reliance on this power of attorney. If this Durable Power of Attorney is terminated by operation of law, any person relying in good faith on the authority of this document, with 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 s I may own on the life of my Agent; and/or (c) my assets to be subject to a general power of appointment by my Agent. Any third party who receives a copy of this document may act under it. Revocationy this power-of-attorney are limited to the extent necessary to prevent (a) my income to be taxable to my Agent; (b) my Agent to have any rights or ownership with respect to any life insurance policien needs to inquire as to the reasons for the use or issuance of this power-ofattorney or as to the disposition of any proceeds paid to my Agent based on this document. The powers granted to my Agent b, illegal or unenforceable under applicable law, then the remaining unaffected parts of the document shall still remain in full force and effect and not be affected by any partial invalidity. No persosting of specific terms, rights, acts or powers are not intended to restrict or limit the definition or scope of powers granted herein in any manner. If any part of this document is held to be invalidon my behalf, my Agent shall provide an accounting for all funds handled and all acts performed as my Agent. This Power of Attorney shall be construed as broadly as a General Power of Attorney. The liy. If desired, my Agent shall also be entitled to reasonable compensation for any services provided as my Agent If so requested by myself or any authorized personal representative or fiduciary acting as certified in writing by a licensed medical doctor. My Agent shall be entitled to reimbursement of all reasonable expenses incurred as a result of carrying out any provision of this Power of Attornein, "disability" or "incapacity" shall mean a lack of capacity to receive and evaluate information effectively, to communicate decisions, and/or to manage my financial resources and affairs properly, t thereafter until my death. This Power of Attorney shall not terminate on my subsequent disability, incapacity or lack of mental competence, except as provided by any applicable statute. As used herecome effective upon my subsequent disability or incapacity as certified in writing by a licensed medical doctor. The rights, powers, and authority of this document shall remain in full force and effecI would be entitled, if the result is that the disclaimed assets pass directly or indirectly to my Agent or my Agent's estate. This Durable Power of Attorney and all rights and powers therein shall beof this document), which might be transferred or distributed to me from any other person, estate, trust, or other entity, as may be appropriate. However, Agent may not disclaim assets, to -3- which ort. 16. To transfer any of my assets to the trustee of any revocable trust created by me, if such trust exists at the time of such transfer. 17. To disclaim any interest (subject to other provisions or (c) use any of my assets to discharge any of my Agent's legal obligations, including any obligations of support which my Agent may owe to others, excluding those whom I am legally obligated to suppeditors, or the creditors of my Agent's estate, (b) exercise any powers of appointment I may hold in favor of my Agent, my Agent's estate, my Agent's creditors, or the creditors of my Agent's estate, ot, unless specifically authorized by this document, (a) gift, appoint, assign or designate any of my assets, interests or rights, directly or indirectly, to my Agent, my Agent's estate, my Agent's cr in value the federal gift tax annual exclusion amount in any one calendar year, and this annual right shall be non-cumulative and shall lapse at the end of each calendar year. However, my Agent may nor pursuant to the Uniform Gifts to Minors Act or the Uniform Transfers To Minors Act. Any gifts made shall be limited to gifts that qualify for the federal gift tax annual exclusion, shall not exceedanning or otherwise, and if necessary, to file any state and federal gift tax returns and documents. Gifts to minors may be made to the minor directly or parent, guardian or close friend of the minor . 15. To make gifts and charitable contributions of my real, personal, tangible or intangible property, to such persons or organizations without regard to whether such gifts are a part of my estate pl related documents; to obtain or provide information to and from any agency, including governmental agencies, relating to tax matters and to negotiate, compromise or settle any matter with such agencyed, sign, and/or file any documents with any federal, state, local or other governmental body, including, but not limited to, federal, state, local or other income and tax returns and necessary and/or and/or business assistance as may be appropriate, including but not limited to, attorneys, accountants, investment professionals, brokers and real estate agents. 14. To prepare, or cause to be prepartions or any other investments. 12. To maintain and/or operate any business that I currently own or have an interest in or may own or have an interest in, in the future. 13. To employ any professionalheir contents, and to examine, remove, keep or otherwise dispose of the contents. 11. To exercise any and all rights, including proxy rights, with respect to stocks, bonds, debentures, commodities, opuding U.S. Treasury Securities. -2- 10. To have access to any safe deposit box, vault or other storage area owned or leased by me alone or in conjunction with any other person, including access to table to me by any person, firm, corporation or political entity; to perform any act necessary to deposit, negotiate, sell or transfer any note, security, or draft of the United States of America, inclsits and withdrawals, negotiating or endorsing any checks or other instruments, obtaining bank statements, passbooks, drafts, warrants, money orders, certificates, cashier checks, cash or vouchers payand other similar accounts with financial institutions; to conduct any business with any banking or financial institution with respect to any of my accounts, including, but not limited to, making depon, maintain and/or close bank accounts, including, but not limited to, checking accounts, savings accounts, certificates of deposit, investment accounts, brokerage accounts, retirement plan accounts, ted to, medical, military and social security benefits), and to appoint anyone, including my Agent, to act as my "Representative Payee" for the purpose of receiving Social Security benefits. 9. To ope and Medicare; to prepare applications, provide information, and perform any other reasonable request by any government or its agencies in connection with governmental benefits (including but not limi and/or sue to recover all payments I receive from any annuity, pension, retirement benefits, retirement plans, insurance benefits and government program including, but not limited to, Social Securitylicies, including life insurance upon my life or the life of any other appropriate person and to make any elections and disclaimers under such policies. 8. To receive, deposit, hold, demand, deal witht, recover and receive all monies which may become due and owing to me by reason of such transaction. 7. To apply for, purchase, maintain and/or deal with insurance and annuity contracts, insurance pos includes the right to sell or encumber any homestead that I now own or may own in the future; the right to remove tenants and to recover possession; and the right to ask for, demand, sue for, collecy real or personal property or asset whatsoever, tangible or intangible (now owned or acquired in the future by me) and to execute any necessary document, instrument or deed for such transactions. Thie, lease, rent, sell, mortgage, improve, repair, exchange, invest, reinvest and in any other manner (on such terms and at prices my Agent may deem proper) deal with all, any part or any interest in anto or disputed, now due or due in the future, owned by, due, owing payable, or belonging to, me or in which I have or may hereafter acquire any interest, to have, or use. 6. To maintain, manage, insurs, commercial papers, checks, drafts, causes of action, bequests, deposits, notes, interests, dividends, certificates of deposit, any and all documents of title and demands whatsoever, whether agreed mpromise and settle any claim, against me or asserted on my behalf against any other person or entity. -1- 5. To receive, hold, possess and/or invest any and all sums of money, accounts, debts, bondents in writing of whatever kind and nature as may be. 3. To request, ask, demand, sue and take any and all legal steps necessary to recover and collect any amount or debt owed to me. 4. To adjust, coompanies or other institutions, proofs of loss, evidences of debts, releases, and satisfaction of mortgages, lien, judgments, security agreements and other debts and obligations and such other instrumedit, stock certificates, proxies, warrants, commercial papers, withdrawal and deposit slips, certificates of deposit of, or investments with or through banks, savings and loan, brokers, mutual fund cding, bonds, contracts, covenants, conveyances, deeds, options, trust deeds, security agreements, leases, mortgages, notes, insurance policies, receipts, title documents, checks, drafts, letters of cr to sign, endorse and execute any written agreement and document necessary to enter into any such contract and/or agreement, including but not limited to applications, assignments, bills of sale or la, but not be limited to: 1. To conduct, engage in, and transact any and all lawful business of whatever kind or nature, on my behalf and in my name. 2. To enter into binding contracts on my behalf andy Agent, or my Agent's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights hereby granted. My Agent's powers and authority shall includeny person, item, transaction, thing, business, property, real or personal, tangible or intangible, or matter whatsoever as I could do if personally present. I hereby ratify and confirm all acts that mdiscretions. My Agent shall have full power and authority to perform any act, power, duty, legal right or obligation whatsoever that I now have or may later acquire in connection with or relating to a__________________________ maintaining an address at: _____________________________________________________ as my alternate or successor Agent, as necessary, to serve with the same powers, rights and _________________________________________ my true and lawful attorney-in-fact for me and in my name, and in my behalf. If the above named Agent is unable to serve for any reason, I appoint ___________ncipal") maintaining an address at _______________________________________________ do hereby make and appoint ________________________________________ ("Agent") maintaining an address at: ____________ciary and other legal responsibilities of an agent. -3- OKLAHOMA DURABLE POWER OF ATTORNEY Effective upon Disability KNOW ALL PERSONS BY THESE PRESENTS: I, ____________________________________ ("Pri make medical and other health-care decisions for you. You may revoke this power of attorney if you later wish to do so. AGENT: By accepting or acting under the appointment, the agent assumes the fiduithin the scope of this power of attorney document, is legally binding upon you. If you have any questions about these powers, obtain competent legal advice. This document does not authorize anyone tother person ("agent") with the power to handle business and legal matters on your behalf, including the power to sell, mortgage or dispose of your property. Any such action undertaken by your agent, wns. -2- CAUTION! PRINCIPAL: The Powers granted by this power of attorney document are broad and sweeping. Before signing this document, consider its consequences. You ("principal") are providing anohis information is general information that is not state specific. Whenever appropriate, the instructions included with the forms packages offered for sale, generally include state specific instructioo so. Two witnesses are necessary, if the Agent will deal with any real estate in Florida. Please note that this information is not intended as and is not a substitute for legal advice. Furthermore, tlow the Durable Power of Attorney to be recorded as a public record, if necessary. Although, some states don't require that a Durable Power of Attorney be witnessed, it is always a very good idea to d require it, especially if the Agent will be dealing with any real property. Notarization will make it more difficult for any third party to challenge the validity of the Power of Attorney and will als Power of Attorney is signed, in the event the original Agent is unable to serve or continue to serve as the Agent. A Durable Power of Attorney should always be notarized, even if your state does notDurable Power of Attorney at any time. Since this Durable Power of Attorney takes effect only after the Principal becomes disabled or incompetent, an alternate Agent can be designated, at the time thily binding upon the Principal. This is especially important if the Principal is incapacitated when the Power of Attorney goes into effect, or the Agent undertakes the acts. The Principal can revoke a power of attorney. A Power of Attorney is a "powerful" instrument and should be granted with care. Any action undertaken by the Agent, within the scope of the Power of Attorney document, will be legalhe word "attorney" is not used here to mean "lawyer". The person acting as the attorney-in-fact for the Principal does not need to be a lawyer. Almost anyone can be appointed an attorney-in-fact by a AttorneyIn-Fact") to act on his or her behalf, even if the Principal later becomes incapacitated. This particular Form becomes effective upon the disability or incapacity of the Principal. Note that t Attorney Effective upon Disability A Durable Power of Attorney allows a natural "mentally competent " person (called the "Principal" or "Principal") to authorize someone else (called the "Agent" or "before negotiating a document with another party. [_] The purchase and use of these forms, is subject to the Disclaimers and Terms of Use found at findlegalforms.com -1- Information Durable Power oftended and are not a substitute for legal advice. These forms should only be a starting point for you and should not be used without consulting with an attorney first. An Attorney should be consulted at the first choice as Agent is unable to serve or continue to serve as the Agent. This section can be removed, deleted (and initialed) or the words "no one" can be entered. [_] These forms are not invery broad and sweeping, as the Agent has the power to handle business and legal matters on the Principal's behalf. [_] This document offers the option of nominating an alternate Agent in the event thn instructing the Agent (or attorney-in-fact) as to the tasks the Agent should complete. The Grantor should also be very careful in the selection of the Agent. The powers granted by this document are o the Principal or Agent. [_] The Principal should keep the original document, as well as a copy. The Agent should have access to the original document as needed. [_] The Principal should be careful i public record, if necessary. [_] In Oklahoma, two witnesses also need to sign the Power of Attorney at the same time as the Notary. The witnesses may not be under 18 or related by blood or marriage tof the Principal. [_] The Principal (i.e. the person granting the Power of Attorney) should sign the document before a Notary. Notarization will allow the Durable Power of Attorney to be recorded as a) Information for Durable Power of Attorney Effective upon Disability; (3) Durable Power of Attorney Effective upon Disability [_] This Durable Power of Attorney becomes effective upon the Disability Instructions & Checklist Oklahoma Durable Power of Attorney Effective upon Disability [_] This package contains (1) Instructions & Checklist for Durable Power of Attorney Effective upon Disability; (2 OklahomaOklahoma amped -6- to the attorney-in-fact by blood or marriage. _________________________________ Signature of person taking acknowledgment (Notary Public) _________________________________ Name typed, printed, or stxpressed in the document, and the witnesses declared to me that they were each eighteen (18) years of age or over, and that neither of them is related to the principal by blood or marriage, or relatedesence that the -5- instrument is his or her power of attorney, and that the principal has willingly and voluntarily made and executed it as the free act and deed of the principal for the purposes eWitness), whose names are signed to the foregoing instrument in their respective capacities, and all of these persons being by me duly sworn, the principal declared to me and to the witnesses in my prthis ______day of _________________, ______, personally appeared _________________________________ (principal), ___________________________________ (Witness), and ___________________________________ (_____ * witnesses may not be under 18 or related by blood or marriage to the Principal or Agent State of OKLAHOMA ) ) ss County of ________________________ ) Before me, the undersigned authority, on ______________________ Witness Signature*: ___________________________________ Name: ___________________________________ City: __________________________________ State: ______________________________the purposes expressed in this document. Witness Signature*: ___________________________________ Name: ___________________________________ City: __________________________________ State: _____________r of attorney granting to the named attorney-in-fact the power and authority specified in this document, and that he or she has willingly made and executed it as his or her free and voluntary act for age or older. I am not related to the principal by blood or marriage, or related to the attorney-in-fact by blood or marriage. The principal has declared to me that this instrument is his or her powe_______ (city), Oklahoma. ________________________________ Signature of Principal The principal is personally known to me and I believe the principal to be of sound mind. I am eighteen (18) years ofle acting under the authority of this Power of Attorney. I may revoke this Power of Attorney at any time by providing written notice to my Agent. Signed on ________________ (date), at ________________hall not be liable for losses resulting from judgment errors made in good faith. However, Agent will be liable for breach of fiduciary duty, failure to act in good faith and/or willful misconduct, whineral Power of Attorney is terminated by operation of law, any person relying in good faith on the authority of this document, without notice of such termination, shall be held harmless. -4- Agent sthe 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. If this Gect to a general power of appointment by my Agent. 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 nt (a) my income to be taxable to my Agent; (b) my Agent to have any rights or ownership with respect to any life insurance policies I may own on the life of my Agent; and/or (c) my assets to be subjepower-ofattorney or as to the disposition of any proceeds paid to my Agent based on this document. The powers granted to my Agent by this power-of-attorney are limited to the extent necessary to prevenaffected parts of the document shall still remain in full force and effect and not be affected by any partial invalidity. No person needs to inquire as to the reasons for the use or issuance of this estrict or limit the definition or scope of powers granted herein in any manner. If any part of this document is held to be invalid, illegal or unenforceable under applicable law, then the remaining uandled and all acts performed as my Agent. This Power of Attorney shall be construed broadly as a General Power of Attorney. The listing of specific terms, rights, acts or powers are not intended to rnsation for any services provided as my Agent If so requested by myself or any authorized personal representative or fiduciary acting on my behalf, my Agent shall provide an accounting for all funds hll be entitled to reimbursement of all reasonable expenses incurred as a result of carrying out any provision of this Power of Attorney. If desired, my Agent shall also be entitled to reasonable compeity" or "incapacity" shall mean a lack of capacity to receive and evaluate information effectively, to communicate decisions, and/or to manage my financial resources and affairs properly. My Agent shathis instrument. The rights, powers, and -3- authority of this document shall remain in full force and effect thereafter until my death or until my disability or incapacity. As used herein, "disabilts pass directly or indirectly to my Agent or my Agent's estate. This General Power of Attorney and the rights, powers, and authority of my Agent shall become effective immediately upon execution of uted to me from any other person, estate, trust, or other entity, as may be appropriate. However, Agent may not disclaim assets, to which I would be entitled, if the result is that the disclaimed asseany revocable trust created by me, if such trust exists at the time of such transfer. 17. To disclaim any interest (subject to other provisions of this document), which might be transferred or distrib's legal obligations, including any obligations of support which my Agent may owe to others, excluding those whom I am legally obligated to support. 16. To transfer any of my assets to the trustee of cise any powers of appointment I may hold in favor of my Agent, my Agent's estate, my Agent's creditors, or the creditors of my Agent's estate, or (c) use any of my assets to discharge any of my Agent gift, appoint, assign or designate any of my assets, interests or rights, directly or indirectly, to my Agent, my Agent's estate, my Agent's creditors, or the creditors of my Agent's estate, (b) exern any one calendar year, and this annual right shall be non-cumulative and shall lapse at the end of each calendar year. However, my Agent may not, unless specifically authorized by this document, (a)iform Transfers To Minors Act. Any gifts made shall be limited to gifts that qualify for the federal gift tax annual exclusion, shall not exceed in value the federal gift tax annual exclusion amount i and federal gift tax returns and documents. Gifts to minors may be made to the minor directly or parent, guardian or close friend of the minor or pursuant to the Uniform Gifts to Minors Act or the Uneal, personal, tangible or intangible property, to such persons or organizations without regard to whether such gifts are a part of my estate planning or otherwise, and if necessary, to file any stateand from any agency, including governmental agencies, relating to tax matters and to negotiate, compromise or settle any matter with such agency. 15. To make gifts and charitable contributions of my rate, local or other governmental body, including, but not limited to, federal, state, local or other income and tax returns and necessary and/or related documents; to obtain or provide information to ding but not limited to, attorneys, accountants, investment professionals, brokers and real estate agents. 14. To prepare, or cause to be prepared, sign, and/or file any documents with any federal, stperate any business that I currently own or have an interest in or may own or have an interest in, in the future. 13. To employ any professional and/or business assistance as may be appropriate, incluse of the contents. 11. To exercise any and all rights, including proxy rights, with respect to stocks, bonds, debentures, commodities, options or any other investments. -2- 12. To maintain and/or oy safe deposit box, vault or other storage area owned or leased by me alone or in conjunction with any other person, including access to their contents, and to examine, remove, keep or otherwise dispo entity; to perform any act necessary to deposit, negotiate, sell or transfer any note, security, or draft of the United States of America, including U.S. Treasury Securities. 10. To have access to ans or other instruments, obtaining bank statements, passbooks, drafts, warrants, money orders, certificates, cashier checks, cash or vouchers payable to me by any person, firm, corporation or politicalto conduct any business with any banking or financial institution with respect to any of my accounts, including, but not limited to, making deposits and withdrawals, negotiating or endorsing any checkot limited to, checking accounts, savings accounts, certificates of deposit, investment accounts, brokerage accounts, retirement plan accounts, and other similar accounts with financial institutions; and to appoint anyone, including my Agent, to act as my "Representative Payee" for the purpose of receiving Social Security benefits. 9. To open, maintain and/or close bank accounts, including, but nion, and perform any other reasonable request by any government or its agencies in connection with governmental benefits (including but not limited to, medical, military and social security benefits),nnuity, pension, retirement benefits, retirement plans, insurance benefits and government program including, but not limited to, Social Security and Medicare; to prepare applications, provide informate of any other appropriate person and to make any elections and disclaimers under such policies. 8. To receive, deposit, hold, demand, deal with and/or sue to recover all payments I receive from any and owing to me by reason of such transaction. 7. To apply for, purchase, maintain and/or deal with insurance and annuity contracts, insurance policies, including life insurance upon my life or the lifhat I now own or may own in the future; the right to remove tenants and to recover possession; and the right to ask for, demand, sue for, collect, recover and receive all monies which may become due ae or intangible (now owned or acquired in the future by me) and to execute any necessary document, instrument or deed for such transactions. This includes the right to sell or encumber any homestead te, invest, reinvest and in any other manner (on such terms and at prices my Agent may deem proper) deal with all, any part or any interest in any real or personal property or asset whatsoever, tangibldue, owing payable, or belonging to, me or in which I have or may hereafter acquire any interest, to have, or use. 6. To maintain, manage, insure, lease, rent, sell, mortgage, improve, repair, exchangts, deposits, notes, interests, dividends, certificates of deposit, any and all documents of title and demands whatsoever, whether agreed to or disputed, now due or due -1- in the future, owned by, my behalf against any other person or entity. 5. To receive, hold, possess and/or invest any and all sums of money, accounts, debts, bonds, commercial papers, checks, drafts, causes of action, beques. To request, ask, demand, sue and take any and all legal steps necessary to recover and collect any amount or debt owed to me. 4. To adjust, compromise and settle any claim, against me or asserted ons of debts, releases, and satisfaction of mortgages, lien, judgments, security agreements and other debts and obligations and such other instruments in writing of whatever kind and nature as may be. 3papers, withdrawal and deposit slips, certificates of deposit of, or investments with or through banks, savings and loan, brokers, mutual fund companies or other institutions, proofs of loss, evidenceptions, trust deeds, security agreements, leases, mortgages, notes, insurance policies, receipts, title documents, checks, drafts, letters of credit, stock certificates, proxies, warrants, commercial document necessary to enter into any such contract and/or agreement, including but not limited to applications, assignments, bills of sale or lading, bonds, contracts, covenants, conveyances, deeds, oransact any and all lawful business of whatever kind or nature, on my behalf and in my name. 2. To enter into binding contracts on my behalf and to sign, endorse and execute any written agreement and lawfully do or cause to be done by virtue of this power of attorney and the rights hereby granted. My Agent's powers and authority shall include, but not be limited to: 1. To conduct, engage in, and t real or personal, tangible or intangible, or matter whatsoever as I could do if personally present. I hereby ratify and confirm all acts that my Agent, or my Agent's substitute or substitutes, shall y to perform any act, power, duty, legal right or obligation whatsoever that I now have or may later acquire in connection with or relating to any person, item, transaction, thing, business, property,aintaining an address at: _____________________________________________________ my true and lawful attorney-in-fact for me and in my name, and in my behalf. My Agent shall have full power and authorit________________________________ ("Principal") maintaining an address at _______________________________________________ do hereby make and appoint ________________________________________ ("Agent") mting or acting under the appointment, the agent assumes the fiduciary and other legal responsibilities of an agent. -3- OKLAHOMA GENERAL POWER OF ATTORNEY KNOW ALL PERSONS BY THESE PRESENTS: I, ____petent 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. AGENT: By accepe of your property. Any such action undertaken by your agent, within the scope of this power of attorney document, is legally binding upon you. If you have any questions about these powers, obtain com consider its consequences. You ("principal") are providing another person ("agent") with the power to handle business and legal matters on your behalf, including the power to sell, mortgage or disposs offered for sale, generally include state specific instructions. -2- CAUTION! PRINCIPAL: The Powers granted by this power of attorney document are broad and sweeping. Before signing this document,ded as and is not a substitute for legal advice. Furthermore, this information is general information that is not state specific. Whenever appropriate, the instructions included with the forms packagelled a Durable Power of Attorneys (available at findlegalforms.com as well), stays in effect even if the Grantor later becomes disabled or incapacitated. Please note that this information is not intenorded as a public record, if necessary. Although, some states don't require that a General Power of Attorney be witnessed, it is always a very good idea to do so. Another type of Power of Attorney, cae dealing with any real property. Notarization will make it more difficult for any third party to challenge the validity of the Power of Attorney and will allow the General Power of Attorney to be rec Grantor. The Grantor can revoke a General Power of Attorney at any time. A General Power of Attorney should always be notarized, even if your state does not require it, especially if the Agent will bA Power of Attorney is a "powerful" instrument and should be granted with care. Any action undertaken by the Agent, within the scope of the Power of Attorney document, will be legally binding upon theperson acting as the Attorney-In-Fact for the Principal does not need to be a lawyer. Almost anyone can be appointed an Attorney-In-Fact by a power of attorney. The Agent should be a competent adult. effective immediately and remains effective until the death of the Grantor or until the Grantor becomes disabled or incapacitated. Note that the word "attorney" is not used here to mean "lawyer". The natural "mentally" competent person (called the "Principal" or "Grantor") to authorize someone else (called the "Agent" or "Attorney-InFact") to act on his or her behalf. This particular Form becomes ty. [_] The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com -1- Information General Power of Attorney A General Power of Attorney allows a . These forms should only be a starting point for you and should not be used without consulting with an attorney first. An Attorney should be consulted before negotiating any document with another parument are very broad and sweeping, as the Agent has the power to handle business and legal matters on the Principal's behalf. [_] These forms are not intended and are not a substitute for legal advice careful in instructing the Agent (or attorney-in-fact) as to the tasks the Agent should complete. The Grantor should also be very careful in the selection of the Agent. The powers granted by this docmarriage to the Principal or Agent. [_] The Principal should keep the original document, as well as a copy. The Agent should have access to the original document as needed. [_] The Principal should beorded as a public record, if necessary. [_] In Oklahoma, two witnesses also need to sign the Power of Attorney at the same time as the Notary. The witnesses may not be under 18 or related by blood or ] The Principal (i.e. the person granting the Power of Attorney; sometimes called the Grantor) should sign the document before a Notary. Notarization will allow the General Power of Attorney to be recneral Power of Attorney [_] This General Power of Attorney becomes effective immediately and remains effective until the death of the Grantor or until the Grantor becomes disabled or incapacitated. [_Instructions & Checklist Oklahoma General Power of Attorney [_] This package contains (1) Instructions & Checklist for General Power of Attorney; (2) Information for General Power of Attorney; (3) Ge OklahomaOklahoma of person taking acknowledgment (Notary Public) _________________________________ Name typed, printed, or stamped -4- ) years of age or over, and that neither of them is related to the principal by blood or marriage, or related to the attorney-in-fact by blood or marriage. _________________________________ Signature s willingly and voluntarily made and executed it as the free act and deed of the principal for the purposes expressed in the document, and the witnesses declared to me that they were each eighteen (18cities, and all of these persons being by me duly sworn, the principal declared to me and to the witnesses in my presence that the instrument is his or her power of attorney, and that the principal ha_____________ (principal), ___________________________________ (Witness), and ___________________________________ (Witness), whose names are signed to the foregoing instrument in their respective capa or stamped State of OKLAHOMA ) ) ss County of ________________________ ) Before me, the undersigned authority, on this ______day of _________________, ______, personally appeared ____________________related to the attorney-in-fact by blood or marriage. _________________________________ Signature of person taking acknowledgment (Notary Public) _________________________________ Name typed, printed,poses expressed in the document, and the witnesses declared to me that they were each eighteen (18) years of age or over, and that neither of them is related to the principal by blood or marriage, or sses in my presence that the instrument is his or her power of attorney, and that the principal has willingly and voluntarily made and executed it as the free act and deed of the principal for the pur_____ (Witness), whose names are signed to the foregoing instrument in their respective capacities, and all of these persons being by me -3- duly sworn, the principal declared to me and to the witnety, on this ______day of _________________, ______, personally appeared _________________________________ (principal), ___________________________________ (Witness), and ___________________________________________ * witnesses may not be under 18 or related by blood or marriage to the Principal or Agent State of OKLAHOMA ) ) ss County of ________________________ ) Before me, the undersigned authori_______________________________ Witness Signature*: ___________________________________ Name: ___________________________________ City: __________________________________ State: ______________________ act for the purposes expressed in this document. Witness Signature*: ___________________________________ Name: ___________________________________ City: __________________________________ State: ____r the Care of Children granting to the named attorney-in-fact the power and authority specified in this document, and that he or she has willingly made and executed it as his or her free and voluntary I am not related to the principals by blood or marriage, or related to the attorney-in-fact by blood or marriage. The principals have declared to me that this instrument is their Power of Attorney foher ________________________________ Signature of Mother The principals (father and mother) are personally known to me and I believe them to be of sound mind. I am eighteen (18) years of age or older. date at any time by providing written notice to the Attorney-in-Fact. Signed on ________________ (date), at _______________________ (city), Oklahoma. ________________________________ Signature of Fatof law, any person relying in good faith on the authority of this document, without notice of such termination, shall be held harmless. -2- We may revoke this Power of Attorney before the expirationrevocation. We agree to indemnify the third party for any claims that arise against the third party because of reliance on this power of attorney. If this Power of Attorney is terminated by operation dity. 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 to be invalid, illegal or unenforceable under applicable law, then the remaining unaffected parts of the document shall still remain in full force and effect and not be affected by any partial invalid. The Attorney-in-Fact shall be entitled to reimbursement of all reasonable expenses incurred as a result of carrying out any provision of this Power of Attorney. If any part of this document is heldimport of this grant of powers to the Attorney-in-Fact named herein. We hereby ratify and confirm all acts by the Attorney-in-Fact done by virtue of this power of attorney and the rights hereby granteney shall be in effect from _______________ to _______________ ("expiration date"). By signing here, we indicate that we are fully informed as to the contents of this document and understand the full ning procedures for any child/children; (ii) have the power to consent to the marriage of our child/children; (iii) have the power to consent to the adoption of our child/children. This power of attorts, claims, agreements, contracts and legal documents. Notwithstanding other provisions in this Power of Attorney, Attorney-in-Fact shall not (i) have the authority to withhold or withdraw life sustaince company. 6. Endorse and execute any documents necessary for the performance of the powers granted by this document, including but not limited to consent forms, releases, waivers, insurance documen Apply for, purchase, maintain and/or deal with any health and other insurance for our child/children and to make and file any medical or other type of claim against any health or other type of insuraemand, sue and take any and all legal steps necessary on behalf of our child/children and to adjust, compromise and settle any claim, our child/children may have against any other person or entity. 5.n the customary living standard of the child/children, including, but not limited to, provisions of living quarters, food, clothing, entertainment and other customary matters. -1- 4. Request, ask, dlar activities; review any school records of the child/children; allow our child/children to participate in activities and events offered by any group, organization or educational facility. 3. Maintaince of operations, diagnostic and other procedures. 2. Determine the education of our child/children and to register and enroll our child/children in any educational programs, schools and extracurricuities incident to the provision of medical, surgical or dental care to our child/children. Health care shall include but not be limited to the administration of anesthesia, X-ray examination, performaeeded for such health care; review and if necessary disclose the contents of any medical records; execute any consent, release or waiver of liability required by medical, dental or other health authorto, the powers to: 1. Provide for, approve, authorize and decline any health care at any hospital or other institution; employ any physicians, dentists, nurses, or other person whose services may be nd authority to act entirely in loco parentis and to do all acts necessary or desirable for maintaining the health, education, and welfare of our above named child/children, including, but not limited ______ born on __________ Name: _________________________________ born on __________ Name: _________________________________ born on __________ The above named Attorney-in-Fact shall have the power an_____________________________ born on __________ Name: _________________________________ born on __________ Name: _________________________________ born on __________ Name: ________________________________________________________________________ as our true and lawful agent and attorney-in-fact for us and in our name, and in our behalf to act as the guardian of our minor child/children: Name: ____incipals", maintaining an address at: ________________________________________ hereby make and appoint ________________________________________ ("Attorney-in-Fact") maintaining an address at: ________ KNOW ALL PERSONS BY THESE PRESENTS: We ______________________________________________________ ("Father") and ______________________________________ ("Mother"), jointly referred to as "Parents" or "PrTTORNEY-IN-FACT: By accepting or acting under the appointment, the Attorney-in-Fact assumes the fiduciary and other legal responsibilities of an agent. -3- POWER OF ATTORNEY FOR THE CARE OF CHILDRENscope of this power of attorney document, is legally binding upon you. If you have any questions about these powers, obtain competent legal advice. You may revoke this power of attorney at any time. Ag another person ("Attorney-in-Fact") with the power to handle and control the care, custody, health and welfare of your child/children. Any such action undertaken by the Attorney-in-Fact, within the N! PARENTS: The powers granted by this Power of Attorney for the Care of Children document are broad and sweeping. Before signing this document, consider its consequences. You ("Parents") are providinis general information that is not state specific. Whenever appropriate, the instructions included with the forms packages offered for sale, generally include state specific instructions. -2- CAUTIO a Power of Attorney be witnessed, it is always a very good idea to do so. Please note that this information is not intended as and is not a substitute for legal advice. Furthermore, this information rized, even if your state does not require it. Notarization will make it more difficult for any third party to challenge the validity of the Power of Attorney. Although, some states don't require thatdren has a beginning and an "end/expiration" date, the Parents can revoke the document at any time even before the expiration date. The Power of Attorney for the Care of Children should always be notaentrusted to the Attorney-in-Fact. The Parents should also be careful in instructing the Attorney-in-Fact as to what the Attorney-in-Fact should do. Although the Power of Attorney for the Care of Chilovide this type of document. The Parents should be very careful in the selection of the Attorney-in-Fact, as the powers granted by this document are very broad and sweeping and the children are being id potential problems when, for example, arranging for medical, dental or any other type of care. Medical personnel will also generally feel more comfortable dealing with an Attorney-inFact who can prstody of the children to the Attorney-infact. By having this type of document available, the Attorney-in-Fact will be able to better deal with any types of emergency involving the children and can avo, education and welfare decisions. This can be useful if the parent will be absent for a period of time. The powers granted by this instrument are very broad. Parents are basically giving temporary cuwyer. Almost anyone can be appointed an Attorney-in-Fact by a power of attorney. This form allows the Attorney-in-Fact to make decisions for the children in place of the parents, including health carer Attorney-in-Fact to care for their children. The word "attorney" is not used here to mean "lawyer". The person acting as the Attorney-in-Fact for the Parents or the children does not need to be a lar of Attorney for the Care of Children form can be used. This document allows parents of one or more children (sometimes called the "Principals" or "Grantors") to appoint another person to act as theirms of Use found at findlegalforms.com -1- Information Power of Attorney for the Care of Children Whenever it becomes necessary to allow someone else to provide for the care of your children, a Poweice. These forms should only be a starting point for you and should not be used without consulting with an attorney first. [_] The purchase and use of these forms, is subject to the Disclaimers and Teso be very careful in the selection of the Attorney-in-Fact, as the powers granted by this document are very broad and sweeping. [_] These forms are not intended and are not a substitute for legal adve witnesses may not be under 18 or related by blood or marriage to the Parents or Attorney-in-Fact. [_] The Parents should be careful giving instructions to the Attorney-in-Fact. The Parents should alould keep a copy of the Power of Attorney for the Care of Children document for their records. [_] In Oklahoma, two witnesses also need to sign the Power of Attorney at the same time as the Notary. Thhe Power of Attorney for the Care of Children document before a Notary. [_] The original Power of Attorney for the Care of Children document should be given to the Attorney-in-Fact. [_] The Parents sh3) additional useful information about Power of Attorney for the Care of Children documents. [_] Both Parents need to sign the Power of Attorney for the Care of Children. [_] The Parents should sign tInstructions & Checklist Oklahoma Power of Attorney for the Care of Children [_] This package contains a (1) Power of Attorney for the Care of Children; (2) simple instructions plus a checklist; and ( OklahomaOklahoma ______________________________________________ -5- ______________________________________ _____________________________________________ (Witness Signature) Print Name: ___________________________________ Address: ______________________________________ve was signed in my presence. _____________________________________________ (Witness Signature) Print Name: ___________________________________ Address: ______________________________________ ________ay of _____________, 20 _____. ________________________________________ (Signature) ___________________________________________________________ City, County and State of Residence This advance directive, my prior directives are revoked. f. I understand the full importance of this advance directive and I am emotionally and mentally competent to make this advance directive. Signed this ___________ de in effect until it is revoked. d. I understand that I may revoke this advance directive at any time. e. I understand and agree that if I have any prior directives, and if I sign this advance directifuse medical or surgical treatment including, but not limited to, the administration of any life-sustaining procedures, and I accept the consequences of such refusal. c. This advance directive shall btions regarding the use of life-sustaining procedures, it is my intention that this advance directive shall be honored by my family and physicians as the -4- final expression of my legal right to reas pregnant and that diagnosis is known to my attending physician, this advance directive shall have no force or effect during the course of my pregnancy. b. In the absence of my ability to give direcicate otherwise. ______________________________________________________________________________ _______________________ (signature) V. General Provisions a. I understand that if I have been diagnosed eted both a living will and have appointed a health care proxy, and if there is a conflict between my health care proxy's decision and my living will, my living will shall take precedence unless I ind] tissue, [___] arteries, [___] eyes/cornea/lens, [___] glands, [___] other _____________ ______________ _______________________ (signature) IV. Conflicting Provision I understand that if I have comply entire body; or [___] The following body organs or parts: [___] lungs, [___] liver, [___] pancreas, [___] heart, [___] kidneys, [___] brain, [___] skin, [___] bones/marrow, [___] bloods/fluids, [___th means either irreversible cessation of circulatory and respiratory functions or irreversible cessation of all functions of the entire brain, including the brain stem. I specifically donate: [___] M or body parts be donated for purposes of transplantation, therapy, advancement of medical or dental science or research or education pursuant to the provisions of the Uniform Anatomical Gift Act. Dea_________________________________________________________ _______________________ (signature) III. Anatomical Gifts -3- I direct that at the time of my death my entire body or designated body organsd other medical directives, if any) _________________________________________________________________________ _________________________________________________________________________ ________________n this paragraph, I am authorizing the withholding and withdrawal of artificially administered nutrition and hydration. _______________________ (signature) (3) I authorize my health care proxy to (adarticular importance. I understand that if I do not sign this paragraph, artificially administered nutrition (food) and hydration (water) will be administered to me. I further understand that if I sigawareness of self and environment are absent. _______________________ (signature) (2) I understand that the subject of the artificial administration of nutrition and hydration (food and water) is of pg treatment be withheld or withdrawn if such treatment will only serve to maintain me in an irreversible condition, as determined by my attending physician and another physician, in which thought and ____________________________________________________________ _______________________ (signature) c. If I am persistently unconscious: (1) I authorize my health care proxy to direct that life-sustainin_____________________ (signature) (3) I authorize my health care proxy to (add other medical directives, if any) _________________________________________________________________________ _____________ydration (water) will be administered to me. I further understand that if I sign this paragraph, I am authorizing the withholding or withdrawal of artificially administered nutrition and hydration. __he artificial administration of nutrition and hydration (food and water) is of particular importance. I understand that if I do not sign this paragraph, artificially administered nutrition (food) or hble condition that even with the administration of life-sustaining treatment will cause my death within six (6) months. _______________________ (signature) -2- (2) I understand that the subject of ttaining treatment be withheld or withdrawn if such treatment would only prolong my process of dying and if my attending physician and another physician determine that I have an incurable and irreversiade by my health care proxy or alternate health care proxy only as I indicate in the following sections. b. If I have a terminal condition: (1) I authorize my health care proxy to direct that life-sus with the same authority. My health care proxy is authorized to make whatever medical treatment decisions I could make if I were able, except that decisions regarding lifesustaining treatment can be m______, whom I appoint as my health care proxy. If my health care proxy is unable or unwilling to serve, I appoint ___________________________________________________ as my alternate health care proxyysician and other health care providers pursuant to the Oklahoma Rights of the Terminally Ill or Persistently Unconscious Act to follow the instructions of ____________________________________________ My Appointment of My Health Care Proxy a. If my attending physician and another physician determine that I am no longer able to make decisions regarding my medical treatment, I direct my attending ph____________ _________________________________________________________________________ _________________________________________________________________________ _______________________ (signature) II.tered nutrition (food) and hydration (water). _______________________ (signature) (3) I direct that (add other medical directives, if any) _____________________________________________________________artificially administered nutrition and hydration will be administered to me. I further understand that if I sign this paragraph, I am authorizing the withholding or withdrawal of artificially adminisial administration of nutrition and hydration (food and water) for individuals who have become persistently unconscious is of particular importance. I understand that if I do not sign this paragraph, by my attending physician and another physician, in which thought and awareness of self and environment are absent. _______________________ (signature) (2) I understand that the subject of the artific I am persistently unconscious: -1- (1) I direct that life-sustaining treatment be withheld or withdrawn if such treatment will only serve to maintain me in an irreversible condition, as determined es, if any) _________________________________________________________________________ _________________________________________________________________________ ______________________.(signature) c. Ifh, I am authorizing the withholding or withdrawal of artificially administered nutrition (food) and hydration (water). _______________________ (signature) (3) I direct that (add other medical directivarticular importance. I understand that if I do not sign this paragraph, artificially administered nutrition and hydration will be administered to me. I further understand that if I sign this paragrapnderstand that the subject of the artificial administration of nutrition and hydration (food and water) that will only prolong the process of dying from an incurable and irreversible condition is of phat I have an incurable and irreversible condition that even with the administration of life-sustaining treatment will cause my death within six (6) months. _______________________ (signature) (2) I uon: (1) I direct that life-sustaining treatment shall be withheld or withdrawn if such treatment would only prolong my process of dying, and if my attending physician and another physician determine tme under the circumstances I have indicated below by my signature. I understand that I will be given treatment that is necessary for my comfort or to alleviate my pain. b. If I have a terminal conditieatment, I direct my attending physician and other health care providers, pursuant to the Oklahoma Rights of the Terminally Ill or Persistently Unconscious Act, to withhold or withdraw treatment from circumstances set forth below. I thus do hereby declare: I. Living Will a. If my attending physician and another physician determine that I am no longer able to make decisions regarding my medical tr voluntarily make known my desire, by my instructions to others through my living will, or by my appointment of a health care proxy, or both, that my life shall not be artificially prolonged under theund at findlegalforms.com -4- Advance Directive for Health Care I, _______________________________________________________, being of sound mind and eighteen (18) years of age or older, willfully andparty. Any possible tax consequences arising out of this document should be discussed with a tax professional. [_] The purchase and use of these forms is subject to the Disclaimers and Terms of Use fousing or signing this document you should have an attorney review it to make sure it fits your particular situation. You should also consult an attorney whenever a document is negotiated with another al and/or tax advice. Laws vary from time to time and from state to state. These forms should only be a starting point for you and should not be used without consulting with an attorney first. Before warranties have been made or are provided as to their suitability for any specific purpose or as to their legal effect or completeness. [_]These forms are not intended and are not a substitute for leg Such designation shall be specified and included as part of the advanced directive executed pursuant to the provisions of this section. [_] These forms are provided "as is" and no implied or express fs or tenets may designate an individual other than the designated health care proxy, in lieu of an attending physician and other physician, to determine the lack of decisional capacity of the person. in the patient's advance directive. E. A person executing an advanced directive appointing a health care proxy who may not have an attending physician for reasons based on established religious beliein consultation with the attending physician, shall have the authority to make treatment decisions for the patient including the withholding or withdrawal of life-sustaining procedures if so indicatedart of the Declarant's medical record and, if unwilling to comply with the advance directive, promptly so advise the Declarant. D. In the case of a qualified patient, the patient's health care proxy, shall be in substantially the following form: (Form included below) C. A physician or other health care provider who is furnished the original or a photocopy of the advance directive shall make it a padvance directive shall be signed by the Declarant and witnessed by two individuals who are eighteen (18) years of age or older who are not legatees, devisees or heirs at law. B. An advance directive ocedures. A. An individual of sound mind and eighteen (18) years of age or older may execute at any time an advance directive governing the withholding or withdrawal of life-sustaining treatment. The ess to the revocation. B. The attending physician or other health care provider shall make the revocation a part of the Declarant's medical record. -3- Section 3101.4 - Advance Directive Form and Prlarant, without regard to the Declarant's mental or physical condition. A revocation is effective upon communication to the attending physician or other health care provider by the Declarant or a witnperative pursuant to subsection A of this section. Section 3101.6 - Revocation of Advance Directive. A. An advance directive may be revoked in whole or in part at any time and in any manner by the Decn the event more than one valid advance directive has been executed and not revoked, the last advance directive so executed shall be construed to be the last wishes of the Declarant and shall become ohe advance directive becomes operative, the attending physician and other health care providers shall act in accordance with its provisions or comply with the provisions of Section 9 of this act. B. Iirective becomes operative when: 1. It is communicated to the attending physician; and 2. The Declarant is no longer able to make decisions regarding administration of lifesustaining treatment. When tning treatment, will, in the opinion of the attending physician and another physician, result in death within six (6) months. Section 3101.5 - When Advance Directive Becomes Operative. A. An advance dnited States, the District of Columbia, or the Commonwealth of Puerto Rico; and 12. "Terminal condition" means an incurable and irreversible condition that, even with the administration of life-sustaia terminal condition or in a persistently unconscious state by the attending physician and another physician who have examined the patient; 11. "State" means a state, territory, or possession of the Uual licensed to practice medicine in this state; 10. "Qualified patient" means a patient eighteen (18) years of age or older who has executed an advance directive and who has been determined to be in ration, business trust, estate, trust, partnership, association, joint venture, government, governmental subdivision or agency, or any other legal or commercial entity; 9. "Physician" means an individ irreversible condition, as determined by the attending physician and another physician, in which thought and awareness of self and environment are absent; -2- 8. "Person" means an individual, corpoude the administration of medication or the performance of any medical treatment deemed necessary to alleviate pain nor the normal consumption of food and water; 7. "Persistently unconscious" means anred to a qualified patient, will serve only to prolong the process of dying or to maintain the patient in a condition of persistent unconsciousness. The term "life-sustaining treatment" shall not inclificial administration of nutrition and hydration if the Declarant has specifically authorized the withholding and withdrawal of artificially administered nutrition and hydration, that, when administeconscious, incompetent, or otherwise mentally or physically incapable of communication; 6. "Life-sustaining treatment" means any medical procedure or intervention, including but not limited to the artions including but not limited to the withholding or withdrawal of life-sustaining treatment if a qualified patient, in the opinion of the attending physician and another physician, is persistently undinary course of business or practice of a profession; 5. "Health care proxy" is an individual eighteen (18) years old or older appointed by the Declarant as attorney-in-fact to make health care decisocedure provided for in Section 4 of this act; 4. "Health care provider" means a person who is licensed, certified, or otherwise authorized by the law of this state to administer health care in the oring physician" means the physician who has primary responsibility for the treatment and care of the patient; 3. "Declarant" means any individual who has issued an advance directive according to the pruted in accordance with the requirements of Section 4 of this act and may include a living will, the appointment of a health care proxy, or both such living will and appointment of a proxy; 2. "Attendcide, or euthanasia. Section 3101.3 - Terms Defined. As used in the Oklahoma Rights of the Terminally Ill or Persistently Unconscious Act: 1. "Advance directive for health care" means any writing exeche individual and the decisions of an authorized proxy. C. The Oklahoma Rights of the Terminally Ill or Persistently Unconscious Act does not condone, authorize, or approve mercy killing, assisted suima Rights of the Terminally Ill or Persistently Unconscious Act also includes necessary and appropriate protection for proxies and health care providers who rely in good faith on the instructions of tcapacity and the delegation of decision-making powers to a health care proxy. -1- B. To be sure that the individual's health care instructions and proxy decision-making will be effective, the Oklahoal's advance directive for health care will continue to be honored during incapacity without court involvement; and 5. Encourage and support health care instructions by the individual in advance of in and to act as the proxy decision-maker of last resort when no other proxy is authorized by the individual or is otherwise authorized by law; 4. Restate and clarify the law to ensure that the individus should be based on the proxy's reasonable judgment about the individual's values and what the individual's wishes would be based upon those values. The proper role of the court is to settle disputesest interests of the individual. If evidence of the individual's wishes is sufficient, those wishes should control; if there is not sufficient evidence of the individual's wishes, the proxy's decisiononal issues that do not belong in court, even if the individual is incapacitated, so long as a proxy decision-maker can make the necessary decisions based on the known intentions, personal views, or btion the physician and other health care providers may have to render care or to preserve life and health; 3. Recognize that decisions concerning one's medical treatment involve highly sensitive, pers, even if death ensues; 2. Recognize that the right of individuals to control some aspects of their own medical treatment is protected by the Constitution of the United States and overrides any obligaecognize the right of individuals to control some aspects of their own medical care and treatment, including but not limited to the right to decline medical treatment or to direct that it be withdrawntutes relating to the Oklahoma Power of Attorney for Health Care Form. Section 3101.2 - Purpose. A. The purpose of the Oklahoma Rights of the Terminally Ill or Persistently Unconscious Act is to: 1. Realth Care (Power of Attorney for Health Care & Living Will) is based Title 63; Chapter 60; Section 3101.2 et. Seq. of the on Oklahoma Statutes. The following are useful excerpts from the Oklahoma Stalth Care (Power of Attorney for Health Care & Living Will); (2) Oklahoma Advance Directive for Health Care (Power of Attorney for Health Care & Living Will) Form. This Oklahoma Advance Directive for HInformation and Instructions Oklahoma Advance Directive for Health Care (Power of Attorney for Health Care) This package contains (1) Information and Instruction for Oklahoma Advance Directive for Hea Oklahoma