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West Virginia Address -6- owledgment (Notary Public) _________________________________ Name typed, printed, or stamped This Document Prepared by: _____________________________________Name _______________________________________________ (name of Principal), who is personally known to me or who has produced ________________________________ as identification. _________________________________ Signature of person taking ackne of __________________________ ) ) ss County of ________________________ ) -5- The foregoing instrument was acknowledged before me this _____ day of ____________________, ______ by ___________________ State: ___________________________________ BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT. Notary's Acknowledgment Stat______________________ State: ___________________________________ Witness Signature: ___________________________________ Name: ___________________________________ City: _______________________________e, the Principal appears to be of sound mind and does not appear to be under duress. Witness Signature: ___________________________________ Name: ___________________________________ City: ____________Signature of ("Principal") On this day ______________ (date) I declare that the Principal indicated that he understands the nature of this document and is signing it freely and voluntarily. Furthermor___________ (name of Principal) has executed this Durable Power of Attorney on ____________ (date) at ____________________ (city), __________________________ (state). ________________________________ ful misconduct, while 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. IN WITNESS WHEREOF, _______________d harmless. Agent shall 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 willttorney. If this Durable -4- 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 hel 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 a 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. Revocation of the power of attorney is not effective as to a 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 policies I may own on the life of my Agent; and/or (c) myr 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 by this power-of-attorney are limited to the extenthen the remaining unaffected 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 oe 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 invalid, illegal or unenforceable under applicable law, t 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 listing of specific terms, rights, acts or powers arreasonable compensation 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 accountingly. My Agent shall 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 herein, "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 properfect 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 the rights, powers, and authority of my Agent shall become effective immediately upon execution of this instrument. The rights, powers, and authority of this document shall remain in full force and efent 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 Agent's estate. This Durable Power of Attorney and m any interest (subject to other provisions of this document), which might be transferred or distributed to me from any other person, estate, trust, or other entity, as may be appropriate. However, Agse 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 exists at the time of such transfer. -3- 17. To disclair 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 support which my Agent may owe to others, excluding thogent, 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 of my Agent, my Agent's estate, my Agent's creditors, ocalendar year. However, my Agent may not, unless specifically authorized by this document, (a) gift, appoint, assign or designate any of my assets, interests or rights, directly or indirectly, to my Atax annual exclusion, shall not exceed 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 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 shall be limited to gifts that qualify for the federal gift 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 to minors may be made to the minor directly or parent, or settle any matter with such agency. 15. To make gifts and charitable contributions of my real, personal, tangible or intangible property, to such persons or organizations without regard to whethere and tax returns and necessary and/or related documents; to obtain or provide information to and from any agency, including governmental agencies, relating to tax matters and to negotiate, compromise 14. To prepare, or cause to be prepared, 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 incomfuture. 13. To employ any professional and/or business assistance as may be appropriate, including but not limited to, attorneys, accountants, investment professionals, brokers and real estate agents.ks, bonds, debentures, commodities, options 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 ny other person, including access to their 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 stoc 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 owned or leased by me alone or in conjunction with a, cashier checks, cash or vouchers payable to me by any person, firm, corporation or political entity; to perform any act necessary to deposit, -2- negotiate, sell or transfer any note, security, oruding, but not limited to, making deposits and withdrawals, negotiating or endorsing any checks or other instruments, obtaining bank statements, passbooks, drafts, warrants, money orders, certificatese accounts, retirement plan accounts, and other similar accounts with financial institutions; to conduct any business with any banking or financial institution with respect to any of my accounts, inclng Social Security benefits. 9. To open, maintain and/or close bank accounts, including, but not limited to, checking accounts, savings accounts, certificates of deposit, investment accounts, brokeragental benefits (including but not limited to, medical, military and social security benefits), and to appoint anyone, including my Agent, to act as my "Representative Payee" for the purpose of receivig, but not limited to, Social Security and Medicare; to prepare applications, provide information, and perform any other reasonable request by any government or its agencies in connection with governmeive, deposit, hold, demand, deal with and/or sue to recover all payments I receive from any annuity, pension, retirement benefits, retirement plans, insurance benefits and government program includince and annuity contracts, insurance policies, 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 recht 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. To apply for, purchase, maintain and/or deal with insuranent 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 to remove tenants and to recover possession; and the rigth all, any part or any interest in any 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, instrum or use. 6. To maintain, manage, insure, 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 wind demands whatsoever, whether agreed to 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,l sums of money, accounts, debts, bonds, commercial papers, checks, drafts, causes of action, bequests, deposits, notes, interests, dividends, certificates of deposit, any and all documents of title a 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. To receive, hold, possess and/or invest any and aland obligations and such other instruments in writing of whatever kind and nature as may be. -1- 3. To request, ask, demand, sue and take any and all legal steps necessary to recover and collect anyvings and loan, brokers, mutual fund companies or other institutions, proofs of loss, evidences of debts, releases, and satisfaction of mortgages, lien, judgments, security agreements and other debts cuments, checks, drafts, letters of credit, stock certificates, proxies, warrants, commercial papers, withdrawal and deposit slips, certificates of deposit of, or investments with or through banks, saions, assignments, bills of sale or lading, bonds, contracts, covenants, conveyances, deeds, options, trust deeds, security agreements, leases, mortgages, notes, insurance policies, receipts, title donto binding contracts on my behalf and 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 applicatt'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 kind or nature, on my behalf and in my name. 2. To enter ieby 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 power of attorney and the rights hereby granted. My Agenre in connection with or relating to any person, item, transaction, thing, business, property, real or personal, tangible or intangible, or matter whatsoever as I could do if personally present. I hery-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 obligation whatsoever that I now have or may later acqui______________ do hereby make and appoint ________________________________________ ("Agent") maintaining an address at: _____________________________________________________ my true and lawful attorneHIS POWER OF ATTORNEY IF YOU LATER WISH TO DO SO. KNOW ALL PERSONS BY THESE PRESENTS: I, ____________________________________ ("Principal") maintaining an address at _________________________________UPON YOU. 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 TRS ON YOUR BEHALF, INCLUDING THE POWER TO SELL, MORTGAGE OR DISPOSE OF YOUR PROPERTY. ANY SUCH ACTION UNDERTAKEN BY YOUR AGENT, WITHIN THE SCOPE OF THIS POWER OF ATTORNEY DOCUMENT, IS LEGALLY BINDING THIS DOCUMENT ARE BROAD AND SWEEPING. BEFORE SIGNING THIS DOCUMENT, CONSIDER ITS CONSEQUENCES. YOU ("GRANTOR") ARE PROVIDING ANOTHER PERSON ("AGENT") WITH THE POWER TO HANDLE BUSINESS AND LEGAL MATTEhe instructions included with the forms packages offered for sale, generally include state specific instructions. -2- DURABLE POWER OF ATTORNEY Effective Immediately (CAUTION): THE POWERS GRANTED BY Please note that this information is not intended as and is not a substitute for legal advice. Furthermore, this information is general information that is not state specific. Whenever appropriate, 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 do so.ire 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 allow tment, will be legally binding upon the Grantor. The Grantor can revoke a Durable Power of Attorney at any time. A Durable Power of Attorney should always be notarized, even if your state does not requhe Agent should be a competent adult. 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 docus 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 power of attorney. Tpacitated. This particular Form becomes effective immediately and remains in full force and effect even if the Principal (i.e. the Grantor) later becomes incapacitated. Note that the word "attorney" intally" competent person (called the "Principal" or "Grantor") to authorize someone else (called the "Agent" or "Attorney-InFact") to act on his or her behalf, even if the Principal later becomes incahese forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com -1- Information Durable Power of Attorney Effective Immediately A Durable Power of Attorney allows a natural "mearting 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 party. [_] The purchase and use of t At the bottom of the document, indicate the name and address of the person who prepared it. [_] These forms are not intended and are not a substitute for legal advice. These forms should only be a sty careful in the selection 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. [_] access to the original document 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 veresses should be adults. The Agent, the Agent's spouse or children, and the Notary should not be witnesses. [_] The Principal should keep the original document, as well as a copy. The Agent should havehe Durable Power of Attorney to be recorded as a public record, if necessary. [_] Although not always required, it is always a good idea to also have two witnesses sign the Power of Attorney. The witn 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 will allow t Durable Power of Attorney Effective Immediately; (3) Durable Power of Attorney Effective Immediately [_] This Durable Power of Attorney becomes effective immediately and remains effective even if theInstructions & Checklist Durable Power of Attorney Effective Immediately [_] This package contains (1) Instructions & Checklist for Durable Power of Attorney Effective Immediately; (2) Information for West VirginiaWest Virginia ________________________________ Signature of person taking acknowledgment (Notary Public) _________________________________ Name typed, printed, or stamped -5- his _____ day of ____________________, ______ by __________________________ (name of Principal), who is personally known to me or who has produced ________________________________ as identification. ________________________ State: ___________________________________ State of __________________________ ) ) ss County of ________________________ ) The foregoing instrument was acknowledged before me t_ City: __________________________________ State: ___________________________________ Witness Signature: ___________________________________ Name: ___________________________________ City: _______________ (city), __________________________ (state). ________________________________ Signature of Principal Witness Signature: ___________________________________ Name: __________________________________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 ___________________l 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, while le 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 shal 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 Durabto 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 the(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 subject er-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 prevent fected 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 powrict 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 unaf and all acts performed as my Agent. This Power of Attorney shall be construed as broadly as a General Power of Attorney. The listing of specific terms, rights, acts or powers are not intended to restn 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 handledentitled 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 compensatioe and evaluate information effectively, to communicate decisions, and/or to manage my financial resources and affairs properly, as certified in writing by a licensed medical doctor. My Agent shall be on my subsequent disability, incapacity or lack of mental competence, except as provided by any applicable statute. As used herein, "disability" or "incapacity" shall mean a lack of capacity to receivin writing by a licensed medical doctor. The rights, powers, and authority of this document shall remain in full force and effect thereafter until my death. This Power of Attorney shall not terminate rectly or indirectly to my Agent or my Agent's estate. This Durable Power of Attorney and all rights and powers therein shall become effective upon my subsequent disability or incapacity as certified any other person, estate, trust, or other entity, as may be appropriate. However, Agent may not disclaim assets, to -3- which I would be entitled, if the result is that the disclaimed assets pass diust 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 distributed to me from ions, 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 any revocable trof 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's legal obligatassign 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) exercise any powers ar 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) gift, appoint, 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 in any one calendt 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 Uniform Transfers angible 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 state and federal gifncy, 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 real, personal, ther 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 and from any ageited 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, state, local or otess 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, including but not limcontents. 11. To exercise any and all rights, including proxy rights, with respect to stocks, bonds, debentures, commodities, options or any other investments. 12. To maintain and/or operate any businosit 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 dispose of the orm 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. -2- 10. To have access to any safe depuments, obtaining bank statements, passbooks, drafts, warrants, money orders, certificates, cashier checks, cash or vouchers payable to me by any person, firm, corporation or political entity; to perfusiness 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 checks or other instrhecking accounts, savings accounts, certificates of deposit, investment accounts, brokerage accounts, retirement plan accounts, and other similar accounts with financial institutions; to conduct any banyone, 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 not limited to, c 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), and to appoint retirement benefits, retirement plans, insurance benefits and government program including, but not limited to, Social Security and Medicare; to prepare applications, provide information, and performppropriate 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 annuity, pension,y 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 life of any other a 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 and owing to me b(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 that I now own orest 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, tangible or intangible le, 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, exchange, invest, reinvts, notes, interests, dividends, certificates of deposit, any and all documents of title and demands whatsoever, whether agreed to or disputed, now due or due in the future, owned by, due, owing payabst any other person or entity. -1- 5. To receive, hold, possess and/or invest any and all sums of money, accounts, debts, bonds, commercial papers, checks, drafts, causes of action, bequests, deposik, 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 on my behalf againases, 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. 3. To request, asal 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, evidences of debts, releeds, security agreements, leases, mortgages, notes, insurance policies, receipts, title documents, checks, drafts, letters of credit, stock certificates, proxies, warrants, commercial papers, withdrawry 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, options, trust deall 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 document necessaause 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 transact any and l, 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 lawfully do or c 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, real or persona___________________________________ as my alternate or successor Agent, as necessary, to serve with the same powers, rights and discretions. My Agent shall have full power and authority to perform any-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 _____________________________________ maintaining an address at: ____________________________ do hereby make and appoint ________________________________________ ("Agent") maintaining an address at: _____________________________________________________ my true and lawful attorney-inLE POWER OF ATTORNEY Effective upon Disability KNOW ALL PERSONS BY THESE PRESENTS: I, ____________________________________ ("Principal") maintaining an address at _____________________________________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 other legal responsibilities of an agent. -3- DURABbinding upon you. 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 al matters on your behalf, including the power to sell, mortgage or dispose of your property. Any such action undertaken by your agent, within the scope of this power of attorney document, is legally of attorney document are broad and sweeping. Before signing this document, consider its consequences. You ("principal") are providing another person ("agent") with the power to handle business and legic. Whenever appropriate, the instructions included with the forms packages offered for sale, generally include state specific instructions. -2- CAUTION! PRINCIPAL: The Powers granted by this power any real estate in Florida. Please note that this information is not intended as and is not a substitute for legal advice. Furthermore, this information is general information that is not state specifcord, if necessary. Although, some states don't require that a Durable Power of Attorney be witnessed, it is always a very good idea to do so. Two witnesses are necessary, if the Agent will deal with eal property. Notarization will make it more difficult for any 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 reis unable to serve or continue to serve as the Agent. A Durable Power of Attorney should always be notarized, even if your state does not require it, especially if the Agent will be dealing with any r of Attorney takes effect only after the Principal becomes disabled or incompetent, an alternate Agent can be designated, at the time this Power of Attorney is signed, in the event the original Agent the Principal is incapacitated when the Power of Attorney goes into effect, or the Agent undertakes the acts. The Principal can revoke a Durable Power of Attorney at any time. Since this Durable Powernt 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 the Principal. This is especially important if n 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. A Power of Attorney is a "powerful" instrumecipal later becomes incapacitated. This particular Form becomes effective upon the disability or incapacity of the Principal. Note that the word "attorney" is not used here to mean "lawyer". The perso allows a natural "mentally competent " person (called the "Principal" or "Principal") to authorize someone else (called the "Agent" or "AttorneyIn-Fact") to act on his or her behalf, even if the Prinase and use of these forms, is subject to the Disclaimers and Terms of Use found at findlegalforms.com -1- Information Durable Power of Attorney Effective upon Disability A Durable Power of Attorneyhould 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 a document with another party. [_] The purchserve as the Agent. This section can be removed, deleted (and initialed) or the words "no one" can be entered. [_] These forms are not intended and are not a substitute for legal advice. These forms susiness and legal matters on the Principal's behalf. [_] This document offers the option of nominating an alternate Agent in the event that the first choice as Agent is unable to serve or continue to he Agent should complete. The Grantor should also be very careful in the selection of the Agent. The powers granted by this document are very broad and sweeping, as the Agent has the power to handle bginal document, as well as a copy. The Agent should have access to the original document as needed. [_] The Principal should be careful in instructing the Agent (or attorney-in-fact) as to the tasks t real estate in Florida. The witnesses should be adults. Generally, anyone related by blood or marriage to the Principal, Agent or Notary should not be a witness. [_] The Principal should keep the oriecord, if necessary. [_] Although not always required, it is always a good idea to also have two witnesses sign the Power of Attorney. Two witnesses are necessary if the Agent will be dealing with anyincipal. [_] 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 public rtion 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 of the PrInstructions & Checklist Durable Power of Attorney Effective upon Disability [_] This package contains (1) Instructions & Checklist for Durable Power of Attorney Effective upon Disability; (2) Informa West VirginiaWest Virginia king acknowledgment (Notary Public) _________________________________ Name typed, printed, or stamped -5- ___________________ (name of Principal), who is personally known to me or who has produced ________________________________ as identification. _________________________________ Signature of person ta________ State of __________________________ ) ) ss County of ________________________ ) The foregoing instrument was acknowledged before me this _____ day of ____________________, ______ by _________________________________ Witness Signature: ___________________________________ Name: ___________________________________ City: __________________________________ State: ________________________________________________ Signature of Principal Witness Signature: ___________________________________ Name: ___________________________________ City: __________________________________ State: _________evoke this Power of Attorney at any time by providing written notice to my Agent. Signed on ________________ (date), at _______________________ (city), __________________________ (state). ___________e in good faith. However, Agent will be liable for breach of fiduciary duty, failure to act in good faith and/or willful misconduct, while acting under the authority of this Power of Attorney. I may rerson relying in good faith on the authority of this document, without notice of such termination, shall be held harmless. -4- Agent shall not be liable for losses resulting from judgment errors madto indemnify the third party for any claims that arise against the third party because of reliance on this power of attorney. If this General Power of Attorney is terminated by operation of law, any py 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 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 subject to a general power of appointment by my Agent. Any third parto my Agent based on this document. The powers granted to my Agent 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 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 power-ofattorney or as to the disposition of any proceeds paid tn in any manner. If any part of this document is held to be invalid, illegal or unenforceable under applicable law, then the remaining unaffected parts of the document shall still remain in full forcey shall be construed broadly as a General Power of Attorney. The listing of specific terms, rights, acts or powers are not intended to restrict or limit the definition or scope of powers granted herei myself or any authorized personal representative or fiduciary acting on my behalf, my Agent shall provide an accounting for all funds handled and all acts performed as my Agent. This Power of Attornered as a result of carrying out any provision of this Power of Attorney. If desired, my Agent shall also be entitled to reasonable compensation for any services provided as my Agent If so requested byd evaluate information effectively, to communicate decisions, and/or to manage my financial resources and affairs properly. My Agent shall be entitled to reimbursement of all reasonable expenses incur document shall remain in full force and effect thereafter until my death or until my disability or incapacity. As used herein, "disability" or "incapacity" shall mean a lack of capacity to receive an This General 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 -3- authority of this, 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 Agent's estate.ime 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, or other entity 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 exists at the tmy 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 support whichor 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 of my Agent, lative 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 assets, interests o 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 shall be non-cumu 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 shall be limited tor 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 to minors mayo 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 such persons d 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 agencies, relating tessionals, 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, but not limiteor 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, investment profg 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 an interest in 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 rights, includinl 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 owned or leased afts, 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, negotiate, seln 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, passbooks, dr of deposit, investment accounts, brokerage accounts, retirement plan accounts, and other similar accounts with financial institutions; to conduct any business with any banking or financial institutioentative 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, certificatesor 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 as my "Represe 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 any government 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 plans, insurancurchase, 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 elections and nts 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. To apply for, pto 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 to remove tenat 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 future by me) and y 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 such terms and ait, 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 which I have or mald, 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, certificates of deposnecessary 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. To receive, hoents, 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 all legal steps , 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 mortgages, lien, judgmes, insurance policies, receipts, title documents, checks, drafts, letters of credit, stock certificates, proxies, warrants, commercial papers, withdrawal and deposit slips, certificates of deposit ofent, including but not limited to applications, assignments, bills of sale or lading, bonds, contracts, covenants, conveyances, deeds, options, trust deeds, security agreements, leases, mortgages, noton 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 and/or agreemney 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 kind or nature, 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 power of attortsoever 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 matter whatsoever _______________ 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 obligation whadress at _______________________________________________ do hereby make and appoint ________________________________________ ("Agent") maintaining an address at: ______________________________________ the fiduciary and other legal responsibilities of an agent. -3- GENERAL POWER OF ATTORNEY KNOW ALL PERSONS BY THESE PRESENTS: I, ____________________________________ ("Principal") maintaining an adnyone 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 accepting or acting under the appointment, the agent assumesagent, within 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 ading another 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 structions. -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 provirmore, this 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 inalforms.com as well), stays in effect even if the Grantor later becomes disabled or incapacitated. Please note that this information is not intended as and is not a substitute for legal advice. Furthestates 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, called a Durable Power of Attorneys (available at findlege 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 recorded as a public record, if necessary. Although, some orney 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 be dealing with any real property. Notarization will makld be granted with care. Any 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 General Power of Att 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. A Power of Attorney is a "powerful" instrument and shoueath of the Grantor or until the Grantor becomes disabled or incapacitated. Note that the word "attorney" is not used here to mean "lawyer". The person acting as the Attorney-In-Fact for the Principalpal" or "Grantor") to authorize someone else (called the "Agent" or "Attorney-InFact") to act on his or her behalf. This particular Form becomes effective immediately and remains effective until the dto the Disclaimers and Terms of Use found at findlegalforms.com -1- Information General Power of Attorney A General Power of Attorney allows a natural "mentally" competent person (called the "Princind should not be used without consulting with an attorney first. An Attorney should be consulted before negotiating any document with another party. [_] The purchase and use of these forms is subject 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. These forms should only be a starting point for you a 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 very broad and sweeping, as the Agent has thehould 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 in instructing the Agent (or attorney-in-fact)g with any real estate in Florida. The witnesses should be adults. Generally, anyone related by blood or marriage to the Principal, the Agent or the Notary should not be a witness. [_] The Principal sa public record, if necessary. [_] Although not always required, it is always a good idea to also have two witnesses sign the Power of Attorney. Two witnesses are necessary if the Agent will be dealinncipal (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 recorded as er 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. [_] The PriInstructions & Checklist General Power of Attorney [_] This package contains (1) Instructions & Checklist for General Power of Attorney; (2) Information for General Power of Attorney; (3) General Pow West VirginiaWest Virginia s _______ day of __________________, 20____. __________________________________________ Notary public Self-proved Will Affidavit [SEAL] public, and by _________________________________________, the testator, and by ___________________________________ , __________________________ , and ___________________________________ witnesses, thi____ (Witness) Print Name: ___________________________________ Address: ______________________________________ Subscribed, sworn, and acknowledged before me ________________________________ a notary ______ _____________________________________________ (Witness) Print Name: ___________________________________ Address: ______________________________________ ____________________________________________________________________________________ (Testator) _____________________________________________ (Witness) Print Name: ___________________________________ Address: ________________________________testator was at that time 18 years of age or older, of sound mind, and under no constraint or undue influence and that each witness is over 18 years of age and otherwise competent to be a witness. __oluntary act for the purposes expressed in it, that each of the witnesses, in the presence and hearing of the testator, signed the will as witness, and that to the best of the witness's knowledge the executed the instrument as the testator's will, that the testator signed willingly (or willingly directed another to sign for the testator), that the testator executed it as the testator's free and vrument in those capacities, personally appearing before the undersigned authority and being first duly sworn, declare to the undersigned authority under penalty of perjury that the testator signed and_____________________, and ________________________________ and ________________________________, the testator and the witnesses, respectively, whose names are signed to the attached or foregoing inst_ Witness __________ Witness Page 7 of ______ Self-Proved Will Affidavit STATE OF __________________________ COUNTY OF ________________________ We, ________________________________, and ________________________________________ ___________________________________ ___________________________________ ___________________________________ Initials: __________ Testator __________ Witness _______________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ _______________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ _____________________ss Page 6 of ______ Dated: ____________________, ______ Witness Signature: Name: Address: City: State: Witness Signature: Name: Address: City: State: Witness Signature: Name: Address: City: State: _f us is now age 18 or older, is a competent witness, and resides at the address set forth after his or her name. Initials: __________ Testator __________ Witness __________ Witness __________ Witnes is the Testator's Will; We believe the maker is of sound mind and memory; We believe that this Will was not procured by duress, menace, fraud or undue influence; The maker is age 18 or older. Each ot and in the Testator's sight and presence and at Testator's request, and in the sight and presence of each other, do hereby subscribe our names as witnesses on the date shown above. We understand thi signatures, was signed in our sight and presence by _____________________________ (the "Testator"), who declared this instrument to be his/her Last Will and Testament and we, at the Testator's requesrtify and declare under penalty of perjury under the laws of the State of ____________________ that the above instrument, which consists of _____ pages, including the page(s) which contain the witnessWitnesses: Three (3) adults must sign as witnesses. Each witness must read the following clause before signing. The witnesses should not receive assets under this Will.) We, the undersigned, hereby cenfluence and ask the Witnesses named below to witness my signature. Testator's Signature: _______________________________________________ Name: _________________________________________ (Notice to __________________, ______. at ____________________ (city), that I declare this to be my Last Will and Testament, that I am of legal age and sound mind, that I make this under no constraint or undue iy, illegality or unenforceability should affect only that provision and all other provision should remain effective. IN WITNESS WHEREOF, I have signed my name below to this Will, this _____ day of __ a beneficiary hereunder, free from all matrimonial rights or controls by his or her spouse. 6. Severability. If any provision of this Will is declared invalid, illegal or unenforceable, any invalidit or other form of sharing or division of property which may exist between any beneficiary and his or her spouse, and every gift together with the income therefrom shall remain the separate property ofey can agree, and if not, by my Executor. 5. Matrimonial Rights. No gift, or the income therefrom, under this Will shall be assigned or anticipated, or fall into any community of property, partnershipest requires that the bequest be distributed between or among two or more beneficiaries, the specific items of property comprising the respective shares shall be determined by such beneficiaries if thness __________ Witness __________ Witness Page 5 of ______ fiduciary, except for such actions or non-actions which constitute fraudulent conduct or bad faith. 4. Beneficiary Disputes. If any bequify such natural person from any and all claims or expenses in connection with or arising out of that fiduciary's good faith actions or non-actions as the Initials: __________ Testator __________ Witiability of Fiduciary. No fiduciary who is a natural person shall, in the absence of fraudulent conduct or bad faith, be liable individually to any beneficiary of my estate, and my estate shall indemntermining the appropriate distributions under this Will, Each beneficiary shall be deemed not to have survived me unless the beneficiary is living on the thirtieth day after the date of my death. 3. L descendants, if, but only if, the adopted person is not more than twelve years of age on the date of the court order granting such adoption. 2. Thirty Day Survival Requirement. For the purposes of de. and any pronouns shall be taken to refer to the person or persons intended regardless of gender or number The terms "child" and "descendant" shall include an adopted person and such adopted person'sas forming a part of this Will in interpreting its provisions. Throughout this Will the use of any gender shall be deemed to include all genders, and the use of the singular the plural, and vice versamy estate shall be supplemented by the following: 1. Paragraph Titles and Gender. The titles given to the paragraphs of this Will are inserted for reference purposes only and are not to be considered ct to any question or review, by any person, official, authority, court or tribunal whatsoever or whomsoever. ARTICLE VII MISCELLANEOUS PROVISIONS The provisions in this Will for the distribution of r as not being maintenance of an even-hand among the beneficiaries and all such exercise of their powers, authority and discretion shall be binding upon all of the beneficiaries and shall not be subjeeffect of conferring an advantage on any one or more of the beneficiaries or would otherwise, but for the foregoing, be considered as being other than an impartial exercise of their duties hereunder ocise the powers, authority and discretion granted herein in what Executor deems to be the best interest, whether monetary or otherwise, of the beneficiaries, whether or not such exercise may have the any discretion granted to them in my Will and shall not be liable to the beneficiaries or their heirs or personal representatives by reason of the exercise of such discretion. The Executor shall exer incurred in connection with administering my estate, including but not limited to attorney, accountant, agent, broker and other professional fees. The Executor shall be fully protected in exercisingon such terms and conditions as the Executor may deem advisable and to refer to arbitration all such claims if the Executor deem same advisable. 11. Pay all necessary and reasonable expenses and costs Page 4 of ______ 10. Compromise, settle, waive or pay any claim or claims at any time owing by my estate or which my estate may have against others for such consideration or no consideration and upolve, settle or continue any partnership or business in which I may have an interest at the time of my death. Initials: __________ Testator __________ Witness __________ Witness __________ Witnessother cost experienced by any such person or by my estate resulting from any election, determination, designation or exercise of discretion, entered into by the Executor in good faith. 9. Windup, diss the Executor shall be conclusive and binding upon all the beneficiaries hereof. The Executor shall not be liable to any person, whether beneficiary or otherwise, by reason of any loss, claim, tax or e United States of America, by the legislature or government of any state, or by any other legislative or governmental body of any other country, state or territory, and such exercise of discretion by used. 8. Make or refrain from making, in Executor's absolute discretion, any elections, determinations, and designations permitted by any statute or regulation enacted by the federal government of thent, without giving any bond or security and without liability for any loss or damage. The Executor shall not be liable or responsible for any injury to, consumption of or loss of any such property so such interest not actually producing income shall be treated as producing income. 7. Permit any beneficiaries of my estate to use any tangible personal property or real property, without paying any rhat investments or assets so retained shall be deemed to be authorized investments for all purposes of my Will. No reversionary or future interest shall be sold prior to falling into possession and nod fractional share in property. 6. Retain any of my investments or assets in the form existing at the date of my death at Executor's absolute discretion without responsibility for loss to the intent tny division or distribution of my residuary estate in money or in other property or partly in both upon the basis of fair market value and cause any share to be composed of money, property or undividesh and part credit as they may in their absolute discretion decide upon, or to postpone such conversion of my estate or any part or parts thereof for such length of time as they may think best. Make aso valued. 5. Sell, call in and convert into money any part of my estate not consisting of money at such time or times, in such manner and upon such terms, and either for cash or credit or for part caing upon all persons concerned, notwithstanding any fluctuation in market value and notwithstanding that one or more of the Executor may be beneficially interested in the property or any part thereof their absolute discretion fix the value of my estate or any part thereof for the purpose of making any such division, setting aside or payment and the decision of the Executor shall be final and bind either wholly or in part in the assets forming my estate at the time of my death or at the time of such division, setting aside or payment, and I expressly will and declare that the Executor shall in pay off any mortgage or mortgages which may be in existence at any time forming part of my estate. 4. Make any division of my real or personal estate or set aside or pay any share or interest therein borrow money on any such Initials: __________ Testator __________ Witness __________ Witness __________ Witness Page 3 of ______ real estate upon the security of any mortgage or mortgages and togenerally to manage any such property. The Executor shall also have the right to renew and keep renewed any mortgage or mortgages upon any real estate forming part of my estate or any part thereof, topair, in the manner and to the extent that the Executor shall deem advisable. 3. To accept surrenders of leases and tenancies, to expend money in repairs, alterations, rebuilding and improvements and y estate for such period as the Executor shall determine; collect any income therefrom; and pay the taxes and expenses thereof, including the cost of keeping such property in adequate condition and reto effect such a sale, mortgage, lease or other disposition. The power of sale herein is discretionary and not mandatory. 2. Take charge of any real property as part of the probate administration of mble, without order of court and without notice to anyone. I also give to the Executor power to execute and deliver such deeds, mortgages, leases or other instruments and documents as may be necessary ll or part of any real or personal property that may be included in my estate in such manner and for such purposes, for such prices, and upon such terms, credits and conditions as may be deemed advisa appropriate for proper administration of my estate, the Executor shall have the right and power to: 1. Lease, sell, grant options, partition, exchange, mortgage, or otherwise encumber or dispose of ared of any Executor serving hereunder. ARTICLE VI POWERS OF EXECUTOR In addition to the existing authority of the Executor and in addition to other powers and authority granted by law or necessary oring "informal", "unsupervised", or "independent" probate or equivalent legislation designed to operate without unnecessary intervention by the probate court. No bond, security or surety shall be requither one or more. To the extent permitted by law, the Executor shall have the right to administer my estate without adjudication, order or direction of the court having jurisdiction over my estate, usll shall include each Executor, Executrix, and Personal Representatives of my Will, my estate or any portion thereof who may be acting as such from time to time whether original or substituted and whe for any reason, I appoint ___________________________________, , to be the Executor of this my Will in the place and stead of the first aforementioned Executor. References to "Executor" in this my WiF EXECUTOR I appoint ___________________________________, ("Executor") as the Executor of this my Will. If such person or entity cannot, does not or is unable to serve or continue to serve as Executor such distribution shall be a sufficient discharge to the Executor. Initials: __________ Testator __________ Witness __________ Witness __________ Witness Page 2 of ______ ARTICLE V NOMINATION Orson, trustee of such person, person with whom the beneficiary resides at the time of the distribution or to any other person the Executor may consider to be a proper recipient thereof. Receipt of anye under any other disability, I authorize the Executor to nevertheless make any distribution for any such person directly to the beneficiary or to a parent, guardian, conservator, committee of such peision. Except as may be specifically otherwise provided herein or directed otherwise by law, if any person should become entitled to any share in my estate before attaining the age of majority or whilidentities and respective shares to be determined under the laws of the State of ________________________, then in effect, as if I had died intestate at the time fixed for distribution under this prov____________ __________________________________________________________________________ If any such beneficiary does not survive me, my residuary estate shall be distributed to my heirs-at-law, their hat my residuary estate be distributed in equal shares per stirpes to: __________________________________________________________________ ______________________________________________________________ot disposed of in this Article, or all of my tangible personal property if there are no specific bequests of tangible personal property, as a part of the rest of my estate. Residuary Estate I direct t________________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. The Executor shall distribute the rest of my tangible personal property n______________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. My remaining tangible personal property shall be distributed to _________________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. _____________________________________________ shall be distributed to ___________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. _____________________________________________ shall be distributed to _____________________ OF PROPERTY Specific Bequests I direct that the following specific bequests be made from my estate. _____________________________________________ shall be distributed to _____________________________er my death pursuant to any agreement with respect to such property. Initials: __________ Testator __________ Witness __________ Witness __________ Witness Page 1 of ______ ARTICLE IV DISPOSITIONon shall not extend to or include any such taxes that may be payable by a purchaser or transferee in connection with any property transferred to or acquired by such purchaser or transferee upon or aftxes shall be made regardless of whether the taxes are owed by my estate or by any beneficiary. The Executor shall not seek reimbursement from any beneficiary for the payment of the taxes. This directiny codicil hereto, outside of this Will, in connection with any insurance on my life or any gift or benefit given or conferred by me either during my lifetime or by survivorship. The payment of the tang any inheritance taxes in the amount necessary to pay said inheritance taxes. The payment of the taxes shall be made regardless of whether the taxes are owed on property passing under this Will or as) and any interest and penalties thereon owed because of my death shall be paid out of the residue of my estate. The Executor shall create, out of the residue, a separate fund for the purpose of payirect that my just debts, testamentary expenses and expenses of last illness be first paid out of and charged to the capital of my general estate. All taxes (including income taxes and inheritance taxe and the erection and engraving of monuments and markers, regardless of any limitation fixed by statute or rule of court and without order of any court. ARTICLE III PAYMENT OF DEBTS AND EXPENSES I dize the Executor of my Will to pay such sums as the Executor deems proper for my funeral, cremation or burial and interment, including the disposition of the ashes or the acquisition of any burial sited declare this to be my Last Will and Testament. ARTICLE I MARRIAGE & CHILDREN I am divorced. I am currently not married to anyone. I have no children. ARTICLE II FUNERAL & BURIAL EXPENSES I authoriment Of ______________________ I, _____________________________________ (name), of _______________________ (county), _______________________ (state), revoke my former Wills and Codicils and publish anl attorney is always recommended when dealing with estate planning matters. Any possible tax consequences arising out of this document should be discussed with a tax professional. Last Will And Testae to state. These forms should only be a starting point for you and should not be used or signed without consulting an attorney first to make sure it fits your particular situation. Advice from a locan, the deduction is limited (it was $100,000 in 2003). This information and these forms are not intended and are not a substitute for legal and/or tax advice. Laws vary from time to time and from statual may leave an unlimited amount to his or her spouse upon death without any federal estate tax liability. This is referred to as the "Marital Deduction". If the recipient spouse is not a U.S. citizeual retirement accounts and qualified employee benefit plans; [] the face value of any life insurance policy; [] property you are holding in trust; any joint property you own In addition, each individe; [] stocks and bonds; [] bank accounts; [] tangible personal property (household furnishings and furniture, jewelry, art, and other personal effects); [] partnership (business) interests; [] individld consult with tax professionals and an attorney. Before using this Will, it may be helpful to determine the value of all of the assets in your estate. Assets may include the following: [] real estatamount, the greater your need for professional estate tax planning advice. If your assets come near the $2,000,000 level, Information about Wills ­ Page 2 you really shouldn't use this will and shouredit is available to each individual and his or her spouse. Estates totaling $2,000,000 or more could be subject to federal estate tax. As your estate approaches $2,000,000 in value and exceeds that death of an individual, there is a credit against the estate tax otherwise due on a portion of the value of an individual's estate. For a person dying in 2006 to 2008, that credit is $2,000,000. The cdocument. If you have a large estate, you may need more complicated planning to reduce or limit death taxes. Testators should have an understanding of tax laws. Federal tax law provides that upon the requires the affidavit to be in a specific format similar to the one included in our wills. The Will is for anyone in any life situation where this Will is to be used as the principal estate planning ct of Columbia, the courts have some latitude to accept a will as self proved, to require an affidavit of the witnesses or to require the witnesses to testify. New Hampshire permits self proving, but es will not invalidate the Will (since it is a separate document from the Will). In those states it will have to be "proven" in court, like any other will. In Ohio, Maryland, California and the Distrie Louisiana, Maryland, Ohio and Vermont (as of 2003) do not have statutes permitting self proving wills. The affidavit will be of no use in those states. However, including the affidavit in those staten they are needed.. However, even with the Affidavit, the Will may still be subject to contest on such grounds as undue influence, lack of testamentary capacity, or prior revocation. A few states likere followed. The Affidavit may eliminate the need to have witnesses testify, that the formalities in signing the Will were followed. The Affidavit can also be useful if witnesses are not available whroved by having one or more of the witnesses come into court and testify under oath, or through sworn affidavits, that each saw the Testator sign the will and that the formalities for signing a Will wot affect the validity or legality of the Will. However, it can speed up the admission of the Will to probate after the death of the Testator. Before the adoption of more modern laws, all wills were pdavit, which contains the Testator's acknowledgment and the affidavit of the witnesses, made before a Notary, that all required formalities were observed when the Will was signed. The Affidavit does nh as life insurance or employee benefit plans), and assets held in trust generally will not be required to be probated and will not be governed by this Will. The Will has an enclosed self-proving affi's estate. It merely directs how the assets which are individually owned by the Testator will be distributed. Assets held jointly with rights of survivorship, assets with beneficiary designations (sucdlegalforms.com Information about Wills This Will distributes the assets of the person making the Will (the "Testator") as specified by the Testator. This Will does not avoid probate for the Testator 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 found at finbe used or signed without consulting an attorney first to make sure it fits your particular situation. Advice from a local attorney is always recommended when dealing with estate planning matters. Anyse forms are not intended and are not a substitute for legal 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 hese forms are provided "as is" and no implied or express warranties have been made or are provided as to their suitability for any specific purpose or as to their legal effect or completeness. [_]Thee reviewed by a lawyer before they are signed. If the Testator moves to another state, the current will should be checked by a lawyer in their new state to make sure it meets local requirements. [_] Tthe beneficiaries' percentage's equal 100%. Check the totals before signing the Will. State and federal laws which affect estate planning can vary over time and from place to place. All wills should b small portion of the estate. Consult an attorney if you wish to disinherit a spouse or any children. If any part of the Will calls for distribution in percentages, make sure that the total of all of dies. Checklist & Instructions ­ Page 4 Most state laws guarantee a minimum share of an estate to a spouse when the other spouse dies. The Will may be invalid if a spouse receives nothing or only al should be written and signed. New wills are commonly necessary when, for example, the Testator's marital status changes, if the Testator has a child or if a named beneficiary or one of the Executorsit by adding, deleting, or changing words on the face of the Will. Such changes are usually disregarded. If changes are desired, the original and all copies should be destroyed and an entirely new Wilhe total taxable estate and other matters. The tax results of the choices made in this Will should be discussed with a competent tax advisor. If it becomes necessary to change the Will, do not modify nce proceeds and survivor benefits arising in other contracts and plans are not normally governed by a will. This Will is not designed to reduce taxes. Estate taxes, if any, are based on the size of t. For example, the Will does not dispose of property held in joint tenancy with rights of survivorship or property held in trust. In addition, the distribution of retirement plan benefits, life insuraamed as Executor / Personal Representative. This Will does not dispose of property that, on the death of the Testator, would automatically pass to another person by operation of law or by any contracte purposes, only the original can be admitted to probate. Copies are rarely accepted. A copy of the Will should be kept by the Testator and may also (if Testator so wishes) be provided to the person nox at a bank or lawyer's office. Unlike other legal instruments where multiple originals are prepared, only one original "copy" of a will should be prepared. While photocopies may be used for referenc willing and can serve. If you select a bank or trust company, be sure to check into their fees for such services. The original of the Will should be kept in a secure location such as a safe deposit bfinancial matters and to deal appropriately with family members. It is best to talk to people (and banks or trust companies) before naming them as a Personal Representative, to make sure that they areand in the bottom right of each page. The Personal Representative / Executor should be picked carefully. It is very important to pick a person (or bank or trust company) that can be trusted to handle hs. The affidavit states that all required formalities were observed when the Will was signed. The total number of pages (excluding i.e. not counting the self-proving affidavit) should be entered by hthe end of the Will. The Affidavit contains the Testator's acknowledgment and the affidavit of the witnesses, made before a Notary or other person authorized to take acknowledgments and administer oatd not be counted because the affidavit is not a part of the Will itself. The Testator and the witnesses should sign the self-proving affidavit (called "Proof of Will" in some states) and attach it to total number of pages in the Will, including the page(s) on which the witness signature lines appear, should be indicated by the Witnesses. The page with the self-proving affidavit, if included, shoul filled in (preferably by hand), with the date of the actual signing. This step could be crucial to determine the validity of the Will at a later date (i.e. if this Will revokes an earlier Will). The witnesses must be satisfied that the Testator is an adult of sound mind and he/she is signing the Will freely and willingly. Checklist & Instructions ­ Page 3 Wherever requested, the date should betution of pages. The witnesses should also initial the bottom of each page of the Will. All witnesses must sign their names in the presence of the Testator and each other and of the notary public. Theit freely and voluntarily" or similar words. Although not required in most states, it is a good idea for the Testator to initial the bottom of each page of the Will. This can prevent subsequent substi Testament. However, the witnesses don't need to read or know the contents of the Will. For example, the Testator can say: "The document I am about to sign is my Last Will and Testament. I am signing public is needed for the self-proved affidavit. Before signing the Will, the Testator should orally declare that the document that is about to be signed, is intended to be the Testator's Last Will andshould not be beneficiaries under the Will. For example children, spouses, heirs or executors should not be witnesses. All witnesses and the notary should watch the Testator sign the Will. The notary gnature of a third witness can provide additional protection if the signature of one of the witnesses is deemed to be invalid for any reason or if one of the witnesses can't be located. The witnesses ate. Although most states only require two witnesses, the Testator should sign the Will in the presence of three (3) qualified, competent, disinterested and adult witnesses and a notary public. The sisually means that the Testator knows that he/she is signing a Will, is familiar with the property and the value thereof and knows about relatives and others who might be entitled to a share of the estnt of each other. The Testator (i.e. the person who is writing the Will) must be of "sound mind" when signing the Will and must be of legal age (i.e. eighteen in most states). Being of "sound mind" uly not part of the Will) states that all required formalities were observed when the Will was signed. The Affidavit needs to be completed and signed, by the Testator, all Witnesses and a Notary in froe; []name Witnesses: Witnesses must provide and fill out: [] name of state; [] number of pages; [] name of testator; []witness signatures and info Affidavit: The enclosed Affidavit (although technicalaking care of the property, and making distributions to the beneficiaries Article VII: Contains miscellaneous provisions Signature Block: Testator needs to fill out: [] day month year city; []Signature and fill out [] the name of executor; [] name of alternate executor. Checklist & Instructions ­ Page 2 Article VI: Powers of Executor empowers the representative to deal with matters like taxes, tion expenses and taxes out of the testator's estate. After paying debts and expenses, the Personal Representative will pay whatever is left to the beneficiaries named in the will. Testator must provide. The Executor will have the responsibility (after the testator's death) of managing the testator's property. The Personal Representative is also responsible for paying outstanding debts, administratment of the Testator's Personal Representative (i.e. Executor) and alternate; It allows the Testator to name an Executor to administer the estate, and an alternate in case the first choice cannot serverson(s)/entity(s) remaining tangible property is given to; [] name(s) of person(s)/entity(s) Residuary Estate is given to; [] state under whose laws the will is made Article V: Deals with the appointnd fill out: [] description of property (or dollar amount); [] name(s) of person/entity property is given to (three blank paragraphs are provided, but you can add as many as you need). [] name(s) of ps payments of debts and expenses. Article IV: Disposes of specific property. Allows Testator to give specific dollar amounts or other property to specific persons or charities. Testator must provide aovide and fill out: []name, [] county and []state Article I: States that Testator is divorced and has no children. Article II: Authorizes payment of funeral and Burial expenses. Article III: Authorizedavit also needs to be completed. Title: Enter name of Testator in blank space under title "Last Will and Testament of". Introduction: Contains preliminary information about the will. Testator must prf-proved affidavit. This Will is divided into various sections. The content of each section is explained below. Some sections require information to be entered in the space provided. The enclosed Affiibutes the assets of the Testator (i.e. person making the will) to specific beneficiaries named in the Will. This Will is suitable for estates worth less than $2,000,000. This Will also includes a sel Information about Wills; (3) Will ­ Divorced Person (not remarried) with no Children with self-proved affidavit. This Will is for a Divorced Person who has not remarried and has no Children. It distrChecklist and Instructions Will ­ Divorced (not remarried) Person with No Children This package contains: (1) Checklist and Instruction for Will ­ Divorced Person (not remarried) with no Children; (2) West VirginiaWest Virginia __ Notary Public 2 d the same before me. Given under my hand this ______ day of ______, 20__. My commission expires:______________________________________ _______________________________________________________________________________________________________________________, as witnesses, whose names are signed to the writing above bearing date on the _______________ day of _______, 20____,have this day acknowledge of said County, do certify that ___________________________________________________________________, as principal, and _________________________________________________________________ and ____________________________ Date:_________________________________________ STATE OF WEST VIRGINIA _______________________________ COUNTY OF ) ) ) ) I, ______________________________________, a Notary Public________ _____________________________________________ (Witness Signature) Print Name: ___________________________________ Address: ______________________________________ Phone: _____________________Witness Signature) Print Name: ___________________________________ Address: ______________________________________ Phone: _______________________________________ Date:_________________________________ian or the principal's medical power of attorney representative or successor medical power of attorney representative under a medical power of attorney. _____________________________________________ (of the principal to the best of my knowledge under any will of principal or codicil thereto, or directly financially responsible for principal's medical care. I am not the principal's attending physicincipal's signature above for or at the direction of the principal. I am at least eighteen years of age and am not related to the principal by blood or marriage, entitled to any portion of the estate ____________________________ Signed _________________________________________________________________ _________________________________________________________________ Address 1 I did not sign the pr my legal right to refuse medical or surgical treatment and accept the consequences resulting from such refusal. I understand the full import of this living will. _______________________________________________________________________________ _____________________________________________________________________________ It is my intention that this living will be honored as the final expression oftments.) _____________________________________________________________________________ _____________________________________________________________________________ ___________________________________chines, cardiopulmonary resuscitation, dialysis and mental health treatment may be placed here. My failure to provide special directives or limitations does not mean that I want or refuse certain treay to keep me comfortable. I want to receive as much medication as is necessary to alleviate my pain. I give the following SPECIAL DIRECTIVES OR LIMITATIONS: (Comments about tube feedings, breathing maong the dying process or maintain me in a persistent vegetative state be withheld or withdrawn. I want to be allowed to die naturally and only be given medications or other medical procedures necessarrsistent vegetative state (I am unconscious and am neither aware of my environment nor able to interact with others), I direct that life-prolonging medical intervention that would serve solely to proling circumstances: If I am very sick and not able to communicate my wishes for myself and I am certified by one physician, who has personally examined me, to have a terminal condition or to be in a pee my wishes for myself. In the absence of my ability to give directions regarding the use of life-prolonging medical intervention, it is my desire that my dying shall not be prolonged under the follow_____________________________________________________________, being of sound mind, willfully and voluntarily declare that I want my wishes to be respected if I am very sick and not able to communicatsubject to the Disclaimers and Terms of Use found at findlegalforms.com STATE OF WEST VIRGINIA Living Will Living will made this _____________________day of _____________________(month, year). I,__commended when dealing with estate planning matters. Any possible tax consequences arising out of this document should be discussed with a tax professional. [_] The purchase and use of these forms is should only be a starting point for you and should not be used or signed without consulting an attorney first to make sure it fits your particular situation. Advice from a local attorney is always repose or as to their legal effect or completeness. [_]These forms are not intended and are not a substitute for legal and/or tax advice. Laws vary from time to time and from state to state. These forms the directions in the living will are severable. [_] These forms are provided "as is" and no implied or express warranties have been made or are provided as to their suitability for any specific purany of the other specific directions be held to be invalid, such invalidity shall not affect other directions of the living will which can be given effect without the invalid direction and to this end unauthorized practice of law. (g) The living will may, but need not, be in the following form and may include other specific directions not inconsistent with other provisions of this article. Should agencies, senior citizens centers, hospitals, nursing homes, personal care homes, community care facilities or any other similar person or group, without separate compensation, does not constitute thewill. (f) The provision of living will or medical power of attorney forms substantially in compliance with this article by health care providers, medical practitioners, social workers, social service ch forms if the person desires: Provided, That under no circumstances may admission to a health care facility be predicated upon a person having completed either a medical power of attorney or living admission to any health care facility, each person shall be advised of the existence and availability of living will and medical power of attorney forms and shall be given assistance in completing suing will or medical power of attorney, shall make the living will, medical power of attorney or a copy of either or a revocation of either a part of the principal's medical records. (e) At the time oftion of the living will or medical power of attorney. An attending physician or other health care provider, when presented with the living will or medical power of attorney, or the revocation of a liv or his or her representative to provide for notification to his or her attending physician and other health care providers of the existence of the living will or medical power of attorney or a revoca operator of a health care facility serving the principal and who is not related to the principal. Living Will Information & Instructions ­ Page 2 (d) It shall be the responsibility of the principal principal; (2) an employee of a treating health care provider not related to the principal; (3) an operator of a health care facility serving the principal; or (4) any person who is an employee of an representative. (c) The following persons may not serve as a medical power of attorney representative or successor medical power of attorney representative: (1) A treating health care provider of the; (4) Directly financially responsible for principal's medical care; (5) The attending physician; or (6) The principal's medical power of attorney representative or successor medical power of attorney medical power of attorney shall not be affected when a witness at the time of witnessing such living will or medical power of attorney was unaware of being a named beneficiary of the principal's will to the principal by blood or marriage; (3) Entitled to any portion of the estate of the principal under any will of the principal or codicil thereto: Provided, That the validity of the living will orction (d) of this section. (b) In addition, a witness may not be: (1) The person who signed the living will or medical power of attorney on behalf of and at the direction of the principal; (2) Related two or more witnesses at least eighteen years of age; and (5) signed and attested by such witnesses whose signatures and attestations shall be acknowledged before a notary public as provided in subseexecuted by the principal or by another person in the principal's presence at the principal's express direction if the principal is physically unable to do so; (3) dated; (4) signed in the presence ofney. (a) Any competent adult may execute at any time a living will or medical power of attorney. A living will or medical power of attorney made pursuant to this article shall be: (1) In writing; (2) q. of the West Virginia Code. For your convenience, we have included useful excerpts from the West Virginia Codes relating to Living Wills. §16-30-4. Executing a living will or medical power of attoriving Will This package contains (1) Information and Instruction for West Virginia Living Will; (2) West Virginia Living Will. This West Virginia Living Will is based on Chapter 16 Section 30-4 et. Se____, 20____. My commission expires:______________________________________ __________________________________________________________ Notary Public -3- Information and Instructions West Virginia Lmes are signed to the writing above bearing date on the ____________ day of _____________, 20_____, have this day acknowledged the same before me. Given under my hand this __________ day of ________________________________, a Notary Public of said County, do certify that_________________________________________, as principal, and ____________________ and __________________, as witnesses, whose na_______ _____________________________________________ (Witness Signature) Print Name: ___________________________________ STATE OF WEST VIRGINA COUNTY OF _______________________________ I, _________ _______________________________________ _____________________________________________ (Witness Signature) Print Name: ___________________________________ -2- Dated: ________________________________ally responsible for the costs of the principal's medical or other care. I am not the principal's attending physician, nor am I the representative or successor representative of the principal. Dated:related to the principal by blood or marriage. I am not entitled to any portion of the estate of the principal or to the best of my knowledge under any will of the principal or codicil thereto, or legMED CONSENT TO MY OWN MEDICAL CARE. __________________________________________ (Principal's Signature) I did not sign the principal's signature above. I am at least eighteen years of age and am not _______ _____________________________________________________________________________ THIS MEDICAL POWER OF ATTORNEY SHALL BECOME EFFECTIVE ONLY UPON MY INCAPACITY TO GIVE, WITHHOLD OR WITHDRAW INFOR___________________________________________________ _____________________________________________________________________________ ______________________________________________________________________vide special directives or limitations does not mean that I want or refuse certain treatments.) _____________________________________________________________________________ __________________________TIONS ON THIS POWER: (Comments about tube feedings, breathing machines, cardiopulmonary resuscitation, dialysis, funeral arrangements, autopsy and organ donation may be placed here). My failure to proho rity under this medical power of attorney, my representative shall act consistently with my special directives or limitations as stated below. I am giving the following SPECIAL DIRECTIVES OR LIMITAformal statement of my desire concerning the method by which any health care -1- decisions should be made on my behalf during any period when I am unable to make such decisions. In exercising the autnot be the subject of review by any health care provider or administrative or judicial agency. It is my intent that this document be legally binding and effective and that this document be taken as a intent that my family, my physician and all legal authorities be bound by the decisions that are made by the representative appointed by this document and it is my intent that these decisions should t to carry into effect the health care decisions that I would make if I were able to do so and because I also believe that this person will act in my best interest when my wishes are unknown. It is my limited to, decisions regarding the withholding or withdrawal of lifeprolonging interventions. I appoint this representative because I believe this person understands my wishes and values and will ac diagnostic procedures, or autopsy if my representative determines that I, if able to do so, would consent to, refuse or withdraw such treatment or procedures. Such authority shall include, but not bes document is specifically authorized to be granted access to my medical records and other health information and to act on my behalf to consent to, refuse or withdraw any and all medical treatment org to medical treatment, surgical treatment, nursing care, medication, hospitalization, care and treatment in a nursing home or other facility, and home health care. The representative appointed by thi__________________ Address: ______________________________________ Phone: _______________________________________ This appointment shall extend to, but not be limited to, health care decisions relatin choose as my successor representative is (Insert the name, address, area code and telephone number of the person you wish to designate as your successor representative): Print Name: ____________________________________ Address: ______________________________________ Phone: _______________________________________ If my representative is unable, unwilling or disqualified to serve, then the person I myself. The person I choose as my representative is (Insert the name, address, area code and telephone number of the person you wish to designate as your representative): Print Name: _____________________________, (name and address ) hereby appoint my representative to act on my behalf to give, withhold or withdraw informed consent to health care decisions in the event that I am not able to do sosclaimers and Terms of Use found at findlegalforms.com -2- STATE OF WEST VIRGINIA MEDICAL POWER OF ATTORNEY Dated: _____________________________ , 20______ I,_______________________________________t is negotiated with another party. 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 Dith an attorney first. Before using 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 documen are not a substitute for legal 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 wis" and no implied or express 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 andt affect other directions of the living will which can be given effect without the invalid direction and to this end the directions in the living will are severable. [_] These forms are provided "as iowing form and may include other specific directions not inconsistent with other provisions of this article. Should any of the other specific directions be held to be invalid, such invalidity shall nommunity care facilities or any other similar person or group, without separate compensation, does not constitute the unauthorized practice of law. (g) The living will may, but need not, be in the folllly in compliance with this article by health care providers, medical practitioners, social workers, social service agencies, senior citizens centers, hospitals, nursing homes, personal care homes, coto a health care facility be predicated upon a person having completed either a medical power of attorney or living will. (f) The provision of living will or medical power of attorney forms substantiae and availability of living will and medical power of attorney forms and shall be given assistance in completing such forms if the person desires: Provided, That under no circumstances may admission attorney or a copy of either or a revocation of either a part of the principal's medical records. (e) At the time of admission to any health care facility, each person shall be advised of the existenclth care provider, when presented with -1- the living will or medical power of attorney, or the revocation of a living will or medical power of attorney, shall make the living will, medical power of an and other health care providers of the existence of the living will or medical power of attorney or a revocation of the living will or medical power of attorney. An attending physician or other heaving the principal and who is not related to the principal. (d) It shall be the responsibility of the principal or his or her representative to provide for notification to his or her attending physicing health care provider not related to the principal; (3) an operator of a health care facility serving the principal; or (4) any person who is an employee of an operator of a health care facility serons may not serve as a medical power of attorney representative or successor medical power of attorney representative: (1) A treating health care provider of the principal; (2) an employee of a treatifor principal's medical care; (5) The attending physician; or (6) The principal's medical power of attorney representative or successor medical power of attorney representative. (c) The following pers affected when a witness at the time of witnessing such living will or medical power of attorney was unaware of being a named beneficiary of the principal's will; (4) Directly financially responsible (3) Entitled to any portion of the estate of the principal under any will of the principal or codicil thereto: Provided, That the validity of the living will or medical power of attorney shall not beion, a witness may not be: (1) The person who signed the living will or medical power of attorney on behalf of and at the direction of the principal; (2) Related to the principal by blood or marriage; years of age; and (5) signed and attested by such witnesses whose signatures and attestations sha ll be acknowledged before a notary public as provided in subsection (d) of this section. (b) In additperson in the principal's presence at the principal's express direction if the principal is physically unable to do so; (3) dated; (4) signed in the presence of two or more witnesses at least eighteen at any time a living will or medical power of attorney. A living will or medical power of attorney made pursuant to this article shall be: (1) In writing; (2) executed by the principal or by another ts from the West Virginia Code relating to the West Virginia Power of Attorney for Health Care Form. §16-30-4. Executing a living will or medical power of attorney. (a) Any competent adult may executeh Care Form (Medical Power of Attorney). This West Virginia Power of Attorney for Health Care is based on Chapter 16 Section 16-30-4 et. Seq. of the West Virginia Code. The following are useful excerpney for Health Care This package contains (1) Information and Instruction for West Virginia Power of Attorney for Health Care (Medical Power of Attorney); (2) West Virginia Power of Attorney for Healtld be discussed with a tax professional. [_] The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Information and Instructions Power of Attorke sure it fits your particular situation. Advice from a local attorney is always recommended when dealing with estate planning matters. Any possible tax consequences arising out of this document shou 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 or signed without consulting an attorney first to marranties 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 legal as an Advance Health Care Directive. The first form is the Power of Attorney for Health Care and the second form is the Living Will. [_] These forms are provided "as is" and no implied or express waWest Virginia Advance Health Care Directive This package contains both a West Virginia Power of Attorney for Health Care and a West Virginia Living Will. Together these forms are also sometimes known West VirginiaWest Virginia Notary Public _______________________________ Printed Name of Notary My commission expires: Quitclaim Deed - 2 in instrument and acknowledged to me that he/she/they executed the same for the purposes therein contained. Witness my hand and official seal. NOTARY SEAL _______________________________ Signature of____________________, personally appeared __________________________ known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the with_________ ____________________________________________ Type or Print Name of Grantor State of West Virginia County of ______________ } ss. On ______________________, 20,___ before me, _____________e buildings, appurtenances and improvements thereon. Quitclaim Deed - 1 IN WITNESS WHEREOF, Grantor has executed this Quitclaim Deed on __________________, 20 __. ___________________________________s, successors and/or assigns forever; so that neither Grantor nor Grantor's heirs, successors and/or assigns shall have claim or demand any right or title to the property described above, or any of th way, covenants, conditions, reservations and restrictions of record. TO HAVE AND TO HOLD all of Grantor's right, title and interest in and to the above described property unto Grantee, Grantee's heiry of __________________________, County of ________________________________, State of West Virginia described as follows: [Insert legal description] SUBJECT TO all, if any, valid easements, rights ofLEASES, AND FOREVER QUITCLAIMS to Grantee, all right, title, interest and claim to the plot, piece or parcel of land, with all the buildings, appurtenances and improvements thereon, if any, in the CitTION, in the amount of _______________________ DOLLARS ($___________) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, Grantor hereby REMISES, RE___________ __________________________________________ and ________________________________ ("Grantee") whose address is _____________________________________________________. FOR A VALUABLE CONSIDERAQUITCLAIM DEED KNOW ALL MEN BY THESE PRESENTS THAT: THIS QUITCLAIM DEED, made and entered into on ___________________, 20_____, between ____________________________ ("Grantor") whose address is ______aimers and Terms of Use found at findlegalforms.com Recording requested by: and when recorded, please return this deed and tax statements to: Escrow No.: For recorder's use only Title Order No.: t be used without consulting with an attorney first. An Attorney should be consulted before negotiating any document with another party. [_] The purchase and use of these forms is subject to the Discly be returned unrecorded or may be charged additional fees [_] These forms are not intended and are not a substitute for legal advice. These forms should only be a starting point for you and should nofiled with it. Please check your local requirements with your local Recorder's (or similar) office. [_] Depending on the type of document, additional requirements may apply. Nonconforming documents mainst third parties. [_] Documents referencing land should include a legal description of the land. Verify that the legal description is correct. [_] A Quitclaim Deed may require other documents to be d sign the Quitclaim Deed before a Notary. Among other things, Notarization will allow the Quitclaim Deed to be recorded as a public record. Without filing, the Quitclaim Deed may not be effective agaInstructions & Checklist for Quitclaim Deed West Virginia (Individual) [_] This package contains (1) Instructions and Checklist for Quitclaim Deed and (2) Quitclaim Deed [_] The Grantor should date an West VirginiaWest Virginia _____________ Name of Survivor: _______________________________ Address: ____________________________________________ City: _______________________________________________ State: __________________________________urposes (strike any of the following you do not want): (1) Transplant (2) Therapy (3) Research (4) Education Date: __________________ Signature of Survivor: __________________________________ Printed_______________ ________________________________________________________________________ ________________________________________________________________________ III. The gift is for the following pthe applicable box): Give any needed organs, tissues, or parts, OR Give the following organs, tissues, or parts only: _______________________ _________________________________________________________ity and state). I. I survive the decedent as (mark the appropriate box): spouse; adult son or daughter; parent; adult brother or sister; grandparent; or guardian of the decedent. II. I hereby (mark this anatomical gift from the body of __________________________________(name of decedent) who died on _____________, 20___ at_______________________________ in ____________________________________ (corney should be consulted for all serious legal matters. Anatomical Gift by Next of Kin or Guardian of the Person Pursuant to the Uniform Anatomical Gift Act and the law of this state, I hereby make rruption) however caused and on any theory of liability, whether in contract, strict liability, or tort (including negligence or otherwise) arising in any way out of the use of these materials. An att direct, indirect, incidental, special, exemplary, or consequential damages (including, but not limited to, procurement of substitute goods or services; loss of use, data, or profits; or business inteals are used at your own risk. In no event will: i) FindLegalForms, Inc, its agents, partners, or affiliates, or ii) the providers, authors or publishers of the forms, be responsible or liable for anym. These materials are provided "AS-IS." We do not give any express or implied warranties of merchantability, suitability or completeness for any of the materials for your particular needs. The materieated by use of these materials. FindLegalForms, Inc. does not provide legal advice. The purchase and use of these materials is subject to the "Disclaimers and Terms of Use" found at findlegalforms.con for the removal of a part from the body of the decedent, the physician, surgeon, technician, or enucleator removing the part knows of the revocation. Disclaimer No Attorney-Client relationship is cr a member of the person's class or a prior class. An anatomical gift by a person authorized under subdivision may be revoked by any member of the same or a prior class if, before procedures have beguoposing to make an anatomical gift knows of a refusal or contrary indications by the decedent. (3) The person proposing to make an anatomical gift knows of an objection to making an anatomical gift byAn anatomical gift may not be made by a person listed above if any of the following occur: (1) A person in a prior class is available at the time of death to make an anatomical gift. (2) The person pre decedent; (3) either parent of the decedent; (4) an adult brother or sister of the decedent; (5) a grandparent of the decedent; and (6) a guardian of the person of the decedent at the time of death ker for an authorized purpose, unless the decedent, at the time of death, has made an unrevoked refusal to make that anatomical gift: (1) the spouse of the decedent; (2) an adult son or daughter of th Gift Form An anatomical gift may be made any member of the following classes of persons, in the order of priority listed, may make an anatomical gift of all or part of the decedent's body or a pacemas made on behalf of the decedent by the next of kin or guardian. Included in this kit are the following: General Instructions for preparing your Anatomical Gift (by next of kin or guardian) Anatomicalt. As the next of kin or guardian, you can prepare and execute an Anatomical Gift on behalf of the decedent. This kit is designed to fulfill the obligations of the Uniform Anatomical Gift Act for giftFindLegalForms.com Information Donation Pursuant to the Uniform Anatomical Gift Act (by Next of Kin or Guardian) A loved one has died and you believe that he/she would desire to make an Anatomical Gif West Virginia