10-6-142
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10-6-142.
The
Georgia Statutory Form for Financial Power of Attorney shall be substantially as
follows:
FINANCIAL
POWER OF ATTORNEY
County of
__________
State of Georgia
State of Georgia
I,
_______________________, (hereinafter 'Principal'), a resident of ________
County, Georgia, do hereby constitute and appoint _______________________ my
true and lawful attorney-in-fact (hereinafter 'Agent') for me and give such
person the power(s) specified below to act in my name, place, and stead in any
way which I, myself, could do if I were personally present with respect to the
following matters:
(Directions:
To give the Agent the powers described in paragraphs 1 through 13, place your
initials on the blank line at the end of each paragraph. If you DO NOT want to
give a power to the Agent, strike through the paragraph or a line within the
paragraph and place your initials beside the stricken paragraph or stricken
line. The powers described in any paragraph not initialed or which has been
struck through will not be conveyed to the Agent. Both the Principal and the
Agent must sign their full names at the end of the last paragraph.)
1.
Bank and Credit Union Transactions: To make, receive, sign, endorse, execute,
acknowledge, deliver, and possess checks, drafts, bills of exchange, letters of
credit, notes, stock certificates, withdrawal receipts and deposit instruments
relating to accounts or deposits in, or certificates of deposit of banks,
savings and loans, credit unions, or other institutions or associations.
______
2.
Payment Transactions: To pay all sums of money, at any time or times, that may
hereafter be owing by me upon any account, bill or exchange, check, draft,
purchase, contract, note, or trade acceptance made, executed, endorsed,
accepted, and delivered by me or for me in my name, by my Agent.
______
Note:
If you initial paragraph 3 or paragraph 4 which follow, a notarized signature
will be required on behalf of the Principal.
3.
Real Property Transactions: To lease, sell, mortgage, purchase, exchange, and
acquire, and to agree, bargain, and contract for the lease, sale, purchase,
exchange, and acquisition of, and to accept, take, receive, and possess any
interest in real property whatsoever, on such terms and conditions, and under
such covenants, as my Agent shall deem proper; and to maintain, repair, tear
down, alter, rebuild, improve, manage, insure, move, rent, lease, sell, convey,
subject to liens, mortgages, and security deeds, and in any way or manner deal
with all or any part of any interest in real property whatsoever, including
specifically, but without limitation, real property lying and being situate in
the State of Georgia, under such terms and conditions, and under such covenants,
as my Agent shall deem proper and may for all deferred payments accept purchase
money notes payable to me and secured by mortgages or deeds to secure debt, and
may from time to time collect and cancel any of said notes, mortgages, security
interests, or deeds to secure debt. ______
4.
Personal Property Transactions: To lease, sell, mortgage, purchase, exchange,
and acquire, and to agree, bargain, and contract for the lease, sale, purchase,
exchange, and acquisition of, and to accept, take, receive, and possess any
personal property whatsoever, tangible or intangible, or interest thereto, on
such terms and conditions, and under such covenants, as my Agent shall deem
proper; and to maintain, repair, improve, manage, insure, rent, lease, sell,
convey, subject to liens or mortgages, or to take any other security interests
in said property which are recognized under the Uniform Commercial Code as
adopted at that time under the laws of Georgia or any applicable state, or
otherwise hypothecate, and in any way or manner deal with all or any part of any
real or personal property whatsoever, tangible or intangible, or any interest
therein, that I own at the time of execution or may thereafter acquire, under
such terms and conditions, and under such covenants, as my Agent shall deem
proper. ______
5.
Stock and Bond Transactions: To purchase, sell, exchange, surrender, assign,
redeem, vote at any meeting, or otherwise transfer any and all shares of stock,
bonds, or other securities in any business, association, corporation,
partnership, or other legal entity, whether private or public, now or hereafter
belonging to me. ______
6.
Safe Deposits: To have free access at any time or times to any safe-deposit box
or vault to which I might have access. ______
7.
Borrowing: To borrow from time to time such sums of money as my Agent may deem
proper and execute promissory notes, security deeds or agreements, financing
statements, or other security instruments in such form as the lender may request
and renew said notes and security instruments from time to time in whole or in
part. ______
8.
Business Operating Transactions: To conduct, engage in, and otherwise transact
the affairs of any and all lawful business ventures of whatever nature or kind
that I may now or hereafter be involved in. ______
9.
Insurance Transactions: To exercise or perform any act, power, duty, right, or
obligation, in regard to any contract of life, accident, health, disability,
liability, or other type of insurance or any combination of insurance; and to
procure new or additional contracts of insurance for me and to designate the
beneficiary of same; provided, however, that my Agent cannot designate himself
or herself as beneficiary of any such insurance contracts. ______
10.
Disputes and Proceedings: To commence, prosecute, discontinue, or defend all
actions or other legal proceedings touching my property, real or personal, or
any part thereof, or touching any matter in which I or my property, real or
personal, may be in any way concerned. To defend, settle, adjust, make
allowances, compound, submit to arbitration, and compromise all accounts,
reckonings, claims, and demands whatsoever that now are, or hereafter shall be,
pending between me and any person, firm, corporation, or other legal entity, in
such manner and in all respects as my Agent shall deem proper.
______
11.
Hiring Representatives: To hire accountants, attorneys at law, consultants,
clerks, physicians, nurses, agents, servants, workmen, and others and to remove
them, and to appoint others in their place, and to pay and allow the persons so
employed such salaries, wages, or other remunerations, as my Agent shall deem
proper. ______
12.
Tax, Social Security, and Unemployment: To prepare, to make elections, to
execute and to file all tax, social security, unemployment insurance, and
informational returns required by the laws of the United States, or of any state
or subdivision thereof, or of any foreign government; to prepare, to execute,
and to file all other papers and instruments which the Agent shall think to be
desirable or necessary for safeguarding of me against excess or illegal taxation
or against penalties imposed for claimed violation of any law or other
governmental regulation; and to pay, to compromise, or to contest or to apply
for refunds in connection with any taxes or assessments for which I am or may be
liable. ______
13.
Broad Powers: Without, in any way, limiting the foregoing, generally to do,
execute, and perform any other act, deed, matter, or thing whatsoever, that
should be done, executed, or performed, including, but not limited to, powers
conferred by Code Section 53-12-232 of the Official Code of Georgia Annotated,
or that in the opinion of my Agent, should be done, executed, or performed, for
my benefit or the benefit of my property, real or personal, and in my name of
every nature and kind whatsoever, as fully and effectually as I could do if
personally present. ______
14.
Effective Date: This document will become effective upon the date of the
Principal´s signature unless the Principal indicates that it should become
effective at a later date by completing the following, which is optional.
The
powers conveyed in this document shall not become effective until the following
time or upon the occurrence of the following event or contingency:
___________________________________________________________________
___________________________________________________________________
Note:
The Principal may choose to designate one or more persons to determine
conclusively that the above-specified event or contingency has occurred. Such
person or persons must make a written declaration under penalty of false
swearing that such event or contingency has occurred in order to make this
document effective. Completion of this provision is optional.
The
following person or persons are designated to determine conclusively that the
above-specified event or contingency has occurred:
___________________________________________________________________
___________________________________________________________________
Signed:_______________________
Principal
_______________________
Agent
Principal
_______________________
Agent
It
is my desire and intention that this power of attorney shall not be affected by
my subsequent disability, incapacity, or mental incompetence. However, I
understand that it shall be revoked and the Agent´s power canceled in the
event a guardian is appointed for my property. As long as no such guardian is
appointed, any and all acts done by the Agent pursuant to the powers conveyed
herein during any period of my disability, incapacity, or mental incompetence
shall have the same force and effect as if I were not disabled, incapacitated,
or mentally incompetent.
I
may, at any time, revoke this power of attorney, and it shall be canceled by my
death. Otherwise, unless a guardian is appointed for my property, this power of
attorney shall be deemed to be in full force and effect as to all persons,
institutions, and organizations which shall act in reliance thereon prior to the
receipt of written revocation thereof signed by me and prior to my death.
I
do hereby ratify and confirm all acts whatsoever which my Agent shall do, or
cause to be done, in or about the premises, by virtue of this power of attorney.
All
parties dealing in good faith with my Agent may fully rely upon the power of and
authority of my Agent to act for me on my behalf and in my name, and may accept
and rely on agreements and other instruments entered into or executed by the
agent pursuant to this power of attorney.
This
instrument shall not be effective as a grant of powers to my Agent until my
Agent has executed the Acceptance of Appointment appearing at the end of this
instrument. This instrument shall remain effective until revocation by me or my
death, whichever occurs first.
Compensation
of Agent. (Directions: Initial the line following your choice.)
1.
My Agent shall receive no compensation for services rendered.
______
2.
My Agent shall receive reasonable compensation for services rendered.
______
3.
My Agent shall receive $__________ for services rendered. ______
IN
WITNESS WHEREOF, I have hereunto set my hand and seal on this _____ day of
______________, ____.
_______________________
Principal
WITNESSES
_______________________
_______________________
Signature and Address
_______________________
_______________________
Signature and Address
Principal
WITNESSES
_______________________
_______________________
Signature and Address
_______________________
_______________________
Signature and Address
Note:
A notarized signature is not required unless you have initialed paragraph 3 or 4
regarding property transactions.
I,
_______________________, a Notary Public, do hereby certify that
_______________________ personally appeared before me this date and acknowledged
the due execution of the foregoing Power of Attorney.
_______________________
Notary Public
State of Georgia
County of __________
Notary Public
State of Georgia
County of __________
ACCEPTANCE
OF APPOINTMENT
I,
_______________________ (print name), have read the foregoing Power of Attorney
and am the person identified therein as Agent for _______________________ (name
of grantor of power of attorney), the Principal named therein. I hereby
acknowledge the following:
I
owe a duty of loyalty and good faith to the Principal, and must use the powers
granted to me only for the benefit of the Principal.
I
must keep the Principal´s funds and other assets separate and apart from my
funds and other assets and titled in the name of the Principal. I must not
transfer title to any of the Principal´s funds or other assets into my name
alone. My name must not be added to the title of any funds or other assets of
the Principal, unless I am specifically designated as Agent for the Principal in
the title.
I
must protect, conserve, and exercise prudence and caution in my dealings with
the Principal´s funds and other assets.
I
must keep a full and accurate record of my acts, receipts, and disbursements on
behalf of the Principal, and be ready to account to the Principal for such acts,
receipts, and disbursements at all times. I must provide an annual accounting
to the Principal of my acts, receipts, and disbursements, and must furnish an
accounting of such acts, receipts, and disbursements to the personal
representative of the Principal´s estate within 90 days after the date of
death of the Principal.
I
have read the
Compensation
of Agent paragraph in the Power of
Attorney and agree to abide by it.
I
acknowledge my authority to act on behalf of the Principal ceases at the death
of the Principal.
I
hereby accept the foregoing appointment as Agent for the Principal with full
knowledge of the responsibilities imposed on me, and I will faithfully carry out
my duties to the best of my ability.
Dated:______________, ____.
(Signature)_______________________
(Address)_______________________
(Address)_______________________
Note:
A notarized signature is not required unless the Principal initialed paragraph 3
or paragraph 4 regarding property transactions.
I,
_______________________, a Notary Public, do hereby certify that
_______________________ personally appeared before me this date and acknowledge
the due execution of the foregoing Acceptance of Appointment.
_______________________
Notary Public
Notary Public