2011 Delaware Code
Title 12 - Decedents' Estates and Fiduciary Relations
CHAPTER 49A. DURABLE PERSONAL POWERS OF ATTORNEY ACT [EFFECTIVE OCT. 1, 2010]
Subchapter III. Statutory Forms [Effective Oct. 1, 2010]

TITLE 12 Decedents' Estates and Fiduciary Relations Fiduciary Relations CHAPTER 49A. DURABLE PERSONAL POWERS OF ATTORNEY ACT Subchapter III. Statutory Forms

§ 49A-301. Statutory form durable personal power of attorney; agent's certification.

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DURABLE

PERSONAL POWER OF ATTORNEY FORM

NOTICE

As the person signing this durable power of attorney you are the Principal.

The purpose of this power of attorney is to give the person you designate

(your "Agent") broad powers to handle your property, which may include powers

to sell, dispose of, or encumber any real or personal property without advance

notice to you or approval by you.

This power of attorney does not authorize your Agent to make health-care

decisions for you.

Unless you specify otherwise, your Agent's authority will continue even if you

become incapacitated, or until you die or revoke the power of attorney, or

until your Agent resigns or is unable to act for you. You should select

someone you trust to serve as your Agent.

This power of attorney does not impose a duty on your Agent to exercise

granted powers, but when powers are exercised, your Agent must use due care to

act for your benefit and in accordance with this power of attorney.

Your Agent must keep your funds and other property separate from your Agent's

funds and other property.

A court can take away the powers of your Agent if it finds your Agent is not

acting properly.

The powers and duties of an Agent under a durable power of attorney are

explained more fully in Delaware Code, Title 12, Chapter 49A, Section 49A-114

and Sections 49A-201 through 49A-217.

If there is anything about this form that you do not understand, you should

ask a lawyer of your own choosing to explain it to you.

I have read or had explained to me this notice and I understand its contents.

________________________ ______________

Principal Date

DURABLE

PERSONAL POWER OF ATTORNEY FORM

INSTRUCTIONS

As the person completing this form, you are the Principal. This form gives

another person the power to act on your behalf. The other person is your

Agent.

This form allows you to designate: (1) one Agent at a time and up to two

Agents in succession; (2) two or more Agents who may act independently of each

other (Concurrent Agents); or (3) two or more Agents who must act together

(Joint Agents).

If your Agent is unable or unwilling to act for you, your power of attorney

will end unless you have named a successor Agent(s).

IF YOU HAVE QUESTIONS ABOUT THIS POWER OF ATTORNEY OR THE AUTHORITY YOU ARE

GRANTING TO YOUR AGENT(S), YOU SHOULD SEEK LEGAL ADVICE BEFORE COMPLETING AND

SIGNING THIS FORM.

DESIGNATION OF AGENT

I, ________________________, name the following person(s) as my

(Name of Principal)

Agent(s):

Name of Agent: =rf

Agent's Address: =rf

Agent's Telephone Number: =rf

DESIGNATION OF ADDITIONAL OR SUCCESSOR AGENTS

(OPTIONAL)

Name of Agent: =rf

Agent's Address: =rf

Agent's Telephone Number: =rf

Name of Agent: =rf

Agent's Address: =rf

Agent's Telephone Number: =rf

If I have named more than one Agent above, I intend for those Agents to:

________ Act successively, one after the other

________ Act concurrently, independent of each other

________ Act jointly, not independent of each other

EFFECTIVE DATE

You must sign ONE of these two choices:

______________________________ This power of attorney

(Sign here if this is your choice)

is effective immediately, and shall not be effected by my subsequent

incapacity.

______________________________ This power of attorney

(Sign here if this is your choice)

is effective only if and while I am incapacitated as determined under 12 Del.

C. § 49A-109(c).

GRANT OF GENERAL AUTHORITY

I grant my Agent and any successor Agent general authority to act for me with

respect to the following powers described in more detail as defined in the

Durable Personal Power of Attorney Act, Delaware Code, Title 12, Chapter 49A.

You should READ the terms of each category of power or authority before

granting any of them to your Agent. A full explanation of each power or

authority is in the Delaware Code. The Delaware Code is available online.

Search: Delaware Code, Title 12, Chapter 49A, and then go to the number next

to the category. Example: Real Property, Section (§ ) 49A-204. The Delaware

Code may also be available at your local library.

INITIAL each category you want to include in the Agent's general authority.

CROSS OUT each category you do not want to include in the Agent's general

authority.

If you do not initial a category listed below, powers associated with that

category will NOT be included as part of your Agent's general authority.

____ Real Property § 49A-204

____ Tangible Personal Property § 49A-205

____ Stocks and Bonds § 49A-206

____ Commodities and Options § 49A-207

____ Banks and Other Financial Institutions § 49A-208

____ Operation of Entity or Business § 49A-209

____ Insurance and Annuities § 49A-210

____ Estates, Trusts, and Other Beneficial Interests § 49A-211

____ Claims and Litigation § 49A-212

____ Personal and Family Maintenance § 49A-213

____ Benefits from Governmental Programs or Civil or Military Service §

49A-214

____ Retirement Plans § 49A-215

____ Taxes § 49A-216

GRANT OF SPECIFIC AUTHORITY (OPTIONAL)

PROCEED WITH CAUTION

Giving your Agent any of the following powers will give your Agent the

authority to take actions that could significantly reduce your property or

change how and to whom your property is distributed at your death.

You should READ the terms describing each power before granting any of them to

your Agent.

INITIAL each power you want to include in the Agent's authority.

CROSS OUT each power you do not want to include in the Agent's authority.

If you do not initial a power listed below, it will NOT be included as part of

your Agent's specific authority.

____ Create, amend, revoke, or terminate an inter vivos trust

____ Make a gift in excess of the limitations in the Durable Personal

Power of Attorney Act, 12 Del. C. § 49A-217

____ Create or change rights of survivorship

____ Create or change a beneficiary designation

____ Delegate authority granted under the power of attorney when all

successor Agents have resigned, died, become incapacitated, are no longer

qualified to serve, or have declined to serve

____ Exercise fiduciary powers that the Principal has authority to

delegate

____ Reject, renounce, disclaim, release, or consent to a reduction in or

modification of a share in or payment from estate, trust, or other beneficial

interest

RELIANCE ON THIS POWER OF ATTORNEY

Any person, including my Agent, may rely upon this power of attorney or a copy

of it unless that person knows it has terminated or is invalid.

SIGNATURE AND ACKNOWLEDGMENT

IF YOU HAVE QUESTIONS ABOUT THIS POWER OF ATTORNEY OR THE AUTHORITY YOU ARE

GRANTING TO YOUR AGENT(S), YOU SHOULD SEEK LEGAL ADVICE BEFORE SIGNING THIS

FORM.

IN WITNESS WHEREOF, I have hereunto set my Hand and Seal this ____ day of

____________, 20____ .

__________________________ __________________________

(SEAL)

Witness Signature Your Signature

______________________________

______________________________

Print Your Name Print Your Name

I, the witness, swear that I am not related to the Principal by blood,

marriage, or adoption; and that I am not entitled to any portion of the estate

of the Principal under the Principal's current will or codicil, or under any

current trust instrument of the Principal

STATE OF DELAWARE :

: SS.

COUNTY OF ____________ :

This Durable Power of Attorney was acknowledged before me by ____________ this

________ day of ______________ 20____ .

______________________________

Notarial Office

IMPORTANT INFORMATION FOR AGENT

Agent's Duties

When you accept the authority granted under this power of attorney, a special

legal relationship is created between you and the Principal. This relationship

imposes upon you legal duties that continue until you resign or the power of

attorney is terminated or revoked. You must:

(1) do what you know the Principal reasonably expects you to do with the

Principal's property or, if you do not know the Principal's expectations, act

in the Principal's best interest;

(2) act in good faith;

(3) do nothing beyond the authority granted in this power of attorney; and

(4) disclose your identity as an Agent whenever you act for the Principal

by writing or printing the name of the Principal and signing your own name as

"Agent" in the following manner:

______________________________

______________________________

(Principal's Name) by (Your Signature)

as Agent

Except as otherwise provided in the power of attorney, you must also:

(1) not act for your own benefit;

(2) avoid conflicts that would impair your ability to act in the Principal's

best interest;

(3) act with care, competence, and diligence;

(4) keep a record of all receipts, disbursements, and transactions made on

behalf of the Principal;

(5) cooperate with any person who has authority to make health-care decisions

for the Principal; and

(6) not act in a manner inconsistent with the Principal's testamentary plan.

Termination of Agent's Authority

You must stop acting on behalf of the Principal if you learn of any event that

terminates this power of attorney or your authority under this power of

attorney. Events that terminate this power of attorney or your authority to

act under it include:

(1) death of the Principal;

(2) the Principal's revocation of the power of attorney or your authority;

(3) the occurrence of a termination event stated in the power of attorney;

(4) the purpose of the power of attorney is fully accomplished; or

(5) an action is filed with a court for your separation, annulment, or divorce

from the Principal, unless the Principal otherwise provided in the power of

attorney that such action will not terminate your authority.

Liability of Agent

The meaning of the authority granted to you is defined in the Durable Personal

Power of Attorney Act, Delaware Code, Title 12, Chapter 49A. If you violate

the Durable Personal Power of Attorney Act, Delaware Code, Title 12, Chapter

49A, or act outside the authority granted, you may be liable for any damages

caused by your violation.

If there is anything about this document or your powers, authority, or duties

as Agent that you do not understand, you should seek legal advice.

AGENT'S CERTIFICATION

I, ________________________, have read the attached durable power

(Name of Agent)

of attorney and I am the person identified as the

Agent for the Principal. To the best of my knowledge this

power has not been revoked. I hereby acknowledge

that, in the absence of a specific provision to

the contrary in the durable power of attorney, when

I act as Agent:

I shall exercise the powers for the benefit of the Principal.

I shall keep the assets of the Principal separate from my assets.

p0;0 I shall exercise reasonable caution and prudence.

I shall keep a full and accurate record of all actions, receipts and

disbursements on behalf of the Principal.

I shall, to the extent reasonably practicable under the circumstances, keep in

regular contact with the Principal and communicate with the Principal.

______________________________

______________________________

Agent Date"

Agent Date"

77 Del. Laws, c. 467, § 4.;