STATUTORY FORM POWER OF ATTORNEY
This power of attorney authorizes another person (your agent) to make decisions concerning your property for you (the principal). Your agent will be able to make decisions and act with respect to your property (including your money) whether or not you are able to act for yourself. The meaning of authority over subjects listed on this form is explained in the "Estates and Protected Individuals Code, Durable Power of Attorney and Designation of Patient Advocate, section 700.5501".
This power of attorney does not authorize the agent to make health-care decisions for you.
You should select someone you trust to serve as your agent. Unless you specify otherwise, generally the agent's authority will continue until you die or revoke the power of attorney or the agent resigns or is unable to act for you.
Your agent is entitled to reasonable compensation unless you state otherwise in the Special Instructions.
This form provides for designation of one agent. If you wish to name more than one agent, you may name a co-agent in the Special Instructions. Co-agents are not required to act together unless you include that requirement in the Special Instructions.
If your agent is unable or unwilling to act for you, your power of attorney will end unless you have named a successor agent. You may also name a second successor agent.
This power of attorney becomes effective immediately unless you state otherwise in the Special Instructions.
If you have questions about the power of attorney or the authority you are granting to your agent, you should seek legal advice before signing this form.
DESIGNATION OF AGENT
I, _________, of _________, telephone number _________, and email address _________ name the following person as my agent:
Name of Agent: _________
Agent's Address: _________
Agent's Telephone Number: _________
Agent's Email Address: _________
DURABLE POWER OF ATTORNEY
GRANT OF GENERAL AUTHORITY
I grant my agent and any successor agent general authority to act for me with respect to the following subjects as defined in the "Estates and Protected Individuals Code, Durable Power of Attorney and Designation of Patient Advocate, section 700.5501":
(INITIAL each subject you want to include in the agent's general authority.)
________ Real Property
________ Tangible Personal Property
________ Stocks and Bonds
________ Commodities and Options
________ Banks and Other Financial Institutions
________ Operation of Entity or Business
________ Insurance and Annuities
________ Estates, Trusts, and Other Beneficial Interests
________ Claims and Litigation
________ Personal and Family Maintenance
________ Benefits from Governmental Programs or Civil or Military Service
________ Retirement Plans
________ Taxes
LIMITATION ON AGENT'S AUTHORITY
An agent that is not my ancestor, spouse, or descendant MAY NOT use my property to benefit the agent or a person to whom the agent owes an obligation of support unless I have included that authority in the Special Instructions.
My Agent(s) is/are entitled to reasonable compensation for services rendered as my Agent.
My Agent(s) is/are entitled to reimbursement for reasonable expenses incurred in acting under this Power of Attorney.
This power of attorney shall be effective immediately and will continue to be effective until my death, even if I became incapacitated, except as may be provided otherwise by an applicable state statute.
This Power of Attorney may be revoked or terminated by me at any time by providing written notice to my Agent.
RELIANCE ON THIS POWER OF ATTORNEY
Any person, including my agent, may rely upon the validity of this power of attorney or a copy of it unless that person knows it has terminated or is invalid.
Dated ____________________, _____, at _________, Michigan.
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Address: _________
Telephone Number: _________
Email Address: _________
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State of Michigan
_________ County
This document was acknowledged before me on | _______________. |
| (date) |
by ___________________________________
_________
_____________________________________
(Seal, if any)
Signature of Notary: __________________________________
My commission expires: _______________________________
Michigan Attorney-in-Fact Acknowledgement
I, _________, have been appointed as attorney-in-fact for _________, the principal, under a durable power of attorney dated __________. By signing this document, I acknowledge that if and when I act as attorney-in-fact, all of the following apply:
(a) Except as provided in the durable power of attorney, I must act in accordance with the standards of care applicable to fiduciaries acting under durable powers of attorney.
(b) I must take reasonable steps to follow the instructions of the principal.
(c) Upon request of the principal, I must keep the principal informed of my actions. I must provide an accounting to the principal upon request of the principal, to a guardian or conservator appointed on behalf of the principal upon the request of that guardian or conservator, or pursuant to judicial order.
(d) I cannot make a gift from the principal's property, unless provided for in the durable power of attorney or by judicial order.
(e) Unless provided in the durable power of attorney or by judicial order, I, while acting as attorney-in-fact, cannot create an account or other asset in joint tenancy between the principal and me.
(f) I must maintain records of my transactions as attorney-in-fact, including receipts, disbursements, and investments.
(g) I may be liable for any damage or loss to the principal, and may be subject to any other available remedy, for breach of fiduciary duty owed to the principal. In the durable power of attorney, the principal may exonerate me of any liability to the principal for breach of fiduciary duty except for actions committed by me in bad faith or with reckless indifference. An exoneration clause is not enforceable if inserted as the result of my abuse of a fiduciary or confidential relationship to the principal.
(h) I may be subject to civil or criminal penalties if I violate my duties to the principal.
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IMPORTANT INFORMATION FOR AGENT
Agent's Duties
When you, the agent, 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 shall continue until you resign or the power of attorney is terminated or revoked. Before exercising authority under a durable power of attorney, you, the agent, shall execute the following acknowledgment of your responsibilities:
_________, have been appointed as agent(s) for _________, the principal, under a durable power of attorney on this _____ day of ____________________, 20____. By signing this document, he/they acknowledge that if and when he/they act as an agent, all of the following apply:
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.
(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
Unless the Special Instructions in this power of attorney state otherwise, you must also:
(1) Act in accordance with the standards of care, competence and diligence applicable to fiduciaries exercising powers under a durable power of attorney.
(2) Take reasonable steps to follow the instructions of the principal.
(3) Avoid conflicts that would impair your ability to act in the principal's best interest.
(4) Keep the principal informed of the attorney-in-fact's actions.
(5) Provide an accounting to the principal upon request of the principal, to a conservator or guardian appointed on behalf of the principal upon request of the guardian or conservator, or pursuant to judicial order, by keeping a record of all receipts, disbursements, and transactions made on behalf of the principal.
(6) Cooperate with any person that has authority to make health-care decisions for the principal to do what you know the principal reasonably expects or, if you do not know the principal's expectations, to act in the principal's best interest.
(7) Attempt to preserve the principal's estate plan if you know the plan and preserving the plan is consistent with the principal's best interest.
(8) Not make a gift of all or any part of the principal's assets.
(9) Not create an account or other asset in joint tenancy between the principal and the agent.
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 a power of attorney or your authority to act under a power of attorney 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.
(5) If you are married to the principal, a legal action is filed with a court to end your marriage, or for your legal separation, unless the Special Instructions in this power of attorney state that such an action will not terminate your authority.
The meaning of the authority granted to you is defined in the Estates and Protected Individuals Code, Durable Power of Attorney and Designation of Patient Advocate, section 700.5501. If you violate the law or act outside the authority granted, you may be liable for any damages or losses caused to the principal by your violation and may be subject to any other available remedy, for breaching the fiduciary duties owed to the principal.
If there is anything about this document or your duties that you do not understand, you should seek legal advice.
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