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DURABLE POWER OF ATTORNEY

Notice to Person Executing Durable Power of Attorney

A durable power of attorney is an important legal document. By signing the durable power
of attorney, you are authorizing another person to act for you, the principal. Before you sign this
durable power of attorney, you should know these important facts:

Your agent (attorney-in-fact) has no duty to act unless you and your agent agree otherwise
in writing. This document gives your agent the powers to manage, dispose of, sell, and convey
your real and personal property, and to use your property as security if your agent borrows money
on your behalf. This document does not give your agent the power to accept or receive any of
your property, in trust or otherwise, as a gift, unless you specifically authorize the agent to accept
or receive a gift.

Your agent will have the right to receive reasonable payment for services provided under
this durable power of attorney unless you provide otherwise in this power of attorney.

The powers you give your agent will continue to exist for your entire lifetime, unless you
state that the durable power of attorney will last for a shorter period of time or unless you
otherwise terminate the durable power of attorney. The powers you give your agent in this durable
power of attorney will continue to exist even if you can no longer make your own decisions
respecting the management of your property.

You can amend or change this durable power of attorney only by executing a new durable
power of attorney or by executing an amendment through the same formalities as an original. You
have the right to revoke or terminate this durable power of attorney at any time, so long as you are
competent.

This durable power of attorney must be dated and must be acknowledged before a notary
public or attested to by 2 witnesses. A durable power of attorney that may affect real property
should be acknowledged before a notary public so that it may easily be recorded.

You should read this durable power of attorney carefully. When effective, this durable
power of attorney will give your agent the right to deal with property that you now have or might
acquire in the future. The durable power of attorney is important to you. If you do not understand
the durable power of attorney, or any provision of it, then you should obtain the assistance of an
attorney or other qualified person.

NOTICE: THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND
SWEEPING. THEY ARE EXPLAINED IN THE UNIFORM STATUTORY FORM POWER
OF ATTORNEY ACT (CALIFORNIA PROBATE CODE SECTIONS 4400-4465). IF YOU
HAVE ANY QUESTIONS ABOUT THESE POWERS, OBTAIN COMPETENT LEGAL
ADVICE. THIS DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL
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AND OTHER HEALTHCARE DECISIONS FOR YOU. YOU MAY REVOKE THIS
POWER OF ATTORNEY IF YOU LATER WISH TO DO SO.

I, _, residing at _________________, _________________, California _________________,
hereby appoint _ of _________________, _________________, California
_________________, as my attorney-in-fact (“Agent”) to exercise the powers and discretions
described below.

If the Agent is unable to serve for any reason, I appoint _________________, of
_________________, _________________, California _________________, as my alternate
or Successor Agent, as the case may be to serve with the same powers and discretions.

This Power of Attorney shall not be affected by my subsequent incapacity.

I hereby revoke any and all general powers of attorney and special powers of attorney that
previously have been signed by me.
My Agent shall have full power and authority to act on my behalf. This power and authority shall
authorize my Agent to manage and conduct all of my affairs and to exercise all of my legal rights
and powers, including all rights and powers that I may acquire in the future. My Agent’s powers
shall include, but not be limited to, the power to:

a. Conduct any business with any banking or financial institution with respect to any of
my accounts, including, but not limited to, making deposits and withdrawals, negotiating
or endorsing any checks or other instruments with respect to any such accounts,
obtaining bank statements, passbooks, drafts, money orders, warrants, and certificates
or vouchers payable to me by any person, firm, corporation or political entity.
b. Add, delete or change beneficiaries to any financial accounts I own including
insurance policies, annuities, retirement accounts, payable on death savings or checking
accounts or other investments.

c. Perform any act necessary to deposit, negotiate, sell or transfer any note, security, or
draft of the United States of America, including U.S. Treasury Securities.
d. Have access to any safe deposit box that I might own, including its contents.
1. Open, maintain or close bank accounts (including, but not limited to, checking accounts,
savings accounts, and certificates of deposit), brokerage accounts, retirement plan accounts,
and other similar accounts with financial institutions.
2. Sell, exchange, buy, invest, or reinvest any assets or property owned by me. Such assets
or property may include income producing or non-income producing assets and property.
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3. Take any and all legal steps necessary to collect any amount or debt owed to me, or to
settle any claim, whether made against me or asserted on my behalf against any other person
or entity.
4. Enter into binding contracts on my behalf.
5. Maintain and/or operate any business that I may own.

6. Employ professional and business assistance as may be appropriate, including attorneys,
accountants, and real estate Agents.

7. Sell, convey, lease, mortgage, manage, insure, improve, repair, or perform any other act
with respect to any of my property (now owned or later acquired) including, but not limited
to, real estate and real estate rights (including the right to remove tenants and to recover
possession). This includes the right to sell or encumber any homestead that I now own or may
own in the future.
8. Prepare, sign, and file documents with any governmental body or agency, including, but not
limited to, authorization to:
a. Prepare, sign and file income and other tax returns with federal, state, local, and other
governmental bodies.
b. Obtain information or documents from any government or its agencies, and represent
me in all tax matters, including the authority to negotiate, compromise, or settle any
matter with such government or agency.
c. Prepare applications, provide information, and perform any other act reasonably
requested by any government or its agencies in connection with governmental benefits
(including medical, military and social security benefits), and to appoint anyone, including
my Agent, to act as my “Representative Payee” for the purpose of receiving Social
Security benefits.
9. Make gifts from my assets to members of my family, including to the Agent, and to such
other persons or charitable organizations with whom I have an established pattern of giving
(or if it is appropriate to make such gifts for estate planning, long-term care planning and/or
tax purposes), to file state and federal gift tax returns, and to file a tax election to split gifts
with my spouse, if any. No Agent acting under this instrument, except as specifically
authorized in this instrument, shall have the power or authority to (a) gift, appoint, assign or
designate any of my assets, interests or rights, directly or indirectly, to such Agent, such
Agent’s estate, such Agent’s creditors, or the creditors of such Agent’s estate, (b) exercise
any powers of appointment I may hold in favor of such Agent, such Agent’s estate, such
Agent’s creditors, or the creditors of such Agent’s estate, or (c) use any of my assets to
discharge any of such Agent’s legal obligations, including any obligations of support which
such Agent may owe to others, excluding those whom I am legally obligated to support.
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10. To transfer any of my assets to the trustee of any revocable trust created by me, if such
trust is in existence at the time of such transfer.

11. Subject to other provisions of this document, my Agent may disclaim any interest, which
might otherwise be transferred or distributed to me from any other person, estate, trust, or
other entity, as may be appropriate. However, my 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. Provided that they are not the same person, my Agent may
disclaim assets which pass to my Gift Agent, and my Gift Agent may disclaim assets which
pass to my Agent.
This Power of Attorney shall be construed broadly as a General Power of Attorney. The listing of
specific powers is not intended to limit or restrict the general powers granted in this Power of
Attorney in any manner.
Any power or authority granted to my Agent under this document shall be limited to the extent
necessary to prevent this Power of Attorney from causing, (i) my income to be taxable to my
Agent, (ii) my assets to be subject to a general power of appointment by my Agent, or (iii) my
Agent to have any incidents of ownership with respect to any life insurance policies that I may own
on the life of my Agent.
My Agent shall not be liable for any loss that results from a judgment error that was made in good
faith. However, my Agent shall be liable for willful misconduct or the failure to act in good faith
while acting under the authority of this Power of Attorney. A Successor Agent shall not be liable
for acts of a prior Agent.

No person who relies in good faith on the authority of my Agent under this instrument shall incur
any liability to me, my estate or my personal representative. I authorize my Agent to indemnify and
hold harmless any third party who accepts and acts under this document.

If any part of any provision of this instrument shall be invalid or unenforceable under applicable
law, such part shall be ineffective to the extent of such invalidity only, without in any way affecting
the remaining parts of such provision or the remaining provisions of this instrument.

My Agent shall be entitled to reasonable compensation for any services provided as my Agent.
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.

My Agent shall provide an accounting for all funds handled and all acts performed as my Agent as
required under state law or upon my request or the request of any authorized personal
representative, fiduciary or court of record acting on my behalf.

This Power of Attorney is granted in, and shall be governed by the laws of the state of California;
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however, I intend that this Power of Attorney be universally recognized and that it be universally
admissible to recordation. In the event that I become a resident of another jurisdiction, or obtain
property, including real property or any other property interest, in another jurisdiction, it remains
my intention that the laws of California shall continue to govern this Power of Attorney.

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This Power of Attorney shall become effective immediately, and shall not be affected by my
disability or lack of mental competence, except as may be provided otherwise by an applicable
state statute. This is a Durable Power of Attorney. This Power of Attorney shall continue effective
until my death. This Power of Attorney may be revoked by me at any time by providing written
notice to my Agent.

Dated ____________________, ______, at _________________, California.

__________________________________

 
_

A notary public or other officer completing this certificate verifies only the identity of the
individual(s) who signed the document to which this certificate is attached, and not the
truthfulness, accuracy, or validity of that document.

STATE OF CALIFORNIA,
COUNTY OF _________________, ss:

On __________________ before me, ___________________________________, personally
appeared _, who proved to me on the basis of satisfactory evidence to be the person(s) whose
name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on
the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the
instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the
foregoing paragraph is true and correct.

WITNESS my hand and official seal.

Signature of Notary Public

________________________________________ (Notary Seal)
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Notice to Person Accepting the Appointment as Attorney-in-Fact:

By acting or agreeing to act as the agent (attorney-in-fact) under this power of attorney
you assume the fiduciary and other legal responsibilities of an agent. These responsibilities include:

1. The legal duty to act solely in the interest of the principal and to avoid conflicts of
interest.

2. The legal duty to keep the principal’s property separate and distinct from any other
property owned or controlled by you.

You may not transfer the principals property to yourself without full and adequate
consideration or accept a gift of the principals property unless this power of attorney specifically
authorizes you to transfer property to yourself or accept a gift of the principal’s property. If you
transfer the principals property to yourself without specific authorization in the power of attorney,
you may be prosecuted for fraud and/or embezzlement. If the principal is 65 years of age or older
at the time that the property is transferred to you without authority, you may also be prosecuted for
elder abuse under Penal Code Section 368. In addition to criminal prosecution, you may also be
sued in civil court.

I have read the foregoing notice and I understand the legal and fiduciary duties that I
assume by acting or agreeing to act as the agent (attorney-in-fact) under the terms of this power of
attorney.

Date:

Signed:

_________________________________

Durable Power of Attorney California