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A person who wishes to designate another as attorney-in-fact or agent by a power of attorney may execute a statutory power of attorney set out in substantially the following form:
GENERAL POWER OF ATTORNEY
THE POWERS GRANTED FROM THE PRINCIPAL TO THE AGENT OR AGENTS IN THE
FOLLOWING DOCUMENT ARE VERY BROAD. THEY MAY INCLUDE THE POWER TO
DISPOSE, SELL, CONVEY, AND ENCUMBER YOUR REAL AND PERSONAL PROPERTY,
AND THE POWER TO MAKE YOUR HEALTH CARE DECISIONS. ACCORDINGLY, THE
FOLLOWING DOCUMENT SHOULD ONLY BE USED AFTER CAREFUL CONSIDERATION. IF
YOU HAVE ANY QUESTIONS ABOUT THIS DOCUMENT, YOU SHOULD SEEK COMPETENT
ADVICE.
YOU MAY REVOKE THIS POWER OF ATTORNEY AT ANY TIME.
Pursuant to AS 13.26.338 - 13.26.353, I, __(Name of principal)__,
of ____(Address of principal)____, do hereby appoint ____(Name and
address of agent or agents)____, my attorney(s)-in-fact to act as I
have checked below 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, as each of them is defined in AS 13.26.344 , to the
full extent that I am permitted by law to act through an agent:
THE AGENT OR AGENTS YOU HAVE APPOINTED WILL HAVE ALL THE POWERS
LISTED BELOW UNLESS YOU
DRAW A LINE THROUGH A CATEGORY; AND
INITIAL THE BOX OPPOSITE THAT CATEGORY
(A) real estate transactions ( )
(B) transactions involving tangible personal property,
chattels, and goods ( )
(C) bonds, shares, and commodities transactions ( )
(D) banking transactions ( )
(E) business operating transactions ( )
(F) insurance transactions ( )
(G) estate transactions ( )
(H) gift transactions ( )
(I) claims and litigation ( )
(J) personal relationships and affairs ( )
(K) benefits from government programs and military
service ( )
(L) records, reports, and statements ( )
(M) delegation ( )
(N) all other matters, including those specified as follows: ( )
IF YOU HAVE APPOINTED MORE THAN ONE AGENT, CHECK ONE OF THE FOLLOWING:
( ) Each agent may exercise the powers conferred separately, without
the consent of any other agent.
( ) All agents shall exercise the powers conferred jointly, with the
consent of all other agents.
TO INDICATE WHEN THIS DOCUMENT SHALL BECOME EFFECTIVE, CHECK ONE OF THE
FOLLOWING:
( ) This document shall become effective upon the date of my
signature.
( ) This document shall become effective upon the date of my
disability and shall not otherwise be affected by my disability.
IF YOU HAVE INDICATED THAT THIS DOCUMENT SHALL BECOME EFFECTIVE ON THE
DATE OF YOUR SIGNATURE, CHECK ONE OF THE FOLLOWING:
( ) This document shall not be affected by my subsequent disability.
( ) This document shall be revoked by my subsequent disability.
IF YOU HAVE INDICATED THAT THIS DOCUMENT SHALL BECOME EFFECTIVE UPON
THE DATE OF YOUR SIGNATURE AND WANT TO LIMIT THE TERM OF THIS
DOCUMENT, COMPLETE THE FOLLOWING:
This document shall only continue in effect for ________ ( )
years from the date of my signature.
NOTICE OF REVOCATION OF THE POWERS GRANTED IN THIS DOCUMENT
You may revoke one or more of the powers granted in this document.
Unless otherwise provided in this document, you may revoke a specific
power granted in this power of attorney by completing a special power
of attorney that includes the specific power in this document that you
want to revoke. Unless otherwise provided in this document, you may
revoke all the powers granted in this power of attorney by completing a
subsequent power of attorney.
NOTICE TO THIRD PARTIES A third party who relies on the reasonable representations of an
attorney-in-fact as to a matter relating to a power granted by a
properly executed statutory power of attorney does not incur any
liability to the principal or to the principal's heirs, assigns, or
estate as a result of permitting the attorney-in-fact to exercise the
authority granted by the power of attorney. A third party who fails to
honor a properly executed statutory form power of attorney may be
liable to the principal, the attorney-in-fact, the principal's heirs,
assigns, or estate for a civil penalty, plus damages, costs, and fees
associated with the failure to comply with the statutory form power of
attorney. If the power of attorney is one which becomes effective upon
the disability of the principal, the disability of the principal is
established by an affidavit, as required by law.
IN WITNESS WHEREOF, I have hereunto signed my name this ____ day of
of __________, ____.
______________________ Signature of Principal
Acknowledged before me at
__________________________ on ______________________________.
______________________________ Signature of Officer or Notary
Note to HTML Version:
This version of the Alaska Statutes is current through December, 2004. The Alaska Statutes were automatically converted to HTML from a plain text format. Every effort has been made to ensure their accuracy, but this can not be guaranteed. If it is critical that the precise terms of the Alaska Statutes be known, it is recommended that more formal sources be consulted. For statutes adopted after the effective date of these statutes, see, Alaska State Legislature If any errors are found, please e-mail Touch N' Go systems at E-mail. We hope you find this information useful.
Last modified 9/3/2005