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Stocks Special Durable


STATE OF _______________________

COUNTY OF _____________________


That I, __________________________of _________________County,

_______________________ (State), being of sound mind and memory, do hereby make, constitute and appoint ________________________ as my true and lawful agent and attorney in fact (hereinafter sometimes called “my agent”), with full power and authority to act for me, individually, and in my name, place and stead, with reference to the transaction of any and all business related to or connected with _______________________ including, but not limited to, the sale of my stock in _______________ and the voting my shares as to any and all matters relating to said corporation, and to do any and all things, exercise any discretion, and execute and deliver any and all conveyances and other documents of whatsoever kind and character, in or about or with respect to any and all matters and things concerning said corporation, as fully and completely as I might lawfully do if present and acting in person with full power of substitution or revocation, and to have all powers and rights that I now possess or may possess hereafter with respect to said corporation.

Without intending in any manner to limit or diminish the foregoing powers granted to my agent, but intending to expand or enlarge upon the same, I specifically authorize and empower my agent, to:

1.         ________________________ on my behalf in the same capacity as I would have with the same powers and authority possessed by me at that time, including but not limited to exercising stock options and voting all of my shares of stock in said corporation or corporations without the necessity of a proxy and the right to appoint proxies therefor, and possessing all powers that I possess as granted to me by the Bylaws of said corporation or corporations, to incorporate, reorganize, merge, consolidate, recapitalize, sell, liquidate or dissolve any business; elect or employ officers, directors and agents; carry out the provisions of any agreement for the sale of any business interest or the stock therein;

  1. Receive, hold, transfer, sell and convey any stock certificates of

___________________________ and all documents of title in connection therewith;

3.         Make, execute and deliver, in my name and on my behalf, for any consideration whatsoever, for cash, instruments of conveyance covering the stock of ___________________________, containing such terms, covenants and conditions deemed necessary or advisable by my agent;

4.         Execute, in my name and on my behalf, such contracts or other assurances as may be requested or required by any bank or other institution or individual when carrying out the powers granted herein;

  1. Acquire, exchange, buy or sell my stock in __________________, or any interest therein, on such terms and conditions as my agent shall deem proper. Execute and deliver, in my name and on my behalf, conveyances of said stock;

6.         This instrument is to be construed and interpreted as a special durable power of attorney.  This instrument is executed and delivered in the State of ________________ , and the laws of the State of ___________ shall govern all questions as to validity of this power and the construction of its provisions;

7.         Third parties may rely upon the representations of the agents as to all matters relating to any power granted to them hereunder, and no person who may act in reliance upon the representations of the agent or the authority granted to it shall incur any liability to the principal or his estate as result of permitting the agent to exercise any power.

I direct that the above-related powers and authority of my said agent shall be so exercisable and effective regardless of the fact that I may be mentally or physically incapacitated or incapable of understanding or unable to express myself or act in my own behalf at the time of any action on my behalf by said agent.  Such incapacity, whether mental or physical, that I may exhibit shall not in any way interfere with the authority of my agent herein to act fully on my behalf according to the terms hereof.  In other words, this Power of Attorney shall not be affected by the subsequent disability, incompetence or incapacity of the principal.

And I do hereby undertake to ratify and confirm, all and singular, the acts heretofore performed and to be hereinafter performed by my said agents, acting in my name and on my behalf.

IN WITNESS WHEREFORE, I have executed this Special Durable Power of Attorney consisting of  ______ pages this the ____ day of ___________, 20____.




The hereinafter named Witnesses, each declare under penalty of perjury under the laws of the State of __________________ that the principal is personally known to us, that the principal signed and acknowledged this durable special power of attorney in our presence, that the principal appears to be of sound mind and under no duress, fraud or undue influence, that we are not the person appointed as attorney-in-fact by this document.  We are not related to the principal by blood, marriage or adoption, and to the best of our knowledge, are not entitled to any part of the estate of the principal upon the death of the principal under a will now existing or by operation of law.


______________________________ of        _____________________________


______________________________ of        _____________________________


STATE OF _______________________

COUNTY OF _____________________

PERSONALLY appeared before me this day, the undersigned authority in and for said county and state, on _____ day of ______________, 20 ___, within my jurisdiction, the within named __________________________ personally known to me or proved to me by satisfactory evidence to be _______________________ who, acknowledged before me that he executed the foregoing Special Durable Power of Attorney which consists of three (3) pages on the day and year therein mentioned.  I declare under the penalty of perjury that the person whose name is subscribed to this instrument appears to be of sound mind and under no duress, fraud or influence.



My Commission Expires:


State Specific Power of Attorney Forms

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Inside Stocks Special Durable