POWER OF ATTORNEY (REAL ESTATE) IMPORTANT INFORMATION
This power of attorney authorizes another person (your agent) to make decisions for you
(the principal) and to act on your behalf concerning your real property. You should selectsomeone 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
This power of attorney does not authorize the agent to make health care decisions for you.
If you have questions about this 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, ___________________________________________________________________________ (name of Principal), name the following person as my agent:
Name of agent: ______________________________________________________________________________
_____________________________________________________________________________
Agent’s telephone number: ______________________________________________________________________
OF AUTHORITY
I grant my agent the authority to act as my true and lawful agent and in my name, place, and stead for my sole
use and benefit to grant, bargain, sell, convey, purchase, encumber, or contract for the sale or purchase of thefollowing described real estate situate in the County of ___________________, State of ___________________:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
My agent is authorized and empowered to collect such monies as may become due from the sale, and to make,
execute, acknowledge and deliver contracts for sale, deeds, Deeds of Trust, and other instruments in writing ofevery kind and nature, including, but not limited to, the sale and loan closing documents and statements, upon suchterms and conditions as my agent may deem necessary and convenient to accomplish such sale or conveyance ofthis real estate. My agent shall have full power and authority to do and perform all acts necessary to be done tocomplete a sale or conveyance of this real estate, as fully as I might do if personally present. LIMITATION ON AGENT’S AUTHORITY
An agent that is not my ancestor, spouse, or descendant MAY NOT use my real property to benefit the agent
or a person to whom the agent owes an obligation of support. No. 34R. Rev. 11-09. POWER OF ATTORNEY (REAL ESTATE) (Page 1 of 3)
Bradford Publishing, 1743 Wazee St., Denver, CO 80202 — (303) 292-2590 — www.bradfordpublishing.com
SPECIAL INSTRUCTIONS
You may give special instructions on the following lines:
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EFFECTIVE DATE AND TERMINATION INSTRUCTIONS: Choose the effective date of this power of attorney by initialing either (A) or (B). If neitheris initialed, this power of attorney will be effective immediately. Initial (C) if you would like this power of attorneyto automatically expire upon completion of its purpose, without any action on your part.
_____________ (A) This power of attorney is effective immediately and is not affected by my subsequent
_____________ (B) This Power of Attorney becomes effective upon my subsequent incapacity.
_____________ (C) This Power of Attorney shall automatically expire by its own terms upon completion of the
RELIANCE ON THIS POWER OF ATTORNEY
I, with full power of revocation, ratify and confirm all that my agent shall lawfully do or cause to be done by
virtue of this Power of Attorney and the powers contained herein. 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. SIGNATURE AND ACKNOWLEDGMENT
_____________________________________________________
Signature of Principal Print your name: ____________________________________Address: _______________________________________________________________________________________________Your telephone number: ______________________________
This Power of Attorney was acknowledged before me on _____________________________________, (date) by
__________________________________________________________. (Name of Principal)
_____________________________________________________Signature of notaryMy commission expires: ______________________________
No. 34R. Rev. 11-09. POWER OF ATTORNEY (REAL ESTATE) (Page 2 of 3) AGENT’S CERTIFICATION AS TO THE VALIDITY OF POWER OF ATTORNEY AND AGENT’S AUTHORITY
I, _____________________________________________________________ (Name of Agent), certify under
penalty of perjury that ________________________________________________________ (Name of Principal)
granted me authority as an agent or successor agent in a power of attorney dated _________________________.
(1) The principal is alive and has not revoked the power of attorney or my authority to act under the power
of attorney and the power of attorney and my authority to act under the power of attorney have not terminated;
(2) If the power of attorney was drafted to become effective upon the happening of an event or
contingency, the event or contingency has occurred;
(3) If I was named as a successor agent, the prior agent is no longer able or willing to serve; and
(4) _____________________________________________________________________________________
_____________________________________________________________________________________
TURE AND ACKNOWLEDGMENT
__________________________________________
_____________________________________________________
Agent’s signature Print agent’s name: __________________________________Agent’s Address: _________________________________________________________________________________________Agent’s telephone number: ____________________________
This document was acknowledged before me on _____________________________________________, (date) by
__________________________________________________________. (Name of Agent)
_____________________________________________________Signature of notaryMy commission expires: ______________________________
No. 34R. Rev. 11-09. POWER OF ATTORNEY (REAL ESTATE) (Page 3 of 3)
Anjuli S. Nayak, M.D. PUBLICATIONS & PRESENTATIONS Anjuli S. Nayak, M.D. Sneeze, Wheeze & Itch Associates, LLC 2010 Jacobssen Drive Normal, IL 61761 (309) 452-0995 http://www.asthma2.com/swia/ Manuscripts and/or articles published as author or a contributor:Effectiveness of Azelastine Nasal Spray Compared with Oral Cetirizine in Patients with Seasonal Allergic