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Vermont Power of Attorney for Property

KNOW ALL PERSONS BY THESE PRESENTS, that I, _____________________________, make the following power of attorney under 14 VSA Chapter 123.

My agent shall be_____________________________.

I give my agent full power to act on my behalf, except as follows: (insert any limitations)

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

This power of attorney will be effective on this date/upon my disability (strike one). This power of attorney shall not be affected by my subsequent disability of or incapacity.

_______________________________     Date  ______________
Principal

State of Vermont
_______________ County

At _____________________(town or city) on _________________(date)

_________________________________ personally appeared and acknowledged the foregoing power of attorney to be his/her free act and deed. Before me:

_____________________________
Notary Public

I, _____________________________, witnessed the signature of the principal above and I affirm that the principal appeared to be of sound mind and free from duress at the time this power of attorney was signed and the principal affirmed to me that he or she was aware of the nature of the document and signed it freely and voluntarily.

_______________________________     Date  ______________
Witness

I, ______________________________, agent named above attest that: (1) I accept appointment as agent; (2) I understand the duties I am assuming under this power of attorney under the law; (3) I understand that I have a duty to act if expressly required to do so in this power of attorney consistent with said 14 VSA Section 3506(c); and (4) I understand that I am expected to use my special skills or expertise on behalf of the principal as follows (insert any such special skills):
__________________________________________________________________

__________________________________________________________________

_______________________________     Date  ______________
Agent


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