About this Form: A power of attorney is a document that evidences the creation of a relationship between two people who are designated as the "principal" and the "agent". The principal designates the agent in the document, and the agent is authorized to act on the principal's behalf--to stand in the shoes of the principal--for whatever business the power of attorney permits. A power of attorney can be general, so that the agent can conduct any sort of business on behalf of the principal, or it may be specific, limited to the transactions expressly provided for in the document. Third parties may treat the agent as if he or she is the principal in any transactions which the agent is authorized to conduct. Powers of attorney are commonly used in all sorts of business activities, and are very frequently executed on behalf of individuals.

DISTRICT OF COLUMBIA STATUTORY POWER OF ATTORNEY
(D.C. Code § 21-2101)

NOTICE: THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING. THEY ARE EXPLAINED IN THE UNIFORM STATUTORY FORM POWER OF ATTORNEY ACT OF 1998. IF YOU HAVE ANY QUESTIONS ABOUT THESE POWERS, OBTAIN COMPETENT LEGAL ADVICE. THIS DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL AND OTHER HEALTH-CARE DECISIONS FOR YOU. YOU MAY REVOKE THIS POWER OF ATTORNEY IF YOU LATER WISH TO DO SO.

I _________________________________________________________________ _________________________________________________________________ (insert your name and address) appoint _________________________________________________________________ _________________________________________________________________ (insert the name and address of the person appointed) as my agent (attorney-in-fact) to act for me in any lawful way with respect to the following initialed subjects:

TO GRANT ALL OF THE FOLLOWING POWERS, INITIAL THE LINE IN FRONT OF (N) AND IGNORE THE LINES IN FRONT OF THE OTHER POWERS.

TO GRANT ONE OR MORE, BUT FEWER THAN ALL, OF THE FOLLOWING POWERS, INITIAL THE LINE IN FRONT OF EACH POWER YOU ARE GRANTING.

TO WITHHOLD A POWER, DO NOT INITIAL THE LINE IN FRONT OF IT. YOU MAY, BUT NEED NOT, CROSS OUT EACH POWER WITHHELD.

INITIAL

_______ (A) Real property transactions, except transactions subject to D.C. Official Code § 42-101.

_______ (B) Tangible personal property transactions.

_______ (C) Stock and bond transactions.

_______ (D) Commodity and option transactions.

_______ (E) Banking and other financial institution transactions.

_______ (F) Business operating transactions.

_______ (G) Insurance and annuity transactions.

_______ (H) Estate, trust, and other beneficiary transactions.

_______ (I) Claims and litigation.

_______ (J) Personal and family maintenance.

_______ (K) Benefits from social security, medicare, medicaid, or other governmental programs, or military service.

_______ (L) Retirement plan transactions.

_______ (M) Tax matters.

_______ (N) ALL OF THE POWERS LISTED ABOVE. YOU NEED NOT INITIAL ANY OTHER LINES IF YOU INITIAL LINE (N).


SPECIAL INSTRUCTIONS:

ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS LIMITING OR EXTENDING THE POWERS GRANTED TO YOUR AGENT.

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

UNLESS YOU DIRECT OTHERWISE ABOVE, THIS POWER OF ATTORNEY IS EFFECTIVE IMMEDIATELY AND WILL CONTINUE UNTIL IT IS REVOKED.

This power of attorney will continue to be effective even though I become disabled, incapacitated, or incompetent.

STRIKE THE PRECEDING SENTENCE IF YOU DO NOT WANT THIS POWER OF ATTORNEY TO CONTINUE IF YOU BECOME DISABLED, INCAPACITATED, OR INCOMPETENT.

I agree that any third party who receives a copy of this document may act under it. Revocation of the power of attorney is not effective as to a third party until the third party learns of the revocation. I agree to indemnify the third party for any claims that arise against the third party because of reliance on this power of attorney.

Signed this _______ day of _______________, 20____



______________________________
(Your Signature)



_______________________________
(Your Social Security Number)


The District of Columbia

This document was acknowledged before me on
_______________ (Date) by _______________________________ (name of principal)



_______________________________
(Signature of notarial officer)

(Seal, if any) _______________________________

[My commission expires: ______]

BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT.