ÿWPCº „q±|žýNf¡ß Bi7D ƒ°„ƒæX´ý—€æp‘Ñÿ¨ }dY†.õ_'·èöX¿¹–ÇEÉ-¸¨Tá/ô6º™[f8Ö[;ËÛ¥.¶=Ãþì(2¸߯mv|¯ò‹¹„ºÛµègþƒÁ¸‘¹µiÚîöA|ÇFžiW|Ü=„Yš„àAI› }†ˆgž›O(!\kåƒ.ÒÔ?ªÚÎ÷¯×ïÜÞ˜pŸ_´áÂÅ‹,… ¤À (i˜u¡&¸"-j„$Ðñ –ÓŽQ¸éŠ’¼¸ü ?@N© ÖoɤÍtX G aJŸ¸ÏS¢ºBðÜë~ùˆ¦ZT6áRô•¨/ÚT1ÎØyò”Í¡ÅgùýnVa¥º3õì§‚ð6nì½~" b ¾Œ¹·Á_+ˆï Ôo<¤œ9ŸíY©gà²F¨Ÿ^2â0 s—HžäîÁ“€jN°X5…0ÒÆkŒ‘T]-ágüœÍVÝ%I¡§?iÿ±dœ£1$Ûu¸‰åI-ò˜IæQ4U¾ZÒAŽž;W²>š“k¼@ºÜ–îE¯"sÈÐ8Jy^‹²L·d쉱=j8x>øéýdáîx(1xr5‡>ûØwAÅâ#Á\UN %k 0:qU:« 1uå 72Z^ Œw˜4œ°¿ mÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁÁfØØØ 1qÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚÚ 0šKKKKKK Båååååååååååååååååååå C Ba99999999999fMaOfcaefyyyyyyyyyyyyyy{a{fa‘f¥a§f»a½½½½½½½½½½½½éј0&Öd9 Z‹6Times New Roman RegularX(üœ$¡¡ÔUSUS.,Ô<þ6X9`("Courier 10cpi3#37=CIQYag­­1.a.i.(1)(a)(i)1)a)i)Ф*. I†e-ê:i¢×+003|xÿU‹ÿÀÀÀ|å$ÿÿ57=GMU]ci511.1.1.A.(1)(a)i)a)(I)(r3¨ø$©©Ý ƒõ(!ÝÔ‡X¢:XXXÔÔ‡X_PXXX¢:ÔÔ  ÔÓ  ÓÝ  Ý dÿÿÿÿÿdöÿ  dTABLE E<TABLE A .TABLE B4\ öÝ ƒ„¨ø)ÝÔ€X;-XXXÔÔ€X;-XXX;-ÔÔ  ÔÓ  ÓÝ  ÝÔ_Ôòòò òInformation€Regarding€€Statutory€Durable€Power€of€Attorneyà€È!È!E(#àPage€Ú  Ú1Ú  Úó óóóTABLE C .TABLE D .TABLE B4\TABLE C ßÝ ƒ„¨ø)ÝÔ€X;-XXXÔÔ€X;-XXX;-ÔÔ  ÔÓ  ÓÝ  ÝÔ_Ôò òòòStatutory€Durable€Power€of€Attorneyà€È!È!E(#àPage€Ú  Ú1Ú  Úó óóóÝ ƒüœ!ÝÔUSUS.,ÔÝ  ÝÔ_ÔÖ€ÎÿÿÖÓ€ o(ÿÿ43ÓÑ  ÑÔ  ÔÌà@k k ìàòòò òINFORMATION€REGARDINGˆÐ ªú Ðà@4 4 ìàSTATUTORY€DURABLE€POWER€OF€ATTORNEYóóòòó óóóˆÐ Ê ÐÌÌTo:à0  àà0` (#(#à[Principal]ÐÞ .` (#` (# ÐÌFrom:à0  àà0` (#(#à[Attorney€Name]ÐÒ "` (#` (# ÐÌDate:à0  àà0` (#(#à________________,€20__ÐÆ  ` (#` (# ÐÌRe:à0  àà0` (#(#àImportant€Information€Regarding€Your€Statutory€Durable€Power€of€Attorneyк ` (#` (# ÐÌà  àThe€Texas€Durable€Power€of€Attorney€Act,€Tex.€Prob.€Code€Ann.€ðððð€481„506€(the€ð ðActðð),Ð ®þ  Ðpermits€you€to€give€someone€you€trust€(called€your€ð ðagentðð€or€ð ðattorney„in„factðð)€broad,€sweepingÐ ¨ø  Ðpower€to€deal€with€your€assets.€€The€Act€permits€the€use€of€a€statutory€form,€called€a€ð ðStatutoryÐ ¢ò ÐDurable€Power€of€Attorney.ðð€€The€statutory€form€gives€the€agent€very€broad€powers,€but€it€permits€youÐ œì Ðto€omit€one€or€more€broad€powers€by€crossing€out€those€powers€if€you€do€not€wish€to€give€your€agentÐ –æ Ðthe€authority€to€act€in€these€areas.€€Most€of€our€clients€are€able€to€name€an€agent€who€they€believe€isÐ à Ðcompletely€trustworthy.€€In€most€cases€where€the€agent€is€trustworthy,€we€recommend€giving€all€of€theÐ ŠÚ Ðstandard€powers€included€in€the€form€„„€in€other€words,€we€recommend€that€none€of€the€listed€powersÐ „Ô Ðbe€crossed€out.€€ò òIf€you€are€concerned€about€giving€your€agent€these€broad€powers,€or€if€youÐ ~Î Ðhave€questions€about€what€specific€powers€are€included,€please€let€us€know,€and€we€will€beÐ xÈ Ðhappy€to€discuss€the€Act€with€you.ó óÐ r ÐÌà  àThe€statutory€form€permits€you€to€give€your€agent€limited€gift„giving€powers€by€placing€yourÐ f¶ Ðinitials€by€the€appropriate€sentence€on€the€form.€€This€gift„giving€provision€in€the€statutory€form€onlyÐ `° Ðapplies€if€it€is€initialed.€€The€gift„giving€provision€in€the€statutory€form€limits€gifts€to€any€one€person€in€anyÐ Zª Ðcalendar€year€to€the€federal€gift€tax€exclusion€amount,€currently€$11,000€per€calendar€year€per€donee.Ð T ¤ ÐÌà  àIt€has€been€our€experience€that€most€of€our€clients€are€willing€to€give€the€agent€broader€gift„Ð H"˜ Ðgiving€powers€than€the€statutory€formððs€standard€provision.€€Therefore,€we€have€modified€the€statutoryÐ B#’ Ðform€to€give€you€a€choice€as€to€gift€giving€powers.€€By€initialing€the€appropriate€box,€you€can:Ð <$Œ  ÐÌà0  àððà0` (#(#àGive€your€agent€no€gift„giving€powers€(which€may€frustrate€planning€if€you€becomeÐ 0&€!" Ðdisabled€but€which€protects€you€from€unwise€gifts€by€your€agent);Ð*'z"#` (#` (# ÐÌà0  àððà0` (#(#àGive€your€agent€the€gift„giving€powers€provided€for€in€the€statutory€form€(the€power€toÐ )n$% Ðmake€gifts€up€to€the€federal€gift€tax€annual€exclusion€amount,€currently€$11,000€perÐ *h%& Ðcalendar€year€per€donee);€orÐ+b&'` (#` (# ÐÌà0  àððà0` (#(#àGive€your€agent€the€power€to€make€larger€gifts,€including€gifts€to€charity€(which€powerÐ -V()  Ðgives€your€agent€more€flexibility€if€you€become€disabled€but€which€may€leave€youÐ ° Ðvulnerable€to€excessive€gifts€by€your€agent€and€may€cause€your€agent€tax€problems€if€heÐ ªú Ðis€within€the€group€of€persons€to€whom€gifts€are€permitted).Фô` (#` (# ÐÌò òYou€should€choose€which€of€these€three€alternatives€you€wish€to€select€and€initial€only€one€boxÐ ˜è Ðon€the€form.ó ó€€If€you€have€questions€about€this€matter€or€wish€to€further€expand€or€limit€gift„givingÐ ’ â Ðpowers,€please€let€us€know€and€we€will€be€happy€to€discuss€it€with€you.Ð Œ Ü ÐÌà  àWe€also€recommend€that€you€give€your€agent€the€power€to€create€a€trust€and/or€make€transfersÐ € Ð Ðto€a€trust.€€While€this€power€is€not€included€in€the€statutory€form,€it€can€be€quite€helpful€if€you€are€facedÐ z Ê  Ðwith€a€long„term€disability.€€If€you€do€not€wish€for€one€or€more€of€these€additional€powers€to€beÐ tÄ  Ðincluded,€you€must€cross€through€it€and€initial€it€when€you€sign€the€power€of€attorney.Ð n¾  ÐÌà  àOf€course,€in€any€given€case€there€may€be€good€reasons€to€include€or€exclude€one€or€moreÐ b²  Ðstandard€powers€or€additional€powers.€€For€example,€you€may€trust€your€agent€and€wish€to€give€him€orÐ \¬  Ðher€broad€authority,€but€you€may€not€wish€to€give€the€agent€the€power€to€engage€in€commodity€andÐ V¦ Ðoption€transactions.€€The€gift„giving€power€gives€your€agent€the€authority€to€make€gifts€to€himself€orÐ P  Ðherself€(if€your€agent€is€a€beneficiary€under€your€will€or€one€of€your€heirs€under€Texas€law).€€This€gift„Ð Jš Ðgiving€authority€may€help€your€family€save€taxes,€but€you€may€be€uncomfortable€giving€your€agent€thisÐ D” Ðmuch€power.€€If€you€have€any€questions€about€these€powers,€please€consult€us.Ð >Ž ÐÌà  àThe€Act€permits€you€to€make€the€power€immediately€effective€(in€other€words,€effective€the€dayÐ 2‚ Ðyou€sign€it,€even€if€you€are€not€incapacitated€or€disabled)€or€effective€only€upon€your€disability€orÐ ,| Ðincapacity.€€You€make€this€choice€by€crossing€out€the€alternative€you€do€not€wish€to€include.€€If€youÐ &v Ðcross€out€neither€alternative,€the€Act€provides€that€the€power€is€immediately€effective.€€If€you€wish€toÐ  p Ðmake€the€power€effective€only€upon€your€disability€or€incapacity€(called€a€ð ðspringing€powerðð),€pleaseÐ j Ðconsider€the€following:Ð d ÐÌà0  àððà0` (#(#àYour€agent€may€have€difficulty€getting€springing€powers€accepted€by€third€parties,€suchÐ  X Ðas€banks.€€These€third€parties€are€reluctant€to€rely€on€the€springing€power€only€to€have€aÐ !R Ðcourt€determine€later€that€the€principal€was€not€in€fact€incapacitated€when€the€powerÐ ü!L Ðwas€used.Ðö"F` (#` (# ÐÌà0  àððà0` (#(#àTo€help€gain€greater€acceptance€of€springing€powers€in€Texas,€the€Act€provides€that€aÐ ê$: ! Ðthird€party,€such€as€a€bank,€acting€in€good€faith€may€rely€on€an€affidavit€of€the€agent€thatÐ ä%4!" Ðthe€principal€is€disabled€or€incapacitated.€€This€means€that€the€agent€needs€to€provideÐ Þ&."# Ðno€further€proof€of€disability€or€incapacity€than€his€or€her€own€sworn€statement.€€ThisÐ Ø'(#$ Ðmay€make€it€easier€to€get€a€springing€power€accepted,€but€it€also€may€undermine€theÐ Ò("$% Ðreason€to€use€a€springing€power€in€the€first€place.ÐÌ)%&` (#` (# ÐÌà  àWe€have€added€a€provision€to€the€statutory€form€revoking€all€previous€powers€of€attorneyÐ À+'( Ðexecuted€under€the€Act€or€its€predecessor.€€(The€provision€makes€clear€that€you€are€not€revoking€otherÐ ° Ðagency„type€arrangements,€such€as€medical€powers€of€attorney,€directives€to€physicians€and€family€orÐ ªú Ðsurrogates,€multi„party€account€agreements,€etc.)€€If€you€have€previously€executed€a€power€of€attorneyÐ ¤ô Ðwhich€has€special€revocation€requirements€(such€as€requiring€the€instrument€revoking€the€power€to€beÐ žî Ðfiled€in€the€public€records),€please€let€us€know.€€Otherwise,€we€will€assume€that€the€provision€we€addedÐ ˜è Ðis€effective€to€revoke€any€old€powers€of€attorney€you€may€have€executed.Ð ’ â ÐÌà  àThe€standard€statutory€form€provides€that€the€power€of€attorney€can€be€revoked€only€by€òòactualóóÐ † Ö Ðnotice€to€third€parties,€making€it€very€difficult€to€revoke€if€your€agent€has€moved€any€of€your€assetsÐ € Ð Ðwithout€disclosing€this€fact€to€you.€€You€may€provide€that€the€power€of€attorney€may€be€revoked€byÐ z Ê  Ðrecording€a€revocation€in€the€records€of€the€county€clerk€where€you€live,€but€this€may€make€the€powerÐ tÄ  Ðof€attorney€more€difficult€for€your€agent€to€use.€€We€have€not€modified€the€standard€form€to€requireÐ n¾  Ðrecording€the€power€of€attorney€and€any€revocations,€but€we€will€do€so€if€you€so€request.Ð  h¸  ÐØØÖ€áΖÖÑ  ÑÌÌà@ªªìàò òòòSTATUTORY€DURABLE€POWER€OF€ATTORNEYóóó óˆÐ ¤ô ÐÌÔ*‹ƒ¼Š½ddd Xdd Xdd X°(#°(#‹ÔÔ,xdd ÔÔ+  ÔÐ &€žð@ð@ &ÐÓ  ÓNOTICE:€€THE€POWERS€GRANTED€BY€THIS€DOCUMENT€ARE€BROAD€ANDÐ T ¤ ÐSWEEPING.€€THEY€ARE€EXPLAINED€IN€THE€DURABLE€POWER€OF€ATTORNEY€ACT,Ð N ž ÐCHAPTER€XII,€TEXAS€PROBATE€CODE.€€IF€YOU€HAVE€ANY€QUESTIONS€ABOUTÐ H ˜ ÐTHESE€POWERS,€OBTAIN€COMPETENT€LEGAL€ADVICE.€€THIS€DOCUMENT€DOESÐ B ’ ÐNOT€AUTHORIZE€ANYONE€TO€MAKE€MEDICAL€AND€OTHER€HEALTH-CAREÐ < Œ  ÐDECISIONS€FOR€YOU.€€YOU€MAY€REVOKE€THIS€POWER€OF€ATTORNEY€IF€YOUÐ 6†  ÐLATER€WISH€TO€DO€SO.Ð1'%0€   ž 1ÐÌI,€[Principal],€[Principal's€Address],€appoint€the€following€as€my€agent€(attorney-in-fact)€to€act€for€me€inÐ T¤  Ðany€lawful€way€with€respect€to€all€of€the€following€powers€except€for€a€power€that€I€have€crossed€outÐ Nž  Ðbelow:Ð H˜ ÐÌÓ  Ó[Agent's€Name€and€Address]Ð <Œ ÐÌÓf'ÓÌà@¬¬ ìàò òTO€WITHHOLD€A€POWER,€YOU€MUST€CROSS€OUT€EACH€POWER€WITHHELD:ó óˆÐ *z ÐÌà  àReal€property€transactions;Ð n Ðà  àTangible€personal€property€transactions;Ð h Ðà  àStock€and€bond€transactions;Ð b Ðà  àCommodity€and€option€transactions;Ð  \ Ðà  àBanking€and€other€financial€institution€transactions;Ð V Ðà  àBusiness€operating€transactions;Ð P Ðà  àInsurance€and€annuity€transactions;Ð úJ Ðà  àEstate,€trust,€and€other€beneficiary€transactions;Ð ô D Ðà  àClaims€and€litigation;Ð î!> Ðà  àPersonal€and€family€maintenance;Ð è"8 Ðà0  àBenefits€from€social€security,€Medicare,€Medicaid,€or€other€governmental€programs€or€civil€orÐ â#2 Ðmilitary€service;ÐÜ$, (#(# Ðà  àRetirement€plan€transactions;Ð Ö%&!! Ðà  àTax€matters.Ð Ð& "" ÐÌIF€NO€POWER€LISTED€ABOVE€IS€CROSSED€OUT,€THIS€DOCUMENT€SHALL€BEÐ Ä($$ ÐCONSTRUED€AND€INTERPRETED€AS€A€GENERAL€POWER€OF€ATTORNEY€AND€MYÐ ¾)%% ÐAGENT€(ATTORNEY€IN€FACT)€SHALL€HAVE€THE€POWER€AND€AUTHORITY€TOÐ ¸*&& ÐPERFORM€OR€UNDERTAKE€ANY€ACTION€I€COULD€PERFORM€OR€UNDERTAKE€IF€IÐ ²+'' ÐWERE€PERSONALLY€PRESENT.Ð ¬,ü'( ÐÐ ¦-ö() ÐÓ  Óò òSPECIAL€INSTRUCTIONS:ó óÐ ° ÐÌÓ  ÓSpecial€instructions€applicable€to€gifts€(initial€in€front€of€the€appropriate€sentence€to€have€it€apply):Ð ¤ô ÐÌò òòòÒ(ÐwO°(#°(#(Òà@ëë àInitial:óóó óˆÐ ˜è Ðò òòòà@É É àChoose€One€of€the€Following€By€Initialing€Your€Choice:ˆÐ ˜è ÐÔ*eƒ¾Š¿ddxdd x¼Š½°€°€eÔÔ,Ðdd ÔÔ+  ÔÐ $€ŸŸŸŸŒ ÜŒ Ü $ÐÐ(ð @ ŸŸŸŸ (Ðóóó óÐ  j Ðòòò òNo€Gift„Giving€Power.óóó ó€€My€agent€(attorney€in€fact)€shall€not€have€the€power€toÐ Œ Ü Ðmake€gifts.Ð † Ö ÐÔ*eƒÀŠÏddÐdd Ð¾Š¿°€°€eÔÔ,Ðdd ÔÔ+  ÔÐ $€ŸŸŸŸ^ ^  $ÐÐ(r  ŸŸŸŸ (ÐÐ œì  Ðò òòòGift„Giving€Power€Limited€to€Gift€Tax€Exclusion.óóó ó€€I€grant€my€agent€(attorneyÐ ^  Ðin€fact)€the€power€to€apply€my€property€to€make€gifts,€except€that€the€amount€of€a€giftÐ X  Ðto€an€individual€may€not€exceed€the€amount€of€annual€exclusions€allowed€from€theÐ R  Ðfederal€gift€tax€for€the€calendar€year€of€the€gift.Ð üL  ÐÔ*eƒЊÑddÐdd ÐÀŠÏ°€°€eÔÔ,Ðdd ÔÔ+  ÔÐ '€ŸŸŸŸð@ ð@ ‹‹'ÐÐ(T¤  ŸŸŸŸ (ÐÐ ~Î  Ðò òòòBroad€Gift„Giving€Power.óóó ó€€My€agent€(attorney€in€fact)€shall€have€the€power€andÐ ð@  Ðauthority€to€make€gifts€out€of€that€portion€of€my€estate€that€my€agent€determines€is€notÐ ê:  Ðrequired€for€my€support€during€my€lifetime€to€any€one€or€more€of€the€followingÐ ä4  Ðpersons€or€organizations€without€the€necessity€of€any€court€approval€or€judicial€actionÐ Þ. Ðof€any€kind€if€my€agent€deems€the€gifts€to€be€in€the€best€interests€of€my€family,€€for€taxÐ Ø( Ðsavings€purposes€or€otherwise:€€(Ô_ÔiÔ_Ô)€organizations€to€which€charitable€contributions€mayÐ Ò" Ðbe€made€under€the€Internal€Revenue€Code€and€in€which€my€agent€reasonably€believesÐ Ì Ðthat€I€have€an€interest;€(ii)€my€wife,€any€of€my€descendants,€or€any€other€personÐ Æ Ðrelated€to€me€by€blood€or€marriage;€(iii)€any€devisee€or€beneficiary€under€what€myÐ À Ðagent€reasonably€believes€is€my€latest€validly€executed€will€or€trust;€and€(iv)€my€agent,Ð º  Ðif€my€agent€is€eligible€under€either€category€(ii)€or€(iii)€above.€€In€exercising€this€powerÐ ´ Ðand€authority,€I€remind€my€agent€that€he€or€she€is€acting€in€a€fiduciary€capacity.Ð ®þ ÐÒ(ÐwO°€°€(ÒÓ  Óò òON€THE€FOLLOWING€LINES€YOU€MAY€GIVE€SPECIAL€INSTRUCTIONSÐ ¢ò ÐLIMITING€OR€EXTENDING€THE€POWERS€GRANTED€TO€YOUR€AGENT:ó óÐ œ ì ÐÓ49ÓÌMy€agent€shall€have€the€power€and€authority€to€create€a€trust€for€my€benefit,€naming€my€agent€as€trusteeÐ "à Ðor,€if€my€agent€so€chooses,€naming€a€bank€or€trust€company€with€assets€under€management€of€$100€millionÐ Š#Ú Ðor€more€as€trustee,€which€trust€may€also€benefit€my€wife,€my€descendants€and/or€the€persons€named€in€myÐ „$Ô Ðlast€validly€executed€will,€and€to€transfer€all€or€any€part€of€my€property€or€estate€to€the€trust€so€created€orÐ ~%Î  Ðto€any€existing€trust€of€which€I€am€a€Ô_ÔsettlorÔ_Ô,€a€€beneficiary,€or€both,€even€though€my€agent€may€be€theÐ x&È! Ðtrustee.€€Any€trust€created€by€my€agent€or€to€which€my€agent€transfers€property€under€this€provision€mayÐ r'Â" Ðcontain€such€Ô_ÔdispositiveÔ_Ô€provisions€as€my€agent€shall€deem€appropriate,€so€long€as€they€are€consistent€withÐ l(¼# Ðthis€provision,€including€but€not€limited€to€placing€assets€in€a€trust€which€will€be€protected€from€and/or€assistÐ f)¶$  Ðin€qualifying€me€or€a€member€of€my€family€for€Medicaid€or€other€governmental€benefits.Ð `*°%! ÐÌWithout€limiting€the€authority€of€my€agent€with€respect€to€tax€matters€as€provided€above,€I€specificallyÐ T,¤'# Ðauthorize€my€agent€to€represent€me,€and€to€appoint€an€agent€or€agents€to€represent€me,€before€the€InternalÐ ° ÐRevenue€Service€or€any€state€or€taxing€authority€by€completing,€signing€and€delivering€IRS€Form€2848€orÐ ªú Ðany€other€governmental€form.Ð ¤ô ÐÌMy€agent€shall€be€entitled€to€reasonable€compensation€from€my€property€for€services€rendered€as€agent,Ð ˜è Ðnot€to€exceed€the€fees€charged€by€corporate€fiduciaries€for€trust€services€in€the€area€in€which€I€live€or€theÐ ’ â Ðamount€approved€by€me€if€I€then€have€capacity.€€In€addition,€my€agent€shall€be€entitled€to€be€reimbursedÐ Œ Ü Ðfrom€my€property€for€reasonable€expenses€incurred€by€my€agent€in€the€course€of€performing€his€or€herÐ † Ö Ðduties€under€this€power€of€attorney,€subject€to€my€approval€if€I€then€have€capacity.òòÐ € Ð ÐÌóóAlthough€this€instrument€contains€modifications€of€the€statutory€durable€power€of€attorney€form€found€inÐ tÄ  ÐTex.€Prob.€Code€Ann.€ðð€490,€I€intend€for€it€to€be€a€ð ðstatutory€durable€power€of€attorneyðð€as€provided€inÐ n¾  Ðthat€section€and€to€be€construed€as€a€ð ðstatutory€durable€power€of€attorney.ððÐ h¸  ÐÌThis€power€of€attorney€terminates€on€my€death,€unless€I€revoke€it€prior€to€that€time.òòÐ \¬  ÐóóÌUNLESS€YOU€DIRECT€OTHERWISE€ABOVE,€THIS€POWER€OF€ATTORNEY€IS€EFFECTIVEÐ P  ÐIMMEDIATELY€AND€WILL€CONTINUE€UNTIL€IT€IS€REVOKED.Ð Jš ÐÌò òÓ  ÓCHOOSE€ONE€OF€THE€FOLLOWING€ALTERNATIVESÐ >Ž ÐBY€CROSSING€OUT€THE€ALTERNATIVE€NOT€CHOSEN:ó óÐ 8ˆ ÐÓ#EÓÌò òòòÒ(ÐwO°(#°(#(Òà@ëë àInitial:óóó óˆÐ ,| Ðò òòòÓ  ÓCross€Out€the€Alternative€Not€Chosen€and€Initial:Ð ,| ÐÓ*FÓÔ*eƒÒŠÓddÐdd ÐЊѰ€°€eÔÔ,Ðdd ÔÔ+  ÔÐ $€ŸŸŸŸ p p $ÐÐ(„Ô ŸŸŸŸ (Ðóóó óÐ ®þ Ð(A)This€power€of€attorney€is€not€affected€by€my€subsequent€disability€or€incapacity.Ð  p ÐÔ*eƒÔŠÕddÐdd ÐÒŠÓ°€°€eÔÔ,Ðdd ÔÔ+  ÔÐ $€ŸŸŸŸ¢ò¢ò $ÐÐ( V ŸŸŸŸ (ÐÐ 0!€ Ð(B)This€power€of€attorney€becomes€effective€upon€my€disability€or€incapacity.Ð ¢ò ÐÒ(ÐwO°€°€(ÒYOU€SHOULD€CHOOSE€ALTERNATIVE€(A)€IF€THIS€POWER€OF€ATTORNEY€IS€TO€BECOMEÐ $#t ÐEFFECTIVE€ON€THE€DATE€IT€IS€EXECUTED.Ð $n ÐÌIF€NEITHER€(A)€NOR€(B)€IS€CROSSED€OUT,€IT€WILL€BE€ASSUMED€THAT€YOU€CHOSEÐ &b! ÐALTERNATIVE€(A).Ð  '\" ÐÌIf€Alternative€(B)€is€chosen€and€a€definition€of€my€disability€or€incapacity€is€not€contained€in€this€power€ofÐ )P$ Ðattorney,€I€shall€be€considered€disabled€or€incapacitated€for€purposes€of€this€power€of€attorney€if€aÐ ú)J% Ðphysician€certifies€in€writing€at€a€date€later€than€the€date€this€power€of€attorney€is€executed€that,€based€onÐ ô*D&  Ðthe€physicianððs€medical€examination€of€me,€I€am€mentally€incapable€of€managing€my€financial€affairs.€€IÐ î+>'! Ðauthorize€the€physician€who€examines€me€for€this€purpose€to€disclose€my€physical€or€mental€condition€toÐ ° Ðanother€person€for€purposes€of€this€power€of€attorney.€€A€third€party€who€accepts€this€power€of€attorneyÐ ªú Ðis€fully€protected€from€any€action€taken€under€this€power€of€attorney€that€is€based€on€the€determinationÐ ¤ô Ðmade€by€a€physician€of€my€disability€or€incapacity.Ð žî ÐÌà@//%ìàò òREVOCATION:ó óˆÐ ’ â ÐÌI€hereby€revoke€all€previous€powers€of€attorney€previously€executed€by€me€to€be€effective€under€the€TexasÐ † Ö ÐDurable€Power€of€Attorney€Act,€Tex.€Prob.€Code€Ann.€ðððð€481„506,€or€its€predecessor,€Tex.€Prob.€CodeÐ € Ð ÐAnn.€ðð€36A.€€However,€I€do€not€revoke€other€agency„type€arrangements€not€governed€by€either€of€theseÐ z Ê  Ðstatutes,€including€but€not€limited€to€durable€powers€of€attorney€for€health€care,€medical€powers€of€attorney,Ð tÄ  Ðdirectives€to€physicians,€directives€to€physicians€and€family€or€surrogates,€and€multi„party€accountÐ n¾  Ðagreements€at€financial€institutions.Ð h¸  ÐÌI€agree€that€any€third€party€who€receives€a€copy€of€this€document€may€act€under€it.€€Revocation€of€theÐ \¬  Ðdurable€power€of€attorney€is€not€effective€as€to€a€third€party€until€the€third€party€receives€actual€notice€ofÐ V¦ Ðthe€revocation.€€I€agree€to€indemnify€the€third€party€for€any€claims€that€arise€against€the€third€party€becauseÐ P  Ðof€reliance€on€this€power€of€attorney.Ð Jš ÐÌà@ÖÖ"ìàò òSUCCESSOR€AGENTS:ó óˆÐ >Ž ÐÌIf€any€agent€named€by€me€dies,€becomes€legally€disabled,€resigns,€or€refuses€to€act,€I€name€the€followingÐ 2‚ Ð(each€to€act€alone€and€successively,€in€the€order€named)€as€successor(s)€to€that€agent:Ð ,| ÐÌÔ*eƒlбddÐdd ÐÔŠÕ°(#°(#eÔÔ,N dd ÔÔ,z dd ÔÔ+  ÔÐ /€ž p p „„/ÐòòFirst€Alternate€or€Successor€Agent:óóÐ 6,!„Ô"ž „„6Ð[Name€and€Address]Ð 2€ž„Ô" „„2ÐòòSecond€Alternate€or€Successor€Agent:óóÐ 6,!í="ž „„6Ð[Name€and€Address]Ð 2€ží=" „„2ÐòòThird€Alternate€or€Successor€Agent:óóÐ 6,!V¦"ž „„6Ð[Name€and€Address]Ð"V¦"  "ÐÌà  àSigned€this€____€day€of€________________,€20___.Ð U!¥ ÐÌÌà0  àà0` (#(#àà0¸ ` (#` (#àà0¸ (#¸ (#àà0h(#(#àà0Àh(#h(#àà0À(#À(#àòòà€(#(#K(#(#(#àóóˆÌà0  àà0` (#(#àà0¸ ` (#` (#àà0¸ (#¸ (#àà0h(#(#àà0Àh(#h(#àà0À(#À(#à[Principal]Ð=% #(#(# Ðâ âÐ 7&‡!$ ÐÔ& Ê Ôâ âSTATE€OF€TEXASÐ ° ÐCOUNTY€OF€__________Ð ªú ÐÌà  àThis€document€was€acknowledged€before€me€on€the€____€day€of€________________,€20___,Ð žî Ðby€[Principal].Ð ˜è ÐÌÌà0  àà0` (#(#àà0¸ ` (#` (#àà0¸ (#¸ (#àà0h(#(#àà0Àh(#h(#àà0À(#À(#àòòà€(#(#K(#(#(#àóóˆÌà0  àà0` (#(#àà0¸ ` (#` (#àà0¸ (#¸ (#àà0h(#(#àà0Àh(#h(#àà0À(#À(#àNotary€Public,€State€of€TexasÔ'ʰ‚XÔЀ Ð(#(# ÐÓ  ÓÌÓ  ÓTHE€ATTORNEY€IN€FACT€OR€AGENT,€BY€ACCEPTING€OR€ACTING€UNDER€THEÐ tÄ  ÐAPPOINTMENT,€ASSUMES€THE€FIDUCIARY€AND€OTHER€LEGAL€RESPONSIBILITIES€OFÐ n¾  ÐAN€AGENT.