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STATE OF COLORADO STATUTORY FORM <br /> POWER OF ATTORNEY <br /> IMPORTANT INFORMATION <br /> This power of attorney authorizes another person (your agent) to make decisions concerning <br /> your property for you (the principal). Your agent will be able to make decisions and act with <br /> respect to your property (including your money) whether or not you are able to act for yourself. <br /> The meaning of authority over subjects listed on this form is explained in the "Uniform Power of <br /> Attorney Act", part 7 of article 14 of title 15, Colorado Revised Statutes. <br /> This power of attorney does not authorize the agent to make health care decisions for you. <br /> You should select someone you trust to serve as your agent. Unless you specify otherwise, <br /> generally the agent's authority will continue until you die or revoke the power of attorney or the <br /> agent resigns or is unable to act for you. <br /> Your agent is entitled to reasonable compensation unless you state otherwise in the special <br /> instructions. <br /> This form provides for designation of one agent. If you wish to name more than one agent you <br /> may name a coagent in the special instructions. Coagents are not required to act together unless <br /> you include that requirement in the special instructions. <br /> If your agent is unwilling or unable to act for you, your power of attorney will end unless you <br /> have named a successor agent.You may also name a second successor agent. <br /> This power of attorney becomes effective immediately unless you state otherwise in the special <br /> instructions. <br /> If you have questions about the power of attorney or the authority you are granting to your <br /> agent, you should seek legal advice before signing this form. <br /> DESIGNATION OF AGENT <br /> (name of principal) name the following person as my agent: <br /> Name of agent: <br /> Agent's address: <br /> Agent's telephone number: - <br /> DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL) <br /> If my agent is unable or unwilling to act for me, I name as my successor agent: <br /> Name of successor agent: <br /> Successor agent's address: <br /> Successor agent's telephone number: <br /> If my successor agent is unable or unwilling to act for me, I name as my second successor agent: <br /> Name of second successor agent: <br /> Second successor agent's address: <br /> Second successor agent's telephone number: <br /> Principal's initials and date ��'';�' Page 1 of 5 <br />