2022-01-11_PERMIT FILE - M2022002 ‎(2)‎

• Permit No: M2022002
• IBM Index Class Name: Permit File
• Doc Date: 1/11/2022
• Doc Name: Application
• From: ACA Products, Inc
• To: DRMS
• Email Name: DMC
• Email Name: THM
• Email Name: AWA
• Media Type: D
• Archive: No

STATE OF COLORADO STATUTORY POWER OF ATTORNEY
IMPORTANT INFORMATION
This power of attorney authorizes another person (your agent) to make decisions concerning your
property for you (the principal). Your agent will be able to make decisions and act with respect to your
property(including your money)whether or not you are able to act for yourself. The meaning of authority
over subjects listed on this form is explained in the"Uniform Power of Attorney Act", Part 7 of Article 14
of Title 15,Colorado Revised Statutes.
This power of attorney does not authorize the agent to make health care decisions for you.
You should select someone 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 instructions.
This form provides for designation of one agent. If you wish to name more than one agent you may
name a co-agent in the special instructions. Co-agents are not required to act together unless you include
that requirement in the special instructions.
If your agent is unable or unwilling to act for you, your power of attorney will end unless you have
named a successor agent.You may also name a second successor agent.
This power of attorney becomes effective immediately unless you state otherwise in the special
instructions.
If you have questions about the 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, Elizabeth Jean Holman, name the following person as my agent:
Name of agent: Frank F. Holman
Agent's address: 14110 County Road 140 Salida CO 81201
Agent's telephone number: 719-239-1894-, fholman5 I(Zboutlook.com
DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL)
If my agent is unable or unwilling to act for me, I name as my successor agent:
Name of successor agent:
Successor agents address:
Successor agent's telephone number:
If my successor agent is unable or unwilling to act for me, 1 name as my second successor agent:
Name of second successor agent:
Second successor agent's address:
Second successor agent's telephone number:
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