Laserfiche WebLink
PRINCIPAL signs here: <br />©SmartLegalForms <br />201801500 <br />(c) GRANT OF SPECIFIC AUTHORITY FOR AN AGENT TO MAKE MAJOR GIFTS OR OTHER <br />TRANSFERS TO HIMSELF OR HERSELF: (OPTIONAL) <br />If you wish to authorize your Agent to make gifts or transfers to himself or herself, you must grant that <br />authority in this section, indicating to which Agent(s) the authorization is granted, and any limitations <br />and guidelines. <br />iJ-I grant specific authority for the following Agent(s) to make the following major gifts or other <br />transfers to himself or herself: <br />(i) 14 - D i N t !V 47J is authorized to transfer <br />himself or herself; <br />(ii) <br />himself or herself; <br />(iii) <br />himself or herself. <br />This authority must be exercised pursuant to my instructions, or otherwise for purposes which the <br />Agent reasonably deems to be in my best interest. <br />(d) ACCEPTANCE BY THIRD PARTIES: <br />I agree to indemnify the third party for any claims that may arise against the third party because of <br />reliance on this Major Gifts Rider. <br />(e) SIGNATURE OF PRINCIPAL AND ACKNOWLEDGMENT: <br />In Witness Whereof I have hereunto signed my name on 62 )0 f tl , 20 1 P <br />my r Yr7 r eytlp. to <br />is authorized to transfer my to <br />is authorized to transfer my to <br />Ar o 0.74 <br />A Notary Public or other officer completing this certificate verifies only the identity of the Individual who signed the <br />document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />STATE OF t9/ <br />COUNTY OF cTh- ti ) <br />On 2..,17./D , 20 f k' , before me, 4N0 (WA) 9 5 Ntv <br />a Notary Public, personally appeared '.P 1 , as Principal, and <br />Ej; te/l q✓ti , as Witness, and ; SuN ArJ , as Witness, who <br />proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are subscribed <br />to the within instrument and acknowledged to me that he /she /they executed the same in his /her /their <br />authorized capacity(ies), and that by his /her /their signature(s) on the instrument the person(s), or the <br />entity upon behalf of which the person(s) acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws of the State of ( Elf-4/2A- <br />that the foregoing paragraph is true and correct. <br />Andww EOM <br />WITNESS my hand and official seal. Noisy Public <br />Slot d Ronde <br />My Commission sion Expires 0/27/2020 <br />Signature of Notary Cemmiwion No, {30 0396 <br />Affiant Known \oduced ID Type of ID (1 ' )41 "' .'4 "— (5' (Seal) <br />LF205 Durable Power of Attorney Major Gifts Rider 6.15, Pg. 2 of 3 <br />