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202105214 <br />STATE OF COLORADO STATUTORY FORM <br />POWER OF ATTORNEY <br />(effective January 1, 2010) <br />IMPORTANT INFORMATION <br />"rhis power ot attorneyc.,,rizes another person (your agent) to make decisions <br />COH0(!fiir our t)loperly for you the prinCipali Your agent wiII be ate to make aecisions ana act <br />witn nispect to ycur property (including your money') whetner or not you are able to act for yourself <br />toe meaning of authority over Subjects listed en thiS form is explained in the Uniform Power of <br />Anorney part 7 of artioie 14 of tile 15 Curd o Revised Statutes <br />power of attooiey does i)ut authorize the agent to make health care decisions for you <br />Yout so c1 sorneon.j trJst to serve as- your agent Uniess you specify otheryvlse, <br />generally the aijerit's autnionty continue until yoo die or revoke the power of attorney or tne <br />:oo resji-is or is unaole to act toi yoJ <br />Your :agent is entitled to reasonaryje compensation unless you state o -e in the special <br />ristructions <br />1 fts tonn provides fur designation of one agent If y ,;;LI 'iv L,n to name more than one agent <br />yoli: r'a frant d oo-agerit special inst!octions Co -agents are not required to act tocjether <br />yuu -ndu,:le that requirement :0 the sPecial )11struction5 <br />yoor agent is unable or unwiii nu tc act for you your power of attorney wtU end unless you <br />ilarineaa sucxessur agent Yoo may also name a second successor agent <br />1 tiiicri.r.ier of attorney econies effective immediately Unless you state otherwise in Inc <br />instructions <br />If you have questions about the power of attorney or the authority you are granting to <br />your agent, you should seek legal advice before signing this form <br />DESIGNATION OF AGENT <br />Narlle 'Jr!aj <br />t <br />.LiOotess ' ' <br />t <br />teletiihorie <br />ame of 30 p0 <br />lrrie <br />t <br />e following person as <br />s I %1 F 1)1 (111A)It !1/41)( '1 111111 <br />1 I'M% l'It 11' 4,11 014%)1"1" hake 1 ar t, <br />