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20218 378 <br />9. DURABILITY AND EFFECTIVE DATE. <br />(INITIAL the clause(s) that apply) <br />( - ) DURABLE. This Power of Attorney shall not be affected by my subsequent <br />disability or incapacity. <br />( ) SPRINGING POWER. It is my intention and direction that my designated agent, <br />and any person or entity that my designated agent may transact business with on my behalf, may <br />rely on a written medical opinion issued by a licensed medical doctor stating that I am disabled or <br />incapacitated, and incapable of managing my affairs, and that said medical opinion shall establish <br />whether or not I am under a disability for the purpose of establishing the authority of my <br />designated agent to act in accordance with this Power of Attorney. <br />) 1 wish to have this Power of Attorney become effective on the following date: <br />�•�,-1C\ <br />( ) 1 wish to have this Power of Attorney end on the following dated: <br />10. TI-IIRD PARTY PROTECTION. <br />Third parties may rely upon the validity of this Power of Attorney or a copy and the <br />representations of my agent as to all matters relating to any power granted to my agent, and no <br />person or agency who relies upon the representation of my agent, or the authority granted by my <br />agent, shall incur any liability to me or my estate as a result of permitting my agent to exercise any <br />power unless a third party knows or has reason to know this Power of Attorney has terminated or is <br />invalid. <br />11. RELEASE OF INFORMATION. <br />1 agree to, authorize and allow full release of information, by any government agency, business, <br />creditor or third party who may have information pertaining to my assets or income, to my agent <br />named herein. <br />12. SIGNATURE AND ACKNOWLEDGMENT. <br />You must sign and date this Power of Attorney. This Power of Attorney will not be valid unless it <br />is acknowledged before a Notary Public. <br />5 <br />