"Power of Attorney Form" - Colorado

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Download "Power of Attorney Form" - Colorado

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Colorado Power of Attorney
Designation of Agent
I, do hereby
[Legal Name], AKA [Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
Hereby appoint:
Name
[Legal Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
If you designate more than one agent above, by default they must act together unless you
initial the statement below.
[___] My agents may act separately.
Designation of Successor Agent(s) (Optional)
If every agent that is listed above is unable or unwilling to serve, I hereby appoint as my
successor agent(s):
_____________________________________________________________________________
If you designate more than one successor agent above, by default they must act together
unless you initial the statement below.
[___] My successor agents may act separately.
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Colorado Power of Attorney
Designation of Agent
I, do hereby
[Legal Name], AKA [Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
Hereby appoint:
Name
[Legal Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
If you designate more than one agent above, by default they must act together unless you
initial the statement below.
[___] My agents may act separately.
Designation of Successor Agent(s) (Optional)
If every agent that is listed above is unable or unwilling to serve, I hereby appoint as my
successor agent(s):
_____________________________________________________________________________
If you designate more than one successor agent above, by default they must act together
unless you initial the statement below.
[___] My successor agents may act separately.
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Grant of General Authority
My attorney-in-fact may act on my behalf for the following purpose(s):
________________________________________________________________
________________________________________________________________
________________________________________________________________
I do hereby grant my attorney in fact complete authority to act in any reasonable manner that
is necessary to execute the above mentioned powers that are granted.
This power of attorney shall become effective immediately unless specified otherwise in the
special instructions.
This power of attorney shall continue until I revoke it or it is terminated by my death.
I agree that any third party who is given a copy of this power of attorney may act relying on it. I
also agree that revocation of this power of attorney is effective as to a third party only upon
receipt of actual notice by the third party. I agree to indemnify the third party for any loss that
may be suffered while carrying out this power of attorney.
Special instructions:
________________________________________________________________
________________________________________________________________
________________________________________________________________
Signature And Acknowledgment
This contract shall be governed by the laws of the State of Colorado in __________ County and any
applicable Federal Law.
__________________________________________________________
Date____________
Signature of Principle
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By accepting this appointment and acting under it, I the attorney-in-fact (“Agent”) do hereby assume the
legal responsibilities of an agent.
_____________________________________________________________________Date____________
Signature of Attorney-in-Fact
_____________________________________________________________________Date____________
Signature of Successor
WITNESS #1) _________________________________
WITNESS #2) _________________________________
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