NORTH CAROLINA STATUTORY STATUTORY SHORT FORM POWER OF ATTORNEY NOTICE: THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING. THEY ARE DEFINED IN CHAPTER 32C OF THE NORTH CAROLINA GENERAL STATUTES, WHICH EXPRESSLY PERMITS THE USE OF ANY OTHER OR DIFFERENT FORM OF POWER OF ATTORNEY DESIRED BY THE PARTIES CONCERNED.

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 North Carolina Uniform Power of Attorney Act.

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 Additional Provisions and Exclusions.

This form provides for designation of one agent, a successor agent, and a second successor agent. If you wish to name more than one agent, successor agent, and second successor agent, you may name a coagent, successor coagent, or second successor coagent in the Additional Provisions and Exclusions. Coagents, successor coagents, or second successor coagents are not required to act together unless you include that requirement in the Additional Provisions and Exclusions.

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.

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.

Principal
Agent's Name

Agent’s Name: the 1st person who will have power of attorney
Successor Agent

Name of Successor Agent: if the 1st person is unable to fulfill this responsibility, name the 2nd agent.
Name of Second Successor Agent:

Name of Second Successor Agent: if the 2nd person is unable to fulfill this responsibility, name the 3rd agent.

Initial if you agree

I give to my acting agent the full power to appoint another to act as my agent, and full power to revoke such appointment, if no agent named by me above is willing or able to act.
Agent Power to Name Successor

INITIAL if you want to give an agent the power to name a successor agent
GRANT OF GENERAL AUTHORITY

I grant my agent and any successor agent general authority to act for me with respect to the following subjects as defined in the North Carolina Uniform Power of Attorney Act, Chapter 32C of the General Statutes:
Real Property

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Tangible Personal Property

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Stocks and Bonds

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Commodities and Options

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Banks and Other Financial Institutions

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Operation of Entity

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Insurance and Annuities

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Estates, Trusts, and Other Beneficial Interests

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Claims and Litigation

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Personal and Family Maintenance

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Benefits from Governmental Programs or Civil or Military Service

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Retirement Plans

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Taxes

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
All Preceding Subjects

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.

GRANT OF SPECIFIC AUTHORITY (OPTIONAL)

Even if you have given your agent general authority to act on your behalf, your agent MAY NOT do any of the following specific acts for you UNLESS you expressly authorize it. If you wish your agent to have that additional authority, you should INITIAL only those additional specific authorities you WANT to give your agent.
(CAUTION: Granting any of the following will give your agent the authority to take actions that could significantly reduce your property or change how your property is distributed at your death. INITIAL ONLY those specific authorities you WANT to give your agent.)
In addition to the General Authority I have given my agent, I expressly authorize my agent to do the following specific acts:
Make a gift, subject to the limitations provided in G.S. 32C-2-217

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Create or change rights of survivorship

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Create or change a beneficiary designation

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Authorize another person to exercise the authority granted under this power of attorney

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Waive my right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Exercise fiduciary powers that I have authority to delegate

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Disclaim or refuse an interest in property, including a power of appointment

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Access the content of electronic communications

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.

TRANSACTIONS THAT BENEFIT AGENT OR PERSONS TO WHOM AGENT OWES OBLIGATION OF SUPPORT

Unless you expressly authorize it, your agent MAY NOT exercise authority under this power of attorney if the exercise of that authority benefits the agent or a person to whom the agent owes an obligation of support. You should INITIAL below ONLY if you WANT to give your agent that authority
My agent MAY exercise authority under this power of attorney to benefit my agent or any person to whom my agent owes an obligation of support.

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
ADDITIONAL PROVISIONS AND EXCLUSIONS (OPTIONAL)

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above name.
Agree to your additional provisions and exclusions

Initial if you agree to give your agent the ability to act on your behalf pertaining the additional provisions and exclusions you listed
EFFECTIVE DATE

This power of attorney is effective immediately.
NOMINATION OF GUARDIAN (OPTIONAL)

INITIAL below ONLY if you WANT your acting agent to be your Guardian
If it becomes necessary for a court to appoint a guardian of my estate or a general guardian, I nominate my agent acting under this power of attorney to be the guardian to serve without bond or other security.

Initial if you agree to give your agent the ability to act on your behalf pertaining to the above.
RELIANCE ON THIS POWER OF ATTORNEY

Any person, including my agent, may rely upon the validity of this power of attorney or a copy of it unless that person knows it has terminated or is invalid.

MEANING AND EFFECT
The meaning and effect of this power of attorney shall for all purposes be determined by the law of the State of North Carolina.

SIGNATURE AND ACKNOWLEDGEMENT
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[Power of Attorney] North Carolina

[Power Of Attorney] North Carolina

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IMPORTANT INFORMATION

GRANT OF GENERAL AUTHORITY

GRANT OF SPECIFIC AUTHORITY (OPTIONAL)

TRANSACTIONS THAT BENEFIT AGENT OR PERSONS TO WHOM AGENT OWES OBLIGATION OF SUPPORT

EFFECTIVE DATE

NOMINATION OF GUARDIAN (OPTIONAL)

RELIANCE ON THIS POWER OF ATTORNEY

MEANING AND EFFECT

SIGNATURE AND ACKNOWLEDGEMENT