(...) Waive the principal's right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan (...) Exercise fiduciary powers that the principal has authority to delegate (...) Disclaim or refuse an interest in property, including a power of appointment LIMITATION ON AGENT'S AUTHORITY An that is not my ancestor, spouse or descendant MAY NOT use my property to benefit the agent or a person to whom the agent owes an obligation of support unless I have included that authority in the Special Instructions. SPECIAL INSTRUCTIONS (OPTIONAL) You may give special instructions on the following lines: EFFECTIVE DATE This of attorney is effective immediately unless I have stated otherwise in the Special Instructions. NOMINATION OF CONSERVATOR OR GUARDIAN (OPTIONAL) If it becomes necessary for a court to appoint a conservator of my estate or guardian of my person, I nominate the following person(s) for appointment: Name of Nominee for conservator of my estate: Nominee's Address: Nominee's Telephone Number: Name of Nominee for guardian of my person: Nominee's Address: Nominee's Telephone Number:
(...) Waive the principal's right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan (...) Exercise fiduciary powers that the principal has authority to delegate (...) Disclaim or refuse an interest in property, including a power of appointment LIMITATION ON AGENT'S AUTHORITY An that is not my ancestor, spouse or descendant MAY NOT use my property to benefit the agent or a person to whom the agent owes an obligation of support unless I have included that authority in the Special Instructions. SPECIAL INSTRUCTIONS (OPTIONAL) You may give special instructions on the following lines: EFFECTIVE DATE This of attorney is effective immediately unless I have stated otherwise in the Special Instructions. NOMINATION OF CONSERVATOR OR GUARDIAN (OPTIONAL) If it becomes necessary for a court to appoint a conservator of my estate or guardian of my person, I nominate the following person(s) for appointment: Name of Nominee for conservator of my estate: Nominee's Address: Nominee's Telephone Number: Name of Nominee for guardian of my person: Nominee's Address: Nominee's Telephone Number: