Okla. Stat. tit. 58, § 58-3041

A document substantially in the following form may be used to

create a statutory power of attorney form that has the meaning and

effect prescribed by this act.

OKLAHOMA

STATUTORY POWER OF ATTORNEY FORM

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

Oklahoma Statutes - Title 58. Probate Procedure Page 187

this form is explained in the Uniform Power of Attorney Act, Section

3001 et seq. of Title 58 of the Oklahoma Statutes.

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 Special Instructions.

This form provides for designation of one agent. If you wish to

name more than one agent you may name a coagent in the Special

Instructions. Coagents are not required to act together unless you

include that requirement in the Special Instructions.

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 unless you

state otherwise in the Special Instructions.

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.

DESIGNATION OF AGENT

I, _______________________________________________,

(Name of Principal)

name the following person as my agent:

Name of Agent:______________________________________________________

Agent's Address:____________________________________________________

Agent's Telephone Number:___________________________________________

DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL)

If my agent is unable or unwilling to act for me, I name as my

successor agent:

Name of Successor Agent:____________________________________________

Successor Agent's Address:__________________________________________

Successor Agent's Telephone Number:_________________________________

If my successor agent is unable or unwilling to act for me, I name

as my second successor agent:

Name of Second Successor Agent:_____________________________________

Second Successor Agent's Address:___________________________________

Second Successor Agent's Telephone Number:__________________________

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

Uniform Power of Attorney Act, Section 3001 et seq. of Title 58 of

the Oklahoma Statutes:

(INITIAL each subject you want to include in the agent's general

authority. If you wish to grant general authority over all of the

Oklahoma Statutes - Title 58. Probate Procedure Page 188

subjects you may initial "All Preceding Subjects" instead of

initialing each subject.)

(___) Real Property

(___) Tangible Personal Property

(___) Stocks and Bonds

(___) Commodities and Options

(___) Banks and Other Financial Institutions

(___) Operation of Entity or Business

(___) Insurance and Annuities

(___) Estates, Trusts and Other Beneficial Interests

(___) Claims and Litigation

(___) Personal and Family Maintenance

(___) Benefits from Governmental Programs or Civil or Military

Service

(___) Retirement Plans

(___) Taxes

(___) All Preceding Subjects

GRANT OF SPECIFIC AUTHORITY (OPTIONAL)

My agent MAY NOT do any of the following specific acts for me UNLESS
___) Insurance and Annuities

(___) Estates, Trusts and Other Beneficial Interests

(___) Claims and Litigation

(___) Personal and Family Maintenance

(___) Benefits from Governmental Programs or Civil or Military

Service

(___) Retirement Plans

(___) Taxes

(___) All Preceding Subjects

GRANT OF SPECIFIC AUTHORITY (OPTIONAL)

My agent MAY NOT do any of the following specific acts for me UNLESS

I have INITIALED the specific authority listed below:

(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 the specific authority you WANT to give your agent.)

(___) Create, amend, revoke or terminate an inter vivos trust

(___) Make a gift, subject to the limitations of the Uniform Power

of Attorney Act, Section 3040 of Title 58 of the Oklahoma

Statutes and any special instructions in this power of

attorney

(___) Create or change rights of survivorship

(___) Create or change a beneficiary designation

(___) Authorize another person to exercise the authority granted

under this power of attorney

(___) 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

(___) Access the content of electronic communications

(___) Disclaim or refuse an interest in property, including a power

of appointment

LIMITATION ON AGENT'S AUTHORITY

An agent 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)

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You may give special instructions on the following lines:

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

EFFECTIVE DATE

This power of attorney is effective immediately unless I have stated

otherwise in the Special Instructions.

NOMINATION OF GUARDIAN (OPTIONAL)

If it becomes necessary for a court to appoint a guardian of my

estate or guardian of my person, I nominate the following person(s)

for appointment:

Name of Nominee for guardian 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:_________________________________________

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.

SIGNATURE AND ACKNOWLEDGMENT

____________________________________________ _______________

Your Signature Date

____________________________________________

Your Name Printed

____________________________________________

Your Address

____________________________________________

Your Telephone Number

State of ____________________________

County of ___________________________

This document was acknowledged before me on _______________

(Date)

by ______________________________________.

(Name of Principal)
________________________________________

Your Name Printed

____________________________________________

Your Address

____________________________________________

Your Telephone Number

State of ____________________________

County of ___________________________

This document was acknowledged before me on _______________

(Date)

by ______________________________________.

(Name of Principal)

____________________________________________ (Seal, if any)

Signature of Notary ____________________________________________

My commission expires: _______________

This document prepared by: ______________________________________

IMPORTANT INFORMATION FOR AGENT

Oklahoma Statutes - Title 58. Probate Procedure Page 190

Agent's Duties

When you accept the authority granted under this power of attorney,

a special legal relationship is created between you and the

principal. This relationship imposes upon you legal duties that

continue until you resign or the power of attorney is terminated or

revoked. You must:

1. Do what you know the principal reasonably expects you to do

with the principal's property or, if you do not know the

principal's expectations, act in the principal's best

interest;

2. Act in good faith;

3. Do nothing beyond the authority granted in this power of

attorney; and

4. Disclose your identity as an agent whenever you act for the

principal by writing or printing the name of the principal

and signing your own name as "agent" in the following

manner:

(Principal's Name) by (Your Signature) as Agent

Unless the Special Instructions in this power of attorney state

otherwise, you must also:

1. Act loyally for the principal's benefit;

2. Avoid conflicts that would impair your ability to act in the

principal's best interest;

3. Act with care, competence and diligence;

4. Keep a record of all receipts, disbursements and

transactions made on behalf of the principal;

5. Cooperate with any person that has authority to make health

care decisions for the principal to do what you know the

principal reasonably expects or, if you do not know the

principal's expectations, to act in the principal's best

interest; and

6. Attempt to preserve the principal's estate plan if you know

the plan and preserving the plan is consistent with the

principal's best interest.

Termination of Agent's Authority

You must stop acting on behalf of the principal if you learn of any

event that terminates this power of attorney or your authority under

this power of attorney. Events that terminate a power of attorney

or your authority to act under a power of attorney include:

1. Death of the principal;

2. The principal's revocation of the power of attorney or your

authority;

3. The occurrence of a termination event stated in the power of

attorney;

4. The purpose of the power of attorney is fully accomplished;

or

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5. If you are married to the principal, a legal action is filed

with a court to end your marriage, or for your legal

separation, unless the Special Instructions in this power of

attorney state that such an action will not terminate your

authority.

Liability of Agent

The meaning of the authority granted to you is defined in the

Uniform Power of Attorney Act, Section 3001 et seq. of Title 58 of

the Oklahoma Statutes. If you violate the Uniform Power of Attorney

Act, Section 3001 et seq. of Title 58 of the Oklahoma Statutes, or

act outside the authority granted, you may be liable for any damages

caused by your violation.

If there is anything about this document or your duties that you do

not understand, you should seek legal advice.