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Vermont Limited Power of Attorney and Tax Information Authorization Form

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Vermont Limited Power of Attorney and Tax Information Authorization Form Page 2
ATTESTATION OF AGENT
I, _____________________________________ do hereby attest that I accept appointment as agent for
_______________________________________ (hereafter "principal") and:
that I understand my duties under this Limited Power of Attorney and under the law;
that I understand that I have a duty for the principal as to the specific transactions and types of transactions if
expressly required to do so in this Limited Power of Attorney;
that I hereby specifically acknowledge and accept such duties to act in signing this Limited Power of Attorney;
in the case of such a duty to act, my agreement to act on or behalf of the principal is enforceable against me
regardless of whether there is any consideration to support a contractual obligation;
that I understand and acknowledge in signing this Limited Power of Attorney, that if I have been selected as agent
with the expectation that I have special skills or expertise I will use those skills on behalf of the principal.
_____________________________________________ _____________________________
Signature of Agent Date Signed
Vermont Limited Power of Attorney and Tax Information Authorization Form
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