20210312 - Owners Consent · EXE21/0023

FORM 1: APPOINTING AN ATTORNEY FOR PERSONAL/HEALTH MATTERS
a

Note:

of:
ph:

 

if you do not want your attorney to make decisions about personal/health matters, rule a line through Form
1 and Certificate of witness to Form 1.

|, Nicole Patricia Morrison (‘the Principal’)
of 56 Lilly Street, Sherwood, 4075

appoint the following:

Simon Michael Morrison (‘Simon’)
56 Lilly Street, Sherwood, 4075

as my attorney/s, under enduring power of attorney, for personal/health matters.

Do you want to set any terms for the power given in clause 1 (e.g. limit the power of your
attorney or give specific information about your wishes)?

No > Goto 4.

C] Yes.

Write these terms here: (For example: ‘My attorney/s must not consent to a blood transfusion on my
behalf or ‘If |need nursing-home care, | want my attorney to try XYZ Nursing Home first’.)

Are you appointing more than one attorney for personal/health matters?
No Go to 6.

C | Yes.

How do you prefer that they make their decisions?

[-]  Severally (any one of them may decide)

Jointly (unanimously)

As a majority (if you are appointing more than three attorneys, please specify,
e.g. ‘Simple majority’, ‘Two-thirds majority’)

Cr] Other:

OO