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8.0 Power Of Attorney Confirmation
I certifu that this is a true copy
of the orioinal
E-P,.o,lH
hava
ATTORNEY'S ACCETT&NCE sighted on .I
As attomey, you complete the section of this form that applies to you by
writtng on the lines and ticking the boxes. lf you are not able to tick all the
boxes truthfully, then you must not accept this appointment as attomey.
{Fimt attorney {ompJ*tes this ss{tisn}
10. r, frUOREY REfn €At , stote that:
[Prlnt your full nome here]
w I om eighteen or over,
w I am not a current poid corer of the principol,
w I om not o current health-care provider for the principal,
I hove read Port 1, giving me enduring power of attorney,
I understond that, by signing this document, I toke on the responsibility of
exercising the power I hove been given in the document,
I olso understond thot I must exercise the power in occordance with t}re Powers of
Attomey Act 1998 and the Guardianship and Administration Act 2N0.
. '.')),.'--.-:,, o
[Sign here]
,4rt fr*{nu
I
(&f*r aoa'o
{S*trrnd attorney, if any, {$mpletet this section)
11. t, Knnew Lrnrbfr lfauneD , stote thot:
[Prtnt your full name here]
ff tom eighteen orove!
ff tam not o current poid corer of the principol,
ff t am not o current health-core provider forthe principol,
ff thove reod Part 1, giving rne endudng polver of ottorney,
ff t understqnd thot, by signing this document, I take on the responsibility of
exercising the power I hove been given in the document,
I olso understond thot I must exercise the pou/er in occordonce with the Powers of
Attomey Acl 1998 ond the Guardianship and Administration Act 2ON.
tu
[Sign here]
ffir,*rx
the dote herel
S'€.veo"*,
{ ffry"st QcJo.
t7
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