Oregon Power of Attorney - Effective upon Disability

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                             This Power of Attorney form is used to appoint an agent to act on the principal's behalf
                             regarding the principal's financial matters in the event of the principal's disability or
                             incapacity. This form grants the agent the right to speak or act on the principal's behalf,
                             including the power to lease or sell real estate or personal property, to collect any money
                             owed to the principal, and to sign documents on behalf of the principal. It contains many of
                             the powers typically included in a power of attorney, but can be customized to contain the
                             specific powers the principal wishes to grant to his or her agent. This document should be
                             used by individuals located in Oregon that wish to appoint an agent to act on their behalf in
                             the event of their disability or incapacity.
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                                    POWER OF ATTORNEY

                                    (Effective upon Disability)

KNOW ALL MEN BY THESE PRESENTS that I ________________________________
[Instruction: Insert the name of principal] residing at ___________________ [Instruction:
Insert the address of principal], (hereinafter referred to as the “Principal”) do hereby make,
constitute and appoint ________________________________ [Instruction: Insert the name of
agent] residing at _______________________________ [Instruction: Insert the address of
agent] (hereinafter termed as “Agent”) as my true and lawful attorney for me and in my name,
place, and stead and on my behalf, generally to act as my Agent with respect to the following
initialed subjects, if in case I am considered/declared disabled or incapacitated pursuant to a
physician’s certificate in writing that, based on the physician’s medical examination of me, I am
mentally incapable of managing my financial affairs.

[Instruction: To grant all of the following powers, initial the line in front of (16) and ignore
the lines in front of the other powers.]

[Instruction: To grant one or more, but fewer than all, of the following powers, initial the
line in front of each power which you wish to grant.]

[Instruction: To withhold a power, do not initial the line in front of it and, for clarity, cross
it out.]

INITIAL.

1. _________ Transactions of Real Property. To lease, sell, mortgage, purchase, exchange,
   and acquire, and to agree, bargain, and contract for the lease, sale, purchase, exchange, and
   acquisition of, and to accept, take, receive, and possess any interest in real property
   whatsoever, on such terms and conditions, and under such covenants, as my Agent shall
   deem proper; and to maintain, repair, tear down, alter, rebuild, improve, manage, insure,
   move, rent, lease, sell, convey, subject to liens, mortgages, and security deeds, and in any
   way or manner deal with all or any part of any interest in real property whatsoever, including
   specifically, but without limitation, real property, under such terms and conditions, and under
   such covenants, as my Agent shall deem proper and may for all deferred payments accept or
   purchase money notes payable to me and secured by mortgages or deeds to secure debt, and
   from time to time collect and cancel any of said notes, mortgages, security interests, or deeds
   to secure debt.

2. _________ Transactions of Tangible Personal Property. To lease, sell, mortgage,
   purchase, exchange, and acquire, and to agree, bargain, and contract for the lease, sale,
   purchase, exchange, and acquisition of, and to accept, take, receive, and possess any personal
   property whatsoever, tangible or intangible, or interest thereto, on such terms and conditions,
   and under such covenants, as my Agent shall deem proper; and to maintain, repair, improve,
   manage, insure, rent, lease, sell, convey, subject to liens or mortgages, or to take any other
   security interests in said property, or otherwise hypothecate (pledge), and in any way or
   manner deal with all or any part of any real or personal property whatsoever, tangible or



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   intangible, or any interest therein, that I own at the time of execution or may thereafter
   acquire, under such terms and conditions, and under such covenants
				
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Description: This Power of Attorney form is used to appoint an agent to act on the principal's behalf regarding the principal's financial matters in the event of the principal's disability or incapacity. This form grants the agent the right to speak or act on the principal's behalf, including the power to lease or sell real estate or personal property, to collect any money owed to the principal, and to sign documents on behalf of the principal. It contains many of the powers typically included in a power of attorney, but can be customized to contain the specific powers the principal wishes to grant to his or her agent. This document should be used by individuals located in Oregon that wish to appoint an agent to act on their behalf in the event of their disability or incapacity.
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