This Limited Power of Attorney for Stock Transactions and Corporate Powers is used by a shareholder in a corporation to authorize an agent to perform all acts necessary for stock transactions and other corporate powers. This document allows the appointed agent to act on behalf of the individual for the limited purpose of exercising stock options and voting rights. Some of the acts authorized include receiving and conveying stock certificates, entering into agreements and executing bank documents. This document can be customized to fit the unique needs of the individual. It should be used by shareholders located in Wisconsin to appoint an agent to act on their behalf for this limited purpose.
Docstoc Legal Agreements This Limited Power of Attorney for Stock Transactions and Corporate Powers is used by a shareholder in a corporation to authorize an agent to perform all acts necessary for stock transactions and other corporate powers. This document allows the appointed agent to act on behalf of the individual for the limited purpose of exercising stock options and voting rights. Some of the acts authorized include receiving and conveying stock certificates, entering into agreements and executing bank documents. This document can be customized to fit the unique needs of the individual. It should be used by shareholders located in Wisconsin to appoint an agent to act on their behalf for this limited purpose. ® DISCLAIMERS: ALL INFORMATION AND FORMS ARE PROVIDED “AS IS” WITHOUT ANY WARRANTY OF ANY KIND, EXPRESS, IMPLIED, OR OTHERWISE, INCLUDING AS TO THEIR LEGAL EFFECT AND COMPLETENESS. 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All Rights Reserved LIMITED POWER OF ATTORNEY FOR STOCK TRANSACTIONS AND CORPORATE POWERS STATE OF Wisconsin COUNTY OF __________________________ KNOW ALL MEN BY THESE PRESENTS: That I, ____________________________ [Instruction: Insert the name of person/principal making this power of attorney] residing at ______________________________ [Instruction: Insert the address of person/principal making this power of attorney] (hereinafter referred to as the “Principal”) being of sound mind and memory, do hereby make, constitute and appoint ____________________________ [Instruction: Insert the name of Agent] residing at _________________________________ [Instruction: Insert the address of Agent], as my true and lawful Attorney-in-Fact (hereinafter referred to as the “Attorney-in-Fact”), THIS DOCUMENT SHALL BE CONSTRUED AND INTERPRETED AS A LIMITED POWER OF ATTORNEY AND THE ATTORNEY-IN-FACT SHALL HAVE THE POWER AND AUTHORITY TO PERFORM OR UNDERTAKE ANY ACTION I COULD PERFORM OR UNDERTAKE IF I WERE PERSONALLY PRESENT. I hereby authorize the Attorney-in-Fact to act with the following limited powers: Exercising stock options and voting all of my shares of stock in ______________________________________ [Instruction: Insert the name of Corporation where the stock is deposited] a Corporation incorporated in the State of Wisconsin, (hereinafter referred to as the "Corporation"), without the necessity of a proxy and the right to appoint proxies therefore, and possessing all powers that I possess as granted to me by the Bylaws of the Corporation, to incorporate, reorganize, merge, consolidate, recapitalize, sell, liquidate or dissolve any business; elect or employ officers, directors and agents; carry out the provisions of any agreement for the sale of any business interest or the stock therein. These powers include, but are not limited to, the following: 1. To receive, hold, transfer, sell and convey any stock certificates of the Corporation and all documents of title in connection therewith; 2. To make, execute and deliver, in my name and on my behalf, for any consideration whatsoever, for cash, instruments of conveyance covering the stock of the Corporation, containing such terms, covenants and conditions deemed necessary or advisable by the Attorney-in-Fact; 3. To acquire, receive and retain investments without regards to principles of diversification, and without regard to predominance of common stock, or stock in closely held corporations; 4. To enter into any plan or agreements for sale, merger, consolidation, liquidation, recapitalization or other disposition of any trust or estate property, or of any corporation © Copyright 2011 Docstoc Inc. registered document proprietary, copy not 2 issuing securities held as part of my estate or any trust; and to accept in such transactions any cash, securities or property that the Attorney-in-Fact deems proper; 5. To execute, in my name and on my behalf, such contracts or other assurances as may be requested or required by any bank or other institution or individual when carrying out the powers granted herein; and 6. To acquire, exchange, buy or sell my stock in the Corporation, or any interest therein, on such terms and conditions as the Attorney-in-Fact shall deem fit and proper. To execute and deliver, in my name and on my behalf, conveyances of said stock. FURTHER, I do authorize the Attorney-in-Fact to execute, acknowledge and deliver any instrument under seal or otherwise, and to do all things necessary to carry out the intent hereof, hereby granting unto the Attorney-in-Fact full power and authority to act in and concerning the premises as fully and effectually as I may do if personally present, limited, however, to the purpose for which this limited power of attorney is executed. PROVIDED, however, that all business transacted hereunder for me or for my account shall be transacted in my name, and that all endorsements and instruments executed by the Attorney-in- Fact for the purpose of carrying out the foregoing powers shall contain my name, followed by that of the Attorney-in-Fact. DURABILITY. [Instruction: Choose any one option as per applicable and mark it “X”] This Power of Attorney shall be: ( _________ ) Non-Durable; ( _________ ) Durable and shall not be affected by any subsequent disability or incompetence. I further declare that any act or thing lawfully done hereunder and within the powers herein stated by the Attorney-in-Fact shall be binding on myself and my heirs, legal and personal representatives and assigns, whether the same shall have been done either before or after my death or other revocation of this instrument, unless and until reliable intelligence or notice thereof shall have been received by the Attorney-in-Fact. IN WITNESS WHEREOF, I have executed this Limited Power of Attorney and here unto set my hand and seal this _______ [Month] _______ [Date], 20_____ ___________________________________ [Instruction: Insert signature of Principal] _____________________________________________ [Instruction: Insert typed/printed name of Principal] © Copyright 2011 Docstoc Inc. registered document proprietary, copy not 3 ___________________________________ [Instruction: Insert signature of Agent] _____________________________________________ [Instruction: Insert typed/printed name of Agent] © Copyright 2011 Docstoc Inc. registered document proprietary, copy not 4 ATTESTATION The hereinafter named Witnesses, each declare under penalty of perjury under the laws of the State of Wisconsin, that the Principal is personally known to us, that the Principal signed and acknowledged this Limited Power of Attorney in our presence, that the Principal appears to be of sound mind and under no duress, fraud or undue influence, that we are not the person appointed as the Attorney-in-Fact by this document and that we witnessed this Limited Power of Attorney in the presence of the Principal. We are not related to the Principal by blood, marriage or adoption, and to the best of our knowledge, are not entitled to any part of the estate of the Principal upon the death of the Principal under a will now existing or by operation of law. Witnesses # 1 Witness # 2 __________________________ __________________________ Signature Signature Name: ____________________ Name: ____________________ Address: ____________________ Address: ____________________ © Copyright 2011 Docstoc Inc. registered document proprietary, copy not 5 ACKNOWLEDGMENT State of Wisconsin County of __________________ I, the undersigned, a Notary Public in and for said County in said State, hereby certify that _________________________, who is known to me, acknowledged before me on this day that, being informed of the contents of the instrument, he/she executed the same voluntarily on the day the same bears date. Given under my hand and official seal this the ________ day of ________, ____. __________________________________ Notary Public My Commission Expires: ______________ (SEAL) © Copyright 2011 Docstoc Inc. registered document proprietary, copy not 6
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