POWER OF ATTORNEY
Pursuant to Item 601(b)(24) of Regulation SK and Rule 462(b) of the Securities Act
of 1933
The undersigned, on behalf of the company set forth below, hereby constitutes and appoints the individuals set
forth below and each of them individually as my true and lawful attorneys with full power to them and each of
them to sign for me and in my name and in the capacity indicated below any and all amendments to the
Registration Statements listed below filed with the Securities and Exchange Commission under the Securities
Act of 1933 and the Investment Company Act of 1940 and any documentation, including Form N-8F, necessary
to deregister any such registrations or to deregister any of the entities (including any issuing separate accounts)
associated with the issuance of any such registrations.
COMPANY:ING USA Annuity and Life Insurance Company
INDIVIDUALS WITH POWER OF ATTORNEY:J. Neil McMurdie, Nicholas Morinigo and
Julie Rockmore
REGISTRATION STATEMENTS FILED UNDER THE SECURITIES ACT OF 1933:
| | | | |
033-23351 | 333-28769 | 333-70600 | 333-117260 | 333-133944 |
033-23458 | 333-30180 | 333-90516 | 333-124953 | 333-133076 |
033-34827 | 333-33914 | 333-101481 | 333-133152 | 333-158928 |
033-59261 | 333-66757 | 333-111684 | 333-133153 | |
333-28679 | 333-57218 | 333-111685 | 333-133154 | |
333-28755 | 333-63692 | 333-111686 | 333-133155 | |
REGISTRATION STATEMENTS FILED UNDER THE INVESTMENT COMPANY ACT OF
1940:
811-05626
811-08524
811-09026
811-05790
811-05627
I hereby ratify and confirm on this 25th day of February, 2011, my signature as it may be signed by my said
attorneys to any such registration statements and any and all amendments thereto.
Signature
/s/ Michael S. Smith
Michael S. Smith, Director and President
POWER OF ATTORNEY
Pursuant to Item 601(b)(24) of Regulation SK and Rule 462(b) of the Securities Act
of 1933
The undersigned, on behalf of the company set forth below, hereby constitutes and appoints the individuals set
forth below and each of them individually as my true and lawful attorneys with full power to them and each of
them to sign for me and in my name and in the capacity indicated below any and all amendments to the
Registration Statements listed below filed with the Securities and Exchange Commission under the Securities
Act of 1933 and the Investment Company Act of 1940 and any documentation, including Form N-8F, necessary
to deregister any such registrations or to deregister any of the entities (including any issuing separate accounts)
associated with the issuance of any such registrations.
COMPANY:ING USA Annuity and Life Insurance Company
INDIVIDUALS WITH POWER OF ATTORNEY:J. Neil McMurdie, Nicholas Morinigo and
Julie Rockmore
REGISTRATION STATEMENTS FILED UNDER THE SECURITIES ACT OF 1933:
| | | | |
033-23351 | 333-28769 | 333-70600 | 333-117260 | 333-133944 |
033-23458 | 333-30180 | 333-90516 | 333-124953 | 333-133076 |
033-34827 | 333-33914 | 333-101481 | 333-133152 | 333-158928 |
033-59261 | 333-66757 | 333-111684 | 333-133153 | |
333-28679 | 333-57218 | 333-111685 | 333-133154 | |
333-28755 | 333-63692 | 333-111686 | 333-133155 | |
REGISTRATION STATEMENTS FILED UNDER THE INVESTMENT COMPANY ACT OF
1940:
811-05626
811-08524
811-09026
811-05790
811-05627
I hereby ratify and confirm on this 25th day of February, 2011, my signature as it may be signed by my said
attorneys to any such registration statements and any and all amendments thereto.
Signature
/s/ Donald Britton
Donald W. Britton, Director
POWER OF ATTORNEY
Pursuant to Item 601(b)(24) of Regulation SK and Rule 462(b) of the Securities Act
of 1933
The undersigned, on behalf of the company set forth below, hereby constitutes and appoints the individuals set
forth below and each of them individually as my true and lawful attorneys with full power to them and each of
them to sign for me and in my name and in the capacity indicated below any and all amendments to the
Registration Statements listed below filed with the Securities and Exchange Commission under the Securities
Act of 1933 and the Investment Company Act of 1940 and any documentation, including Form N-8F, necessary
to deregister any such registrations or to deregister any of the entities (including any issuing separate accounts)
associated with the issuance of any such registrations.
COMPANY:ING USA Annuity and Life Insurance Company
INDIVIDUALS WITH POWER OF ATTORNEY:J. Neil McMurdie, Nicholas Morinigo and
Julie Rockmore
REGISTRATION STATEMENTS FILED UNDER THE SECURITIES ACT OF 1933:
| | | | |
033-23351 | 333-28769 | 333-70600 | 333-117260 | 333-133944 |
033-23458 | 333-30180 | 333-90516 | 333-124953 | 333-133076 |
033-34827 | 333-33914 | 333-101481 | 333-133152 | 333-158928 |
033-59261 | 333-66757 | 333-111684 | 333-133153 | |
333-28679 | 333-57218 | 333-111685 | 333-133154 | |
333-28755 | 333-63692 | 333-111686 | 333-133155 | |
REGISTRATION STATEMENTS FILED UNDER THE INVESTMENT COMPANY ACT OF
1940:
811-05626
811-08524
811-09026
811-05790
811-05627
I hereby ratify and confirm on this 24th day of February, 2011, my signature as it may be signed by my said
attorneys to any such registration statements and any and all amendments thereto.
Signature
/s/ Patrick Flynn
Patrick G. Flynn, Director and Chairman
POWER OF ATTORNEY
Pursuant to Item 601(b)(24) of Regulation SK and Rule 462(b) of the Securities Act of 1933
The undersigned, on behalf of the company set forth below, hereby constitutes and appoints the
individuals set forth below and each of them individually as my true and lawful attorneys with
full power to them and each of them to sign for me and in my name and in the capacity indicated
below any and all amendments to the Registration Statements listed below filed with the
Securities and Exchange Commission under the Securities Act of 1933 and the Investment
Company Act of 1940 and any documentation, including Form N-8F, necessary to deregister any
such registrations or to deregister any of the entities (including any issuing separate accounts)
associated with the issuance of any such registrations.
COMPANY:ING USA Annuity and Life Insurance Company
INDIVIDUALS WITH POWER OF ATTORNEY:J. Neil McMurdie, Nicholas Morinigo and
Julie Rockmore
REGISTRATION STATEMENTS FILED UNDER THE SECURITIES ACT OF 1933:
| | | | |
033-23351 | 333-28769 | 333-70600 | 333-117260 | 333-133944 |
033-23458 | 333-30180 | 333-90516 | 333-124953 | 333-133076 |
033-34827 | 333-33914 | 333-101481 | 333-133152 | 333-158928 |
033-59261 | 333-66757 | 333-111684 | 333-133153 | |
333-28679 | 333-57218 | 333-111685 | 333-133154 | |
333-28755 | 333-63692 | 333-111686 | 333-133155 | |
REGISTRATION STATEMENTS FILED UNDER THE INVESTMENT COMPANY ACT
| | | | | |
OF 1940 | : | | | | |
811-05626 | | 811-08524 | 811-09026 | 811-05790 | 811-05627 |
I hereby ratify and confirm on this 25th day of February, 2011, my signature as it may be signed
by my said attorneys to any such registration statements and any and all amendments thereto.
Signature
/s/ Lynne R. Ford
Lynne R. Ford, Director
State of New York
County of New York
On the 25th day of February in the year 2011, before me, the undersigned, personally appeared Lynne R.
Ford, personally known to me or proved to me on the basis of satisfactory evidence to be the individual
whose name is subscribed to the within instrument and acknowledged to me that she executed the same in
her capacity, and that by her signature on the instrument, the individual, or the person upon behalf of which
the individual acted, executed the instrument.
| |
/s/ Helen M. Scheuer | Helen M. Scheuer |
Notary Public | Notary Public, State of New York |
| No. 01SC3352985 |
| Qualified in New York County |
| Commission Expires 4-30-2011 |
CAUTION TO THE PRINCIPAL: Your Power of Attorney is an important document. As the
“principal,” you give the person whom you choose (your “agent”) authority to spend your money
and sell or dispose of your property during your lifetime without telling you. You do not lose
your authority to act even though you have given your agent similar authority.
When your agent exercises this authority, he or she must act according to any instructions you
have provided or, where there are no specific instructions, in your best interest. “Important
Information for the Agent” at the end of this document describes your agent’s responsibilities.
Your agent can act on your behalf only after signing the Power of Attorney before a notary
public.
You can request information from your agent at any time. If you are revoking a prior Power of
Attorney by executing this Power of Attorney, you should provide written notice of the
revocation to your prior agent(s) and to the financial institutions where your accounts are located.
You can revoke or terminate your Power of Attorney at any time for any reason as long as you
are of sound mind. If you are no longer of sound mind, a court can remove an agent for acting
improperly.
Your agent cannot make health care decisions for you. You may execute a “Health Care Proxy”
to do this.
The law governing Powers of Attorney is contained in the New York General Obligations Law,
Article 5, Title 15. This law is available at a law library, or online through the New York State
Senate or Assembly websites,www.senate.state.ny.usorwww.assembly.state.ny.us.
If there is anything about this document that you do not understand, you should ask a lawyer of
your own choosing to explain it to you.
| |
Signature of Agents: | |
|
|
/s/ Nicholas Morinigo | State of Pennsylvania |
Nicholas Morinigo | County of Chester |
|
| On this, the 31st day of March, 2011, before me |
Commonwealth of Pennsylvania | Tabitha E. Muniz, the undersigned officer, personally |
Notarial Seal | appeared Nicholas Morinigo, known to me (or |
Tabitha E. Muniz, Notary Public | satisfactorily proven) to be the person whose name is |
West Whiteland Twp., Chester | subscribed as attorney in fact for Lynne R. Ford, and |
County | acknowledged that he executed the same as the act of his |
My Commission Expires Dec. 10, | principal for the purposes therein contained. |
2014 | |
| /s/ Tabitha E. Muniz |
| Notary Public |
|
|
State of Connecticut |
/s/ J. Neil McMurdie | County of Hartford Town of Windsor |
J. Neil McMurdie | |
| The foregoing instrument was executed and acknowledged |
| before me this 25th day of March, 2011, by J. Neil |
Nicole L. Molleur | McMurdie, as attorney in fact on behalf of Lynne R. Ford. |
Notary Public Within and for | |
The State of Connecticut | |
My commission expires: Nov. 30, | /s/ Nicole L. Molleur |
2014 | Notary Public |
|
|
|
State of Connecticut |
/s/ Julie Rockmore | County of Hartford Town of Windsor |
Julie Rockmore | |
| The foregoing instrument was executed and acknowledged |
| before me this 23rd day of March, 2011, by Julie |
Nicole L. Molleur | Rockmore, as attorney in fact on behalf of Lynne R. Ford. |
Notary Public Within and for | |
The State of Connecticut | |
My commission expires: Nov. 30, | /s/ Nicole L. Molleur |
2014 | Notary Public |
IMPORTANT INFORMATION FOR THE AGENT:
When you accept the authority granted under this Power of Attorney, a special legal relationship
is created between you and the principal. This relationship imposes on you legal responsibilities
that continue until you resign or the Power of Attorney is terminated or revoked. You must:
(1) act according to any instructions from the principal, or, where there are no instructions, in the
principal’s best interest;
(2) avoid conflicts that would impair your ability to act in the principal’s best interest;
(3) keep the principal’s property separate and distinct from any assets you own or control, unless
otherwise permitted by law;
(4) keep a record of all receipts, payments, and transactions conducted for the principal; and
(5) disclose your identity as an agent whenever you act for the principal by writing or printing the
principal’s name and signing your own name as “agent” in either of the following manner:
(Principal’s Name) by (Your Signature) as Agent, or (your signature as Agent for (Principal’s
Name).
You may not use the principal’s assets to benefit yourself or give major gifts to yourself or
anyone else unless the principal has specifically granted you that authority in this Power of
Attorney or in a Statutory Major Gifts Rider attached to this Power of Attorney. If you have that
authority, you must act according to any instructions of the principal or, where there are no such
instructions, in the principal’s best interest.; You may resign by giving written notice to the
principal and to any co-agent, successor agent, monitor if one has been named in this document,
or the principal’s guardian if one has been appointed. If there is anything about this document or
your responsibilities that you do not understand, you should seek legal advice.
Liability of the agent:
The meaning of the authority given to you is defined in New York’s General Obligations Law,
Article 5, Title 15. If it is found that you have violated the law or acted outside the authority
granted to you in the Power of Attorney, you may be liable under the law for your violation.
POWER OF ATTORNEY
Pursuant to Item 601(b)(24) of Regulation SK and Rule 462(b) of the Securities Act of 1933
The undersigned, on behalf of the company set forth below, hereby constitutes and appoints the
individuals set forth below and each of them individually as my true and lawful attorneys with
full power to them and each of them to sign for me and in my name and in the capacity indicated
below any and all amendments to the Registration Statements listed below filed with the
Securities and Exchange Commission under the Securities Act of 1933 and the Investment
Company Act of 1940 and any documentation, including Form N-8F, necessary to deregister any
such registrations or to deregister any of the entities (including any issuing separate accounts)
associated with the issuance of any such registrations.
COMPANY:ING USA Annuity and Life Insurance Company
INDIVIDUALS WITH POWER OF ATTORNEY:J. Neil McMurdie, Nicholas Morinigo and
Julie Rockmore
REGISTRATION STATEMENTS FILED UNDER THE SECURITIES ACT OF 1933:
| | | | |
033-23351 | 333-28769 | 333-70600 | 333-117260 | 333-133944 |
033-23458 | 333-30180 | 333-90516 | 333-124953 | 333-133076 |
033-34827 | 333-33914 | 333-101481 | 333-133152 | 333-158928 |
033-59261 | 333-66757 | 333-111684 | 333-133153 | |
333-28679 | 333-57218 | 333-111685 | 333-133154 | |
333-28755 | 333-63692 | 333-111686 | 333-133155 | |
REGISTRATION STATEMENTS FILED UNDER THE INVESTMENT COMPANY ACT
| | | | | |
OF 1940 | : | | | | |
811-05626 | | 811-08524 | 811-09026 | 811-05790 | 811-05627 |
I hereby ratify and confirm on this 8th day of March, 2011, my signature as it may be signed by
my said attorneys to any such registration statements and any and all amendments thereto.
Signature
/s/ Robert G. Leary
Robert G. Leary, Director
State of New York
County of New York
On the 8th day of March in the year 2011, before me, the undersigned, personally appeared Robert G.
Leary, personally known to me or proved to me on the basis of satisfactory evidence to be the individual
whose name is subscribed to the within instrument and acknowledged to me that he executed the same in
his capacity, and that by his signature on the instrument, the individual, or the person upon behalf of which
the individual acted, executed the instrument.
| |
| Helen M. Scheuer |
/s/ Helen M. Scheuer | Notary Public, State of New York |
Notary Public | No. 01SC3352985 |
| Qualified in New York County |
| Commission Expires 4-30-2011 |
CAUTION TO THE PRINCIPAL: Your Power of Attorney is an important document. As the
“principal,” you give the person whom you choose (your “agent”) authority to spend your money
and sell or dispose of your property during your lifetime without telling you. You do not lose
your authority to act even though you have given your agent similar authority.
When your agent exercises this authority, he or she must act according to any instructions you
have provided or, where there are no specific instructions, in your best interest. “Important
Information for the Agent” at the end of this document describes your agent’s responsibilities.
Your agent can act on your behalf only after signing the Power of Attorney before a notary
public.
You can request information from your agent at any time. If you are revoking a prior Power of
Attorney by executing this Power of Attorney, you should provide written notice of the
revocation to your prior agent(s) and to the financial institutions where your accounts are located.
You can revoke or terminate your Power of Attorney at any time for any reason as long as you
are of sound mind. If you are no longer of sound mind, a court can remove an agent for acting
improperly.
Your agent cannot make health care decisions for you. You may execute a “Health Care Proxy”
to do this.
The law governing Powers of Attorney is contained in the New York General Obligations Law,
Article 5, Title 15. This law is available at a law library, or online through the New York State
Senate or Assembly websites,www.senate.state.ny.usorwww.assembly.state.ny.us.
If there is anything about this document that you do not understand, you should ask a lawyer of
your own choosing to explain it to you.
| |
Signature of Agents: | |
|
|
| State of Pennsylvania |
/s/ Nicholas Morinigo | County of Chester |
Nicholas Morinigo | |
| On this, the 31st day of March, 2011, before me |
| Tabitha E. Muniz, the undersigned officer, personally |
Commonwealth of Pennsylvania | appeared Nicholas Morinigo, known to me (or |
Notarial Seal | satisfactorily proven) to be the person whose name is |
Tabitha E. Muniz, Notary Public | subscribed as attorney in fact for Robert G. Leary, and |
West Whiteland Twp., Chester | acknowledged that he executed the same as the act of his |
County | principal for the purposes therein contained. |
My Commission Expires Dec. 10, | |
2014 | /s/ Tabitha E. Muniz |
| Notary Public |
|
|
State of Connecticut |
/s/ Neil McMurdie | County of Hartford Town of Windsor |
J. Neil McMurdie | |
| The foregoing instrument was executed and acknowledged |
| before me this 25th day of March, 2011, by J. Neil |
Nicole L. Molleur | McMurdie, as attorney in fact on behalf of Robert G. |
Notary Public Within and for | Leary. |
The State of Connecticut | |
My commission expires: Nov. 30, | |
2014 | /s/ Nicole L. Mollur |
| Notary Public |
| |
State of Connecticut |
/s/ Julie Rockmore | County of Hartford Town of Windsor |
Julie Rockmore | |
| The foregoing instrument was executed and acknowledged |
| before me this 23rd day of March, 2011, by Julie |
Nicole L. Molleur | Rockmore, as attorney in fact on behalf of Robert G. |
Notary Public Within and for | Leary. |
The State of Connecticut | |
My commission expires: Nov. 30, | |
2014 | /s/ Nicole L. Molleur |
| Notary Public |
IMPORTANT INFORMATION FOR THE AGENT:
When you accept the authority granted under this Power of Attorney, a special legal relationship
is created between you and the principal. This relationship imposes on you legal responsibilities
that continue until you resign or the Power of Attorney is terminated or revoked. You must:
(1) act according to any instructions from the principal, or, where there are no instructions, in the
principal’s best interest;
(2) avoid conflicts that would impair your ability to act in the principal’s best interest;
(3) keep the principal’s property separate and distinct from any assets you own or control, unless
otherwise permitted by law;
(4) keep a record of all receipts, payments, and transactions conducted for the principal; and
(5) disclose your identity as an agent whenever you act for the principal by writing or printing the
principal’s name and signing your own name as “agent” in either of the following manner:
(Principal’s Name) by (Your Signature) as Agent, or (your signature as Agent for (Principal’s
Name).
You may not use the principal’s assets to benefit yourself or give major gifts to yourself or
anyone else unless the principal has specifically granted you that authority in this Power of
Attorney or in a Statutory Major Gifts Rider attached to this Power of Attorney. If you have that
authority, you must act according to any instructions of the principal or, where there are no such
instructions, in the principal’s best interest.; You may resign by giving written notice to the
principal and to any co-agent, successor agent, monitor if one has been named in this document,
or the principal’s guardian if one has been appointed. If there is anything about this document or
your responsibilities that you do not understand, you should seek legal advice.
Liability of the agent:
The meaning of the authority given to you is defined in New York’s General Obligations Law,
Article 5, Title 15. If it is found that you have violated the law or acted outside the authority
granted to you in the Power of Attorney, you may be liable under the law for your violation.
POWER OF ATTORNEY
Pursuant to Item 601(b)(24) of Regulation SK and Rule 462(b) of the Securities Act
of 1933
The undersigned, on behalf of the company set forth below, hereby constitutes and appoints the individuals set
forth below and each of them individually as my true and lawful attorneys with full power to them and each of
them to sign for me and in my name and in the capacity indicated below any and all amendments to the
Registration Statements listed below filed with the Securities and Exchange Commission under the Securities
Act of 1933 and the Investment Company Act of 1940 and any documentation, including Form N-8F, necessary
to deregister any such registrations or to deregister any of the entities (including any issuing separate accounts)
associated with the issuance of any such registrations.
COMPANY:ING USA Annuity and Life Insurance Company
INDIVIDUALS WITH POWER OF ATTORNEY:J. Neil McMurdie, Nicholas Morinigo and
Julie Rockmore
REGISTRATION STATEMENTS FILED UNDER THE SECURITIES ACT OF 1933:
| | | | |
033-23351 | 333-28769 | 333-70600 | 333-117260 | 333-133944 |
033-23458 | 333-30180 | 333-90516 | 333-124953 | 333-133076 |
033-34827 | 333-33914 | 333-101481 | 333-133152 | 333-158928 |
033-59261 | 333-66757 | 333-111684 | 333-133153 | |
333-28679 | 333-57218 | 333-111685 | 333-133154 | |
333-28755 | 333-63692 | 333-111686 | 333-133155 | |
REGISTRATION STATEMENTS FILED UNDER THE INVESTMENT COMPANY ACT OF
1940:
811-05626
811-08524
811-09026
811-05790
811-05627
I hereby ratify and confirm on this 25th day of February, 2011, my signature as it may be signed by my said
attorneys to any such registration statements and any and all amendments thereto.
Signature
/s/ Steven T. Pierson
Steven T. Pierson, Senior Vice President and Chief Accounting Officer
POWER OF ATTORNEY
Pursuant to Item 601(b)(24) of Regulation SK and Rule 462(b) of the Securities Act of 1933
The undersigned, on behalf of the company set forth below, hereby constitutes and appoints the
individuals set forth below and each of them individually as my true and lawful attorneys with
full power to them and each of them to sign for me and in my name and in the capacity indicated
below any and all amendments to the Registration Statements listed below filed with the
Securities and Exchange Commission under the Securities Act of 1933 and the Investment
Company Act of 1940 and any documentation, including Form N-8F, necessary to deregister any
such registrations or to deregister any of the entities (including any issuing separate accounts)
associated with the issuance of any such registrations.
COMPANY:ING USA Annuity and Life Insurance Company
INDIVIDUALS WITH POWER OF ATTORNEY:J. Neil McMurdie, Nicholas Morinigo and
Julie Rockmore
REGISTRATION STATEMENTS FILED UNDER THE SECURITIES ACT OF 1933:
| | | | |
033-23351 | 333-28769 | 333-70600 | 333-117260 | 333-133944 |
033-23458 | 333-30180 | 333-90516 | 333-124953 | 333-133076 |
033-34827 | 333-33914 | 333-101481 | 333-133152 | 333-158928 |
033-59261 | 333-66757 | 333-111684 | 333-133153 | |
333-28679 | 333-57218 | 333-111685 | 333-133154 | |
333-28755 | 333-63692 | 333-111686 | 333-133155 | |
REGISTRATION STATEMENTS FILED UNDER THE INVESTMENT COMPANY ACT
| | | | | |
OF 1940 | : | | | | |
811-05626 | | 811-08524 | 811-09026 | 811-05790 | 811-05627 |
I hereby ratify and confirm on this 8th day of March, 2011, my signature as it may be signed by
my said attorneys to any such registration statements and any and all amendments thereto.
Signature
/s/ Ewout Steenbergen
Ewout Steenbergen, Director, Executive Vice President and Chief Financial Officer
State of New York
County of New York
On the 8th day of March in the year 2011, before me, the undersigned, personally appeared Ewout
Steenbergen, personally known to me or proved to me on the basis of satisfactory evidence to be the
individual whose name is subscribed to the within instrument and acknowledged to me that he executed the
same in his capacity, and that by his signature on the instrument, the individual, or the person upon behalf
of which the individual acted, executed the instrument.
Helen M. Scheuer
/s/ Helen M. Scheuer
Notary Public, State of New York
Notary Public
No. 01SC3352985
Qualified in New York County
Commission Expires 4-30-2011
CAUTION TO THE PRINCIPAL: Your Power of Attorney is an important document. As the
“principal,” you give the person whom you choose (your “agent”) authority to spend your money
and sell or dispose of your property during your lifetime without telling you. You do not lose
your authority to act even though you have given your agent similar authority.
When your agent exercises this authority, he or she must act according to any instructions you
have provided or, where there are no specific instructions, in your best interest. “Important
Information for the Agent” at the end of this document describes your agent’s responsibilities.
Your agent can act on your behalf only after signing the Power of Attorney before a notary
public.
You can request information from your agent at any time. If you are revoking a prior Power of
Attorney by executing this Power of Attorney, you should provide written notice of the
revocation to your prior agent(s) and to the financial institutions where your accounts are located.
You can revoke or terminate your Power of Attorney at any time for any reason as long as you
are of sound mind. If you are no longer of sound mind, a court can remove an agent for acting
improperly.
Your agent cannot make health care decisions for you. You may execute a “Health Care Proxy”
to do this.
The law governing Powers of Attorney is contained in the New York General Obligations Law,
Article 5, Title 15. This law is available at a law library, or online through the New York State
Senate or Assembly websites,www.senate.state.ny.usorwww.assembly.state.ny.us.
If there is anything about this document that you do not understand, you should ask a lawyer of
your own choosing to explain it to you.
| |
Signature of Agents: | |
|
|
| State of Pennsylvania |
/s/ Nicholas Morinigo | County of Chester |
Nicholas Morinigo | |
| On this, the 31st day of March, 2011, before me |
| Tabitha E. Muniz, the undersigned officer, personally |
Commonwealth of Pennsylvania | appeared Nicholas Morinigo, known to me (or |
Notarial Seal | satisfactorily proven) to be the person whose name is |
Tabitha E. Muniz, Notary Public | subscribed as attorney in fact for Ewout Steenbergen, |
West Whiteland Twp., Chester | and acknowledged that he executed the same as the act |
County | of his principal for the purposes therein contained. |
My Commission Expires Dec. 10, | |
2014 | /s/ Tabitha E. Muniz |
| Notary Public |
|
|
State of Connecticut |
/s/ J. Neil McMurdie | County of Hartford Town of Windsor |
J. Neil McMurdie | |
| The foregoing instrument was executed and acknowledged |
| before me this 25th day of March, 2011, by J. Neil |
Nicole L. Molleur | McMurdie, as attorney in fact on behalf of Ewout |
Notary Public Within and for | Steenbergen. |
The State of Connecticut | |
My commission expires: Nov. 30, | |
2014 | /s/ Nicole L. Molleur |
| Notary Public |
| |
State of Connecticut |
/s/ Julie Rockmore | County of Hartford Town of Windsor |
Julie Rockmore | |
| The foregoing instrument was executed and acknowledged |
| before me this 23rd day of March, 2011, by Julie |
Nicole L. Molleur | Rockmore, as attorney in fact on behalf of Ewout |
Notary Public Within and for | Steenbergen. |
The State of Connecticut | |
My commission expires: Nov. 30, | |
2014 | /s/ Nicole L. Molleur |
| Notary Public |
IMPORTANT INFORMATION FOR THE AGENT:
When you accept the authority granted under this Power of Attorney, a special legal relationship
is created between you and the principal. This relationship imposes on you legal responsibilities
that continue until you resign or the Power of Attorney is terminated or revoked. You must:
(1) act according to any instructions from the principal, or, where there are no instructions, in the
principal’s best interest;
(2) avoid conflicts that would impair your ability to act in the principal’s best interest;
(3) keep the principal’s property separate and distinct from any assets you own or control, unless
otherwise permitted by law;
(4) keep a record of all receipts, payments, and transactions conducted for the principal; and
(5) disclose your identity as an agent whenever you act for the principal by writing or printing the
principal’s name and signing your own name as “agent” in either of the following manner:
(Principal’s Name) by (Your Signature) as Agent, or (your signature as Agent for (Principal’s
Name).
You may not use the principal’s assets to benefit yourself or give major gifts to yourself or
anyone else unless the principal has specifically granted you that authority in this Power of
Attorney or in a Statutory Major Gifts Rider attached to this Power of Attorney. If you have that
authority, you must act according to any instructions of the principal or, where there are no such
instructions, in the principal’s best interest.; You may resign by giving written notice to the
principal and to any co-agent, successor agent, monitor if one has been named in this document,
or the principal’s guardian if one has been appointed. If there is anything about this document or
your responsibilities that you do not understand, you should seek legal advice.
Liability of the agent:
The meaning of the authority given to you is defined in New York’s General Obligations Law,
Article 5, Title 15. If it is found that you have violated the law or acted outside the authority
granted to you in the Power of Attorney, you may be liable under the law for your violation.