Quebec Power of Attorney Form - Free Download | Page 2
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Quebec Power of Attorney Form Page 2
Quebec Power of Attorney Form
Page 2 of 2
The undersigned acknowledges that termination or redemption of a Registered Retirement Savings Plan could result in significant tax liability.
*Delete if customer
does not intend the
Power of Attorney
also to constitute a
Mandate.
The undersigned declares that this Power of Attorney may be exercised during any subsequent mental infirmity or legal incapacity on the part of
the undersigned.
The undersigned hereby declares that this Power of Attorney constitutes a Mandate in Anticipation of Incapacity (the "Mandate") and the
undersigned hereby constitutes and appoints the attorney named above as the true and lawful mandatary of the undersigned mandator in the event
that the undersigned mandator becomes incapable of administering his or her own affairs with all the powers and authority hereinabove set forth
and instructs the said mandatary to have this Mandate homologated.
The Bank may, by virtue of this Mandate, continue to deal with the mandatary, who is authorized to continue to deal with the Bank with the powers
of simple administration pending the homologation of the Mandate.
The undersigned hereby revokes any Power of Attorney (and/or, if applicable, Mandate in Anticipation of Incapacity) filed with the Bank prior to the day
of execution of this Power of Attorney (and/or, if applicable, Mandate). However, it is the intention of the undersigned that the undersigned may have
multiple Powers of Attorney (and/or, if applicable, Mandates in Anticipation of Incapacity) and, as such, the execution of this Power of Attorney (and/or,
if applicable, this Mandate) does not necessarily constitute the revocation of any previously executed Power of Attorney (and/or, if applicable, Mandate in
Anticipation of Incapacity) that has not been filed with the Bank.
And the undersigned hereby ratifies and confirms all and whatsoever the said attorney (and/or, if applicable, the mandatary) or any substitute shall do
or cause to be done under or by virtue hereof. The Bank may continue to deal with the said attorney (and/or, if applicable, the mandatary) until
notice of revocation hereof has been given in writing to the manager or acting manager at the branch of the Bank in which the account of the
undersigned is kept, and receipt of such notice duly acknowledged in writing.
It is the express wish of the parties that this agreement and any related documents be drawn up and executed in English. Les parties conviennent que
la présente convention et tous les documents s'y rattachant soient rédigés et signés en anglais.
Witness at
this
day of
,
.
The witness must not
be the attorney, the
spouse of the attorney
or any person who
has any interest in the
Mandate.
Signed and Delivered in the presence of:
(Signature of Witness)
(Name of Witness)
(Address)
(Occupation)
A second witness is
required if the
customer intends the
Power of Attorney to
also constitute a
Mandate.
Signed and Delivered in the presence of:
(Signature of Donor)
(Signature of Witness)
(Name of Witness)
(Address)
(Occupation)
I hereby accept the above appointment.
(Date)
(Signature of attorney and/or, if applicable, the mandatory)
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Quebec Power of Attorney Form