GENERAL PROCURATION UNITED STATES OF AMERICA BY: STATE OF LOUISIANA TO: PARISH OF BE IT KNOWN, that on this day of, 20, BEFORE ME, the undersigned Notary Public, duly commissioned and qualified in the State of Louisiana, and in the presence of the witnesses hereinafter named and undersigned, PERSONALLY CAME AND APPEARED:, a person of the full age of majority and a resident of the Parish of, State of Louisiana (hereinafter Appearer ); who declared that he/she has made and appointed, and by these presents he/she does make, name, nominate, ordain, authorize, constitute, and appoint, and in his/her place and stead, depute and put, a person of the full age of majority, and a resident of the Parish of, State of Louisiana (hereinafter Agent or ); to be his/her true and lawful agent and attorney-in-fact, general and special. Article 1. General Powers 1.1 Generally. Appearer grants unto Agent the authority to transact all Appearer s affairs, business, concerns, and matters of whatever nature of kind, without any exception or reservation whatsoever, in Appearer s name and behalf, as completely and effectively as Appearer could do if personally present. 1.2 Substitution. Appearer grants unto Agent the full power of substitution and revocation. 1.3 Ratification. Appearer hereby agrees to ratify and confirm all of Agent s actions performed under authority of this Act of Procuration.
Article 2. Additional Powers Without limiting the forgoing, Agent shall have the following powers: 2.1 Correspondence. To open all letters of correspondence addressed to Appearer and to answer the same; 2.2 Borrowing. A. To draw and endorse promissory notes and negotiable instruments in the name of Appearer and renew, extend, or waive prescription on these items; B. To borrow money from any bank(s), homestead(s), insurance company(ies), or other entity or individual and execute obligations from time to time for the renewal of all or any part thereof; C. To pay any and all indebtedness of Appearer in such manner and at such times as Agent may deem appropriate; D. To become a surety, and execute or release such deeds of trust or other security agreements as may be necessary or proper in the Agent s sole discretion; E. To acknowledge a debt; 2.3 Financial Institutions. A. To make, receive, and endorse checks and drafts, deposit and withdraw funds in bank(s), homestead(s), savings and loan association(s), brokerage house(s), or other institution(s); B. To deposit drafts, bills of exchange, acceptances, checks and notes, or other obligations, for collection in any bank(s), brokerage account(s), homestead(s), savings and loan association(s), or other institution(s) and withdraw the same or the proceeds thereof, at pleasure, by check, or otherwise; - 2 -
2.4 Corporations. A. To sell and transfer any of the shares of capital stock of any corporation owned by Appearer and receive and receipt for the dividends due thereon; B. To pledge and pawn all or any shares of stock in any corporation owned by Appearer; C. To attend any meetings of the stockholders of any corporation in which Appearer may own stock or be interested, to vote or execute proxies in favor of others and to vote in the name of Appearer on all questions or matters that shall or may be submitted at such meeting; 2.5 Creditor Powers. A. To demand and by all lawful ways and means recover and receive from any person, firm or corporation, all sums of money, goods, debts, property, and effects whatsoever, that now is, or may hereafter be in the debtor s custody or possession, due to Appearer for any reason whatsoever; B. To attend any meeting of creditors wherein Appearer may be interested, vote in Appearer s name on all matters that may be submitted to such meetings; C. To make remission of a debt, adjust and settle all accounts, and upon ecovery and receipt in the premises to make and give good and sufficient discharges and acquittances; D. To receive and acknowledge notices of protest of all or any bills, drafts, or promissory notes, to which Appearer may be a party; 2.6 Property Transactions. A. To alienate or encumber all or any part of the movable or immovable property of Appearer and to receive the price thereof; B. To acquire any movable or immovable property in the name of Appearer on such terms and conditions as Agent deems proper; - 3 -
C. To lease, let, or hire all or any part of the movable and immovable property belonging to Appearer; D. To make and execute mineral and royalty deeds either selling or buying mineral or royalty rights; E. In connection with the forgoing powers, to execute in the name of Appearer all acts, whether of sale, mortgage, lease, release, contract, compromise, covenant, deed, assignment, agreement, division order, or otherwise, that shall or may be requisite or necessary, and containing such terms, conditions, and provisions as Agent shall deem proper, including, without limitation, confession of judgment, pact de non alienando, waiver of appraisement, and all normal Louisiana security clauses and devices, and bind Appearer thereby as firmly as if the same were or had been Appearer s own proper acts and deeds; 2.7 Mineral Interests. A. To sell, lease, exchange, partition, or otherwise alienate oil, gas, salt, sulphur, and other minerals and interests therein; B. To make and execute all mineral leases and other contracts, including unitization, repressurization and pooling agreements, and any other type of agreement, for the exploration and development of oil, gas, sulphur, and other minerals and interests therein, or any of them, in and under any of the properties of Appearer, and/or for the conservation of such mineral property, upon such terms and conditions and for such consideration as Agent may deem to be appropriate, and to receive and receipt for the bonuses, rents, and proceeds thereof as the same shall fall due; 2.8 Taxes. To sign all bonds, returns, petitions, waivers, or other documents required by the Internal Revenue Service, the Louisiana Department of Revenue, or other taxing authority. 2.9 Appearer as Agent. To act for Appearer and be Appearer s substitute in all cases wherein Appearer may be appointed the agent or attorney of others. 2.10 Compromise and Arbitration. To compromise any matter or refer any matter to arbitration. - 4 -
2.11 Lawsuits. A. To appear before all courts of law to prosecute, defend or compromise, by arbitration or otherwise, as Agent deems fit; B. To apply for and obtain any attachments, sequestrations, injunctions, and appeals, give the requisite security and sign the necessary bonds; 2.12 Investments. To invest and reinvest all or any part of Appearer s property in any property, wherever located, including bonds, certificates of deposit, brokerage accounts, debentures, notes, secured or unsecured, stocks of corporations regardless of class, interests in limited partnerships, real estate, or any interest in real estate whether or not productive at the time of investment, interests in trusts, investment trusts, whether of the open and/or closed fund types, and participation in common, collective, or pooled trust funds or annuity contracts without being limited by any statute or rule of law concerning investments by fiduciaries. 2.13 Contracts. To execute any and all contracts of every kind or nature. 2.14 Successions. A. To represent Appearer judicially and otherwise, whether as heir, legatee, creditor, executor, administrator, or otherwise, in all successions or estates in which Appearer is or may become interested, including any acceptance or renunciation thereof; B. To apply for the administration of any succession and to demand, obtain, and execute all orders and decrees as Agent may deem proper therein, to settle, compromise, and liquidate Appearer s interest therein, and to receive and receipt for all property to which Appearer may be entitled in respect of said successions or estates; 2.15 Donations. To make donations either outright, in trust or otherwise for the benefit of such other persons as Agent, in Agent s sole discretion, may determine to be in Appearer s best interest or in the best interest of Appearer s estate, including gifts that will be eligible for the annual exclusion from federal gift taxes. - 5 -
Article 3. Interdiction Proceeding 3.1 Generally. Pursuant to Article 4561 of the Louisiana Code of Civil Procedure, Appearer nominates as the Curator of his/her person and his/her property, to serve in the event Appearer should be later interdicted. 3.2 Trust Formation. Appearer further authorizes to execute trust instruments on his/her behalf as Settlor in accordance with the provisions of Article 4566 of the Louisiana Code of Civil Procedure and to transfer property on behalf of Appearer to the trust or trusts created by them. Appearer expressly requests that these trusts shall be revocable. Appearer expressly authorizes to add assets to any of these trusts, to revoke or terminate any of these trusts on his behalf and to withdraw or receive the income or principal therefrom and to request or demand such withdrawals of any trusts. Article 4. Backup Agent 4.1 Alternate Agents. If is unwilling or unable to act or to continue to act as my Agent under this Act of Procuration, then Appearer designates,, to serve as alternate to my Agent named above. In the event that, is unable to serve or continue to serve as Agent, I name, as alternate Agent. 4.2 Proof of Inability. Any agent or backup agent named herein shall be considered unable to act as my Agent upon presentation of a statement by authentic act from two physicians, selected by the agent s or backup agent s alternate named above, to the effect that such agent or backup agent is consistently unable to make or to communicate reasoned decisions regarding the care of the his or her person or property. Any person, organization, or entity to whom a statement of disability referred to herein is presented may rely on such statement as evidencing the agent or backup agent s continuing disability. - 6 -
Article 5. Effectiveness It is expressly intended that this Act of Procuration shall not expire in the event of Appearer s incapacity, disability, or other condition making express revocation impossible or impractical. This General Procuration shall be effective immediately with regard to my initial Agent named herein,. With regard to my backup agent(s) named herein, this General Procuration shall be effective upon presentation of a statement by authentic act from two physicians selected by such backup Agent(s) to the effect that Appearer is consistently unable to make or to communicate reasoned decisions regarding the care of Appearer s person or property as described in LSA-R.S. 9:3890. Any person, organization, or entity to whom a statement of disability referred to herein is presented may rely on such statement as evidencing my continuing disability. Pursuant to Article 3025 of the Louisiana Civil Code, this General Procuration revokes all prior General Procurations executed by me. THUS DONE AND PASSED, in multiple originals, in, Louisiana, on the day, month, and year herein first above written, in the presence of the undersigned competent witnesses, who hereunder sign their names with the Appearer and me, Notary, after due reading of the whole. WITNESSES: Print Name: Appearer: Print Name: NOTARY NAME: NOTARY NUMBER: - 7 -