Maryland

STATE OF MARYLAND COUNTY OF _______________ Before me, the undersigned notary public, on this day personally appeared {testatorName}, _______________, and _______________, known to me to be the testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument and, all of these persons being by me duly sworn, {testatorName}, the testator, declared to me and to the witnesses in my physical presence that the said instrument is the testator's will, that the testator is of sound mind, and that the testator had willingly signed or willingly directed another to sign the will under no constraint or undue influence, and executed it in the physical presence of the witnesses as a free and voluntary act for the purposes therein expressed, and that the witnesses, in the physical presence and at the request of the testator, signed the will as witnesses, and that to the best of the witnesses' knowledge the testator was at least 18 years old, of sound mind, and under no constraint or undue influence. ___________________________________ Testator ___________________________________ Witness ___________________________________ Witness Subscribed, sworn and acknowledged before me by {testatorName}, the testator, and subscribed and sworn to before me by _______________ and _______________, witnesses, this __________ day of _______________, __________. ___________________________________ Notary Public My commission expires: ___________________________________ (Affix official seal)

Maryland has no purging statute; Md. Est. & Trusts §4-102(b)(3) requires only 'credible' witnesses, so an interested witness (including a beneficiary) may attest without forfeiture or invalidation. Best practice is still to use two disinterested witnesses. The narrow exception is the remotely-witnessed-will pathway: per Md. Est. & Trusts §4-102(d)(3)(ii), the notary public certifying a remotely-witnessed will may not also be one of the two attesting witnesses. This contrasts with the §17-110(b) POA rule, where the notary CAN double-count as one of the two POA witnesses.

PLEASE READ CAREFULLY (Md. Code Ann., Est. & Trusts §17-203) This power of attorney authorizes another person (your agent) to make decisions concerning your property for you (the principal). You need not give to your agent all the authorities listed below and may give the agent only those limited powers that you specifically indicate. This power of attorney gives your agent the right to make limited decisions for you. You should very carefully weigh your decision as to what powers you give your agent. Your agent will be able to make decisions and act with respect to your property (including your money) whether or not you are able to act for yourself. If you choose to make a grant of limited authority, you should check the boxes that identify the specific authorization you choose to give your agent. This power of attorney does not authorize the agent to make health care decisions for you. You should select someone you trust to serve as your agent. Unless you specify otherwise, generally the agent's authority will continue until you die or revoke the power of attorney or the agent resigns or is unable to act for you. Your agent is not entitled to compensation unless you indicate otherwise in the special instructions of this power of attorney. If you indicate that your agent is to receive compensation, your agent is entitled to reasonable compensation or compensation as specified in the Special Instructions. This form provides for designation of one agent. If you wish to name more than one agent you may name a coagent in the Special Instructions. Coagents are required to act together unanimously unless you specify otherwise in the Special Instructions. If your agent is unavailable or unwilling to act for you, your power of attorney will end unless you have named a successor agent. You may also name a second successor agent. This power of attorney becomes effective immediately unless you state otherwise in the Special Instructions. If you have questions about the power of attorney or the authority you are granting to your agent, you should seek legal advice before signing this form.

General categories: A. Real Property B. Tangible Personal Property C. Stocks and Bonds D. Commodities E. Banks and Other Financial Institutions F. Operation of an Entity or a Business G. Insurance and Annuities H. Estates, Trusts, and Other Beneficial Interests (including trusts, probate estates, guardianships, conservatorships, escrows, or custodianships or funds from which the principal is, may become, or claims to be entitled to a share or payment) I. Claims and Litigation J. Personal and Family Maintenance K. Benefits from Governmental Programs or Civil or Military Service (including any benefit, program, or assistance provided under a statute or regulation including Social Security, Medicare, and Medicaid) L. Retirement Plans (including a plan or account created by an employer, the principal, or another individual to provide retirement benefits or deferred compensation of which the principal is a participant, beneficiary, or owner, including a plan or account under the following sections of the Internal Revenue Code: (1) An individual retirement account under Internal Revenue Code Section 408, 26 U.S.C. § 408; (2) A Roth individual retirement account under Internal Revenue Code Section 408A, 26 U.S.C. § 408A; (3) A deemed individual retirement account under Internal Revenue Code Section 408(q), 26 U.S.C. § 408(q); (4) An annuity or mutual fund custodial account under Internal Revenue Code Section 403(b), 26 U.S.C. § 403(b); (5) A pension, profit–sharing, stock bonus, or other retirement plan qualified under Internal Revenue Code Section 401(a), 26 U.S.C. § 401(a); (6) A plan under Internal Revenue Code Section 457(b), 26 U.S.C. § 457(b); and (7) A nonqualified deferred compensation plan under Internal Revenue Code Section 409A, 26 U.S.C. § 409A) M. Taxes N. Gifts and Transfers Powers that must be granted separately: Take any of the actions I have authorized in section N of this power of attorney without restriction on the amount of the gift or transfer (Md. Est. & Trusts §17-203) Take any of the actions I have authorized in section N of this power of attorney in favor of my agent (Md. Est. & Trusts §17-203) Create and fund an inter vivos trust, including a special needs trust, any trust authorized under § 1917 of the federal Social Security Act, or a third–party special needs trust, or establish and fund an ABLE account as defined under § 529A of the Internal Revenue Code, for the benefit of the principal or the principal’s family, heirs at law, or descendants, or any other person designated by the principal as a beneficiary under an existing will, trust, or other instrument (Md. Est. & Trusts §17-203) Amend, revoke, or terminate an existing inter vivos trust if the trust expressly authorizes that action by the agent (Md. Est. & Trusts §17-203) Make a gift, subject to any special instructions in this power of attorney, including a gift of the principal’s assets to assist the principal in meeting the eligibility requirements and qualifying for a governmental benefit or program, including gifts to or in favor of my agent who is my spouse or descendant (Md. Est. & Trusts §17-203) Create or change rights of survivorship (Md. Est. & Trusts §17-203) Create or change a beneficiary designation, subject to any special instructions in this power of attorney; and, if I wish to authorize my agent to designate the agent, the agent’s spouse, or a dependent of the agent as a beneficiary, I will explicitly state this authority within the special instructions of this power of attorney or in a separate power of attorney (Md. Est. & Trusts §17-203) Authorize another person to exercise the authority granted under this power of attorney (Md. Est. & Trusts §17-203) Waive the principal’s right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan (Md. Est. & Trusts §17-203) Exercise fiduciary powers that the principal has authority to delegate (Md. Est. & Trusts §17-203) Disclaim or refuse an interest in property, including a power of appointment (Md. Est. & Trusts §17-203) In accordance with the Maryland Fiduciary Access to Digital Assets Act, access and take control of (1) the content of any of my electronic communications, (2) any catalogue of electronic communications sent or received by me, and (3) any other digital asset in which I have a right or interest (Md. Est. & Trusts §17-203) Demand the delivery of the principal’s will from the custodian of the will and, on delivery of the principal’s will, take custody of the will subject to the requirements of Title 4, Subtitle 2 of the Estates and Trusts Article (Md. Est. & Trusts §17-203)

IMPORTANT INFORMATION FOR AGENT (Md. Code Ann., Est. & Trusts §17-203) Agent's Duties. 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 duties that continue until you resign or the power of attorney is terminated or revoked. You must: (1) Do what you know the principal reasonably expects you to do with the principal's property or, if you do not know the principal's expectations, act in the principal's best interest; (2) Act with care, competence, and diligence for the best interest of the principal; (3) Do nothing beyond the authority granted in this power of attorney; and (4) Disclose your identity as an agent whenever you act for the principal by writing or printing the name of the principal and signing your own name as "agent" in the following manner: (Principal's Name) by (Your Signature) as Agent. Unless the Special Instructions in this power of attorney state otherwise, you must also: (1) Act loyally for the principal's benefit; (2) Avoid conflicts that would impair your ability to act in the principal's best interest; (3) Keep a record of all receipts, disbursements, and transactions made on behalf of the principal; (4) Cooperate with any person that has authority to make health care decisions for the principal to do what you know the principal reasonably expects or, if you do not know the principal's expectations, to act in the principal's best interest; and (5) Attempt to preserve the principal's estate plan if you know the plan and preserving the plan is consistent with the principal's best interest. Termination of Agent's Authority. You must stop acting on behalf of the principal if you learn of any event that terminates this power of attorney or your authority under this power of attorney. Events that terminate a power of attorney or your authority to act under a power of attorney include: (1) Death of the principal; (2) The principal's revocation of the power of attorney or your authority; (3) The occurrence of a termination event stated in the power of attorney; (4) The purpose of the power of attorney is fully accomplished; or (5) If you are married to the principal, a legal action is filed with a court to end your marriage, or for your legal separation, unless the Special Instructions in this power of attorney state that such an action will not terminate your authority. Liability of Agent. The meaning of the authority granted to you is defined in the Maryland Power of Attorney Act, Title 17 of the Estates and Trusts Article. If you violate the Maryland Power of Attorney Act, Title 17 of the Estates and Trusts Article, or act outside the authority granted, you may be liable for any damages caused by your violation. If there is anything about this document or your duties that you do not understand, you should seek legal advice.

I am an adult, and I attested and signed this Power of Attorney in the physical presence of the principal and of the other witness (Md. Code, Est. & Trusts §17-110(a)(4)).

Md. Health-Gen. §5-602(c)(2)(ii): the health care agent of the declarant may not serve as a witness. Under §5-602(c)(2)(iii), at least one of the two witnesses must be an individual who is not knowingly entitled to any portion of the estate of the declarant or knowingly entitled to any financial benefit by reason of the death of the declarant. Otherwise, under §5-602(c)(2)(i), any competent individual may serve as a witness, including an employee of a health care facility, nurse practitioner, physician assistant, or physician caring for the declarant if acting in good faith.