Oklahoma

State of Oklahoma County of _______________ Before me, the undersigned authority, on this day personally appeared {testatorName}, the Testator, and _______________ and _______________, the subscribing Witnesses, all of whom being by me duly sworn, the Testator declared to me and to the Witnesses, in my presence, that the foregoing instrument is the Testator's Last Will and Testament, that the Testator willingly signed and executed it as a free and voluntary act for the purposes therein expressed, and that the Testator is 18 years of age or older, of sound mind, and under no constraint or undue influence. Each Witness, in the presence and hearing of the Testator, declared that the Testator signed (or acknowledged the Testator's earlier signature on) the instrument in the Witness's presence, that the Witness signed the instrument as a witness in the presence of the Testator, that to the best of the Witness's knowledge the Testator is 18 years of age or older, of sound mind, and acting freely and voluntarily without duress, fraud, or undue influence, and that each Witness is at least eighteen years of age and otherwise competent to be a witness, substantially in conformity with 84 O.S. § 55(5)(a). Subscribed, sworn to, and acknowledged before me by {testatorName}, the Testator, and by _______________ and _______________, the Witnesses, this _____ day of ______________, 20____. (84 O.S. § 55(5)(a))

IMPORTANT INFORMATION This power of attorney authorizes another person (your agent) to make decisions concerning your property for you (the principal). 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. The meaning of authority over subjects listed on this form is explained in Section 3001 et seq. of Title 58 of the Oklahoma Statutes (Oklahoma Uniform Power of Attorney Act). 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 the power of attorney provides otherwise, your agent has the power to act on your behalf for all matters covered by this instrument, even if you are able to act for yourself. Your agent is entitled to reasonable compensation unless you state otherwise 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 co-agent in the Special Instructions. Co-agents are not required to act together unless you include that requirement in the Special Instructions. If your agent is unable 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. Your agent is required to act in accordance with your reasonable expectations to the extent actually known by your agent and, otherwise, in your best interest, to act in good faith, and to act only within the scope of authority granted in the power of attorney. The law that governs powers of attorney is contained in 58 O.S. §§3001-3045. If you have any questions about the power of attorney or the authority you are granting to your agent, you should seek legal advice before signing this form.

IMPORTANT INFORMATION FOR AGENT (Okla. Stat. tit. 58, §3041; agent duties at §3014) 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 upon 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, where there is no specific expectation known to you, act in the Principal's best interest; (2) act in good faith; (3) do nothing beyond the authority granted in this Power of Attorney; and (4) disclose your identity as an agent or attorney-in-fact 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 Principal has specified otherwise in this Power of Attorney or you agree otherwise with the Principal in writing, you must also (a) act loyally for the Principal's benefit; (b) avoid conflicts that would impair your ability to act in the Principal's best interest; (c) act with the care, competence, and diligence ordinarily exercised by agents in similar circumstances; (d) keep a record of all receipts, disbursements, and transactions made on behalf of the Principal; (e) cooperate with any person who has authority to make health care decisions for the Principal to carry out the Principal's reasonable expectations to the extent actually known by you and, otherwise, act in the Principal's best interest; and (f) attempt to preserve the Principal's estate plan, to the extent actually known by you, if preserving the plan is consistent with the Principal's best interest. Termination of an agent's authority or of a Power of Attorney is not effective as to the agent or another person who, without actual knowledge of the termination, acts in good faith under the Power of Attorney. An act so performed, unless otherwise invalid or unenforceable, binds the Principal and the Principal's successors in interest. An agent that violates the Oklahoma Uniform Power of Attorney Act (Section 3001 et seq. of Title 58 of the Oklahoma Statutes) is liable to the Principal or the Principal's successors in interest for the amount required to (1) restore the value of the Principal's property to what it would have been had the violation not occurred and (2) reimburse the Principal or the Principal's successors in interest for the attorney fees and costs paid on the agent's behalf. If you have any questions about your duties under this Power of Attorney, or about the meaning of this notice, you should consult an attorney before acting.