Transcription of https://members.lacera.com/lmpublic/forms/pdf/leg402.pdf
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https://members.lacera.com/lmpublic/forms/pdf/leg402.pdf
Page 1 of 8 Page 1 of 8 About This FormA Power of Attorney is a legal instrument used to delegate legal authority to another. By executing a Power of Attorney, you give legal authority to a representative you designate (called an Attorney-In-Fact) to make property, financial, and other legal decisions on your LACERA Special Durable Power of Attorney form is a legal document, executed by a member, which designates another person to act on the member s behalf with regard to retirement matters only, including retiree healthcare plan completing and returning this form, please read the LACERA Special Durable Power of Attorney Guide and the Instructions for Completing the LACERA Special Durable Power of SPECIAL DURABLEPOWER OF ATTORNEY FORMPage 1 of 8 Page 2 of 8 Page 2 of 8 CHECKLIST FOR LACERA S SPECIAL DURABLE POWER OF ATTORNEYI am of sound mind and acting of my own free Attorney-In-Fact is at least 18 years have included valid identification of my have initialed the specific options to which I authorize my have carefully read the Warning have signed and dated the Power of Attorney-In-Fact has signed and dated the Power of people who are at least 18 have witnessed my signature, or a Notary Public has acknowledged my 1 of 5[Barcode][Form #]Page 1of 5 LOS ANGELES COUN
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