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Ontario Power of Attorney/Guardian Form

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Ontario Power of Attorney/Guardian Form
Ontario Power of Attorney/Guardian Form
Existing Attorney/Guardian and Bondholder Information:
Attorney/Guardian:
Name __________________________________________________________________
Address __________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Phone Number: ( ) ___________________________
Bondholder (provide all available information)
Name __________________________________________________________________
Address __________________________________________________________________
___________________________________________________________________
__________________________________________________________________
Bond Certificate Number(s) ___________________________________________________
Par value of bond(s)__________________ Series ________________
Statement of Attorney/Guardian:
I,
___________________________
, affirm that
Full Name of Attorney/Guardian
I am the existing:
_ attorney under a continuing power of attorney OR
_ attorney under a power of attorney for personal care OR
_ guardian of the person OR
_ guardian of the property
of: .
Name of Bondholder
POWER OF ATTORNEY/GUARDIAN
(page 1 of 2)
ONTARIO SAVINGS BONDS
Ontario Power of Attorney/Guardian Form
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