Fillable Printable General Power of Attorney - Manitoba

General Power of Attorney - Manitoba

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General Power of Attorney

CIBC Investor Services Inc.

Account No.

Account Name

This General Pow er of Att or n ey is m ad e this

day of

Name of Account Holder

For the ab ov e n ot e d Investor Services account

1. Appointment of Attorney(s). I appoint

to be my lawful Atto rney(s) on my behalf, in my name, for my benefit an d from time to time, to carry o ut each and every securities-

related transaction that I can carry out with CIBC Investor Service Inc. ("CIBC Investor Services"). Without limiting the generality of the

foregoing, I specifically grant my Attorney(s) full power and authority to:

a) give instructions for my account including the address for receipt of confirmations, statements and other communications from

CIBC Investor Servi c es;

b) deposit a ny securities or moneys with CIBC Investor Services;

c) request payments or securities from the account to be made or delivered to my Attorney(s), or to his or her order, and to give a

receipt fo r t he same;

d) sell, assign, endorse and tra nsfer any sec urities of any nature at any t i me st a ndi ng i n my na m e a nd to execute any doc ument s

necessa ry to effec t the foregoi ng;

e) receive and ac qui esce in t he correctness of an y and all not ices o f transactions, statements of account and other records and

documents;

f) settle, co m promise, adjust a n d give rel ea ses with respect to a ny and all claims, dema nds, disput es o r c o nt rover sies;

g) receive requests a n d demands for payments or securiti es due, notices of i ntention t o sel l o r purchase a nd other not ices and

demands; and

h) borrow money in connectio n wi t h a ny sec uri t i es-related tra nsact i o n i nc ludi ng t ra ding on margin and giving security in my na me for

any margin loan if I have opened a margin ac c o unt with CIBC Invest o r Service s Inc .

2. Trading by my Attorney.

I hereby ratif y and con firm a ny and all trades, inst r uctio ns , tra ns acti ons and o t h er ac ts previously and subsequ e ntly ma de by my

Attorney(s). I wi l l indemnify and hold CIBC Invest or Services, i t s di rec tors, offic ers and emplo yees harmless against, a n d demand for,

any loss, l i ability and expense ( including any legal c o s t s) i f CIBC Investor Servi c es is ma de a pa rty to any action by t he A ttorney or to

which I am a pa rty whi c h relates in any way to t his Power of Atto rney.

3. Actions for my benefit.

The actions of my Attorney ( s) m ust be exclusively f o r m y benef it; he or she may not deal with my pro perty fo r hi s o r her personal

purposes. Each Attorney is aware of this limitation. CIBC Investor Services may, therefore, choose not to allow my Attorney to take

certain actions if CIBC Investor Services is not sat isfied tha t such actio ns are for my benef i t .

4. Substitute attorneys.

My Attorney(s) may not appoint or substitute any person to act as an attorney on my behalf.

5. Subsequent mental infirmity or legal incapacity.

Subject to applicable provincial law, this Power of Attorney is to continue notwithstanding, and may be exercised during, any

subsequent mental infirmity or legal incapacity of mine.

6. Termination upon death.

This Power of Attorney terminates u pon my death.

7. Dealings with my Attorney(s).

If the name of mo re than one At t o rney a ppears in pa ra graph 1, C IB C Investor Services, will a c t upon t he i nst ructio ns o f ei t her Attorney.

CIBC Investo r S ervices may c o ntinue to dea l wi t h m y A t t o rney under this Power of Attorney until notice of revocation or any act or

event (including, among other things, the appointment of a committee of my estate) that may revoke this Power of Attorney has been

given in writing to CIB C Investor S ervic es. U nt i l suc h no t i c e, t he acts of my Attorney with CIBC Investor Services will be binding on me.

8. To the extent permitt ed by law this agreement sha ll enure t o t he benefit o f and be bin di ng o n me and C IB C Investor Services and our

respecti ve heirs, li quidat o rs, a dminis t ra t ors, suc c essors and assi gns.

Attorney Name

Attorney Address

Attorney Name

Attorney Address

CIBC Investor Servic es Inc . is a su bsidiary of CIBC and a Mem be r of the Can adian Investor Protec tio n Fu nd an d Inv e stm ent I nd ustry Regulatory Organization of Canada.

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CIBC Inv estor S ervi c es Inc . General Power of Attorney

9. I acknowl edge that I have read and understand all of the provisions contained in this instrument and that I have received a copy of it.

10. This Power of At t orn e y does not nece ssaril y revoke any P ower of At torney that I have previou sly signed, but if a pre v io u s P o w er

of Att or n e y h as c lau ses that are in co n sistent with th is on e, the terms of this one will prevail. I may sign othe r P owers of

Attorney in the future.

11. The parties confirm that they have requested this agreement and all documents relating thereto to be drawn up in the English language only.

Les parties confirment avoir exigé que ce contrat et tous les documents s'y rapportant soient rédigés en anglais seulement

Confi

rmation of Acts of Attorney(s)

I hereby ratify and confirm all acts of my Attorney(s) in connection with this Power of Attorney will indemnify and hold CIBC Investor

Service s, its dire ctors, off ic e r s an d employe es harmless ag ainst, an d I will p ay promptly on d emand, an y l oss, liability or e xpenses

(inclu d ing any le gal costs) C IBC Inve stor Servic e s in c u r s or may b e under o r any claim made against C IBC Inve stor Services w hich

relate in any way to CIBC Investor S e r v ic e s’ actions un der this P o w er of Att or n e y .

Signature of Account Hold er

Witnesses must not be the Attorney or the Attorney's spouse.

Name of Witness

Address of Witness

Signature of Witness

Name of Witness

Address of Witness

Signature of Witness

CIBC Investor Servic es Inc . is a su bsidiary of CIBC and a Mem be r of the Can adian Investor Protec tio n Fu nd an d Inv e stm ent I nd ustry Regulatory Organization of Canada.

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CIBC Inv estor Servic es Inc. Ge nera l Po wer o f Atto rney

Attorney Acknowledgement and I ndemnity

The undersigned Attorney(s) acknowledge that the Customer signed the attached Power of Attorney appointing me/us as his/her

Attorney(s), and to the best of my/our knowledge, this Power of Attorney is valid and has not been revoked. I/We have read the

Power of Attorney and accept the appointment of Attorney, and understand my/our duties and obligations under this Power of

Attorn e y an d u n der applic ab l e l aws. I/We h ave a fiduciary duty to always act in t h e b e st in terest of t he Customer. Unless the Power

of Att or n e y an d ap plicable law sp ecifically all ows, I/we cannot m ak e the Customer’ s asse ts joint with the Attorney(s), or use the

Power of Attorney for the Customer’s estate planning, including but not limited to, the opening of accounts identify in g a beneficiar y

or chang in g a bene f ic iary .

I/we have r ead, under s tood, receive d a copy o f, an d a gree to be bo un d by the ter ms and condi tions a pplicabl e to the Cu stom er ’s

accounts and dealings with CIBC Investor Services. The Attorney hereby consents to the collection, use and sharing of information as

described in CIBC’s privacy policy Your Privacy is Protected. This may include collecting, during the course of the relationship with

CIBC, information about the Attorney from and sharing it with, the CIBC group of compa nies, credi t bur eaus, gover nm en t institutions or

registries, mutual fund companies and other issuers, regulators and self-regulatory organizations, other financial institutions, applicable

program partners, and other such parties as may reasonably be required for the purposes of: (i) identification; (ii) verifying information

given to yo u; (iii ) pro tec ting from er ror and c r imina l activity ; and (iv) co m plying wi th legal and r egulato r y obli gations. CIBC’s privacy

policy is available at any bran ch or www.ci bc .com. Thi s policy may be ame nded, r eplace d or s uppl emented fr om time to tim e.

I/We acknowledge and CIBC Investor Services has no duty or obligation to monitor or inquire into my/our conduct as Attorney(s).

CIBC Investor Services may, however, in its sole d isc retion, before proce e ding, seek ratificat ion f r om t he Custom e r of any act of the

Attorney(s), may req uire c ourt or ot he r d ocu me n t at ion, or may refuse to deal w it h the Attorney(s). CIBC I n vestor Se rv ice s may

refuse or limit th e Attorney(s) access to the C u stomer’s acc ou n ts if CIBC I n vestor Se rvices has reason able grou n ds to belie ve the

Attorn e y (s) did or may c om mit fraud, use the Cust omer’s accoun ts for any u n lawful or imp r oper purp ose, cause a l oss to CIBC

Investor Services, ope r ate a Customer ’s accounts in a man ner un satisfactory t o C IBC Inve stor Services or contrar y to CIBC In vestor

Service s p ol ic ies, or v iol ate the terms of t h e Po w er of Attorney or any ag reement s ap plicable t o t he Customer’s accoun ts.

NOW THEREFORE IN CONSIDERATION OF CIBC Investor Services accepting the Power of Attorney and applying the Power of Attorney

to the Custome r’s account s with CIBC Investor Se r v ic e s, and rec ognizing that CIBC Investor Services is relyin g on the r e pre sentations

made in this Acknow ledgeme n t and Indemnity, su bject to app lic able law, I / w e will indemnify CIBC I n vestor Se rvices, its dir e c t o rs,

officer s, employe es, agen ts, successors, administrators an d assigns harmless against, and I/w e will pay promptly on demand, any

loss, liability and expe nse (including any le gal costs) C IBC Investo r S ervices incu r s or m ay be un d er or any claim made against CIBC

Inve st o r S ervices wh ic h r e l ate in any w ay to CIBC Inv e stor Services acc e pting t h is Power of A ttorney and/or my/our actions under

this Pow e r of At t orn e y .

IT IS ALSO UNDERSTOOD AND AGREED that if this is a joint Acknowledgement and Indemnity, that this Acknowledgement and

Inde mn ity shall be binding u pon e ac h of us joint l y an d severally ( so lidarily in Q uebec) and on o u r su cc e sso rs, heirs and assigns.

Date (mm/dd/yyyy)

Signature of Attorney

Date (mm/dd/yyyy)

Signature of Attorney

For Customer or At torneys resident in B r it ish C olumbia only

In British Columbi a, there m ust be two (2) w itnesses to t he Attorney (s) signat u r e (s) or only one w it ness is requ ired if the w itness is a

practisin g member o f the Law Socie ty of British C ol u m b ia o r a membe r of the Societ y of Notaries Public of British Columbia. The

followin g persons may not witn e ss t he Attorney(s) sig n ature(s): the Attorn e y; a spou se, child, parent, employee or agent of the

Attorney; a person who is not an adult; a person who does not understand the type of communication used by the Attorney, unless

the p erson receives inter pretive assistance to u n derstand that ty pe of communicat ion.

Name of Witness

Address of Witness

Signature of Witness

Name of Witness

Address of Witness

Signature of Witness

IIROC-Registered Advisors Only:

I confir m that I h av e completed a su itability re view on t h e account

associated with this request.

IIROC Registered Advisor Signature

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CIBC Inv estor Servic es Inc. Ge nera l Po wer o f Atto rney

Directions for Filling O ut General Power of Attorney

This General Power of Attorney gives your Attorney the unlimited and unrestricted authority over the property and funds in your

account and the right to carry out e v ery securities-related t ransaction that you can, including among other thing s, se l l in g all

securities in your portfolio. I f you pre f e r, you may wish to give your At t orn e y limite d powers in relation to only some of your

securit ie s by signing a limited trad ing authoriza tion form.

General Power of Attorney

1. Notes.

a) Power to Borrow.

This Gene ral P ow e r of At torney allows your Attorne y t o b orr ow mone y in you r n ame . If you do not wish y ou r At torney to have

that power, delete paragraph 1(h) and add "No power to borrow".

b) Attorney must act for your benefit.

Your Attorn e y must act for your benefit. He or she cannot use your money for his or her own purposes. We may (but do not have

to) ask your Attorney to justify to us that any transactions that your Attorney has requested are indeed for your benefit. We

may decline to carry ou t an y in struction from your At torney if w e are not satisf ie d that it is for y ou r b enefit.

c) Substitute At t or ney (s).

The person you are appointing as your Attorney may later be unable or unwilling to act. If you wish to give your Attorney the

ability to appoint a su b stitute to act in his or h er place, d e let e the word "not" from se ction 4 (on page 1) and init ial the change.

Please note that, if you have given the Attorney the power to appoint a substitute, the substitute Attorney cannot in turn appoint a

substitute.

d) Mental infirmity or legal inca pacity.

If you wish your Attorney to continue to be able to act on your behalf if you later become mentally infirm or legally incapable of

handlin g your aff airs, then l e ave section 5 (on page 1) as is; otherwise, delete it. (Not e : This p r ovision, if l e ft in, is only v al id in

certain p r ovinces/te rritories.)

e) Consent.

The Attorney c on se nts that CIBC Investor s S e r v ic e s may c ol lect, use and disclose inform ation provid ed about the attorney to

verify the attorney's identity, to protect against fraud an d error and to c om p l y with leg al and r e gulatory r e quiremen t s. If the

attorney revokes this consent, the attorney's authority will be terminated and if there are joint attorneys who must only act

jointl y , all attor n e y ’s authority with respect to t h e Customer’ s acc ou nts and d e al in gs with C I BC I n vestor Se rvices will b e

terminated.

2. General Comments.

a) Recovery of E xpenses.

Your Attorney can recover any out-of-pocket expenses of acting as your Attorney. If your Attorney is a professional p e rson (su c h

as a lawyer or acc ou ntant) , he or she may be able to ch arge for p ro f essional services as wel l .

b) C ompleting the form.

The c orr e c t names and ad dresses of the Cust o me r , Witne ss(e s) and the At torney, as w ell as the date of the Powe r of Attorney,

must be inserte d where indicated.

c) Witnesses.

For addit ional details please refer to the appl icable prov in cial or territorial witness requirement s in t he online P OA FAQ’s.

3. All P r ovinces.

a) The Customer' s signature mu st be witne ssed by a minimum of one adult person other than the Attorney or the Attorney's

spouse in the presence of the Customer.

b) The Att or n e y ' s signature is required to be witne sse d in British C ol u mbia.

Additio n al Requirem e n ts:

c) Alberta. In addition to above witness eligibility requirement s, t he witness must be someone other than the Attorney,

spouse or adult interdependent partner of either the Attorney or the Customer.

d) British Col umbia. Either t wo witnesses are require d (must be adult s and not the attorney or a f amil y member of either the

Custome r or the att or n e y ) or one witn e ss (must be a l aw y er or notary pu blic in British C olumbia) is require d.

e) Saskatchewan. Either t wo witne sse s are require d (must be adults and not the att or n e y or a f am ily me m b er of eith er the

Customer or t he attorney) or one witn ess (must be a lawye r) is r e quired. W itness certificate(s) must b e at tached in the

prescribed form. P lease contact your legal advisor for more details.

f) Manitoba. Only c e r tain individ uals may be a witness incl u ding a lawy er, judg e, medical pr ac t itioner, a n otary, a pol ice

officer , in eve ry c ase , the witne ss mu st have no reason to be l ie ve that the Custome r is in e l igible of granting t he power of

attorney.

g) Yukon and the Northwest Territories. Additional explanatory notes a nd/or cer tificates of legal advice and/or

acknowledgements are required. Please contact your legal advisor for more details.

h) Ontario and Quebec. Two witnesses are required. In Ontario, they must be someone other than a child or spouse of the

Customer, or a person whom the Customer has demonstrated a settled i nten tion to trea t as his or he r c hild.

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Account No.

CIBC Investor Serv ic es Inc. Genera l Power of At torney

Attorn e y I n formation

Legal Name of Attorney

Date of Birth (mm/dd/yyyy)

Primary Telephone No.

Address

City

Province/Foreign Info

Country

Po s tal C ode

Employment Information

Employer’s Name

Address

City

Province/Foreign Info

Country

Type of Business

Occupation

Are yo u, your sp ouse, any person(s) living in the sam e hom e, trading authority, or anyone who exercises influence o n this

acco unt an In ves tm e nt Ind ustr y P ro fess i ona l ?

Yes

Are you an insider of a

reporting issuer or any other issuer w h ose se curities are publicly trad ed?

Yes

If Yes, list below

Do you alone or as part of a group hold more than 20% or have a control block of a reporting

issuer or any other issuer

whose securities a re p u blicly tr ad ed?

Yes

If Yes, list below

Primary Financial Institution

- Required only if the Attorney's identification was not verified at the Bank ing Centre.

Financial Ins t itutio n

Bank Transit

Bank Account No.

Financial Ins t itutio n Conta ct Name

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Account No.

CIBC Investor Serv ic es Inc. Genera l Power of At torney

Attorn e y I n formation

Legal Name of Attorney

Date of Birth (mm/dd/yyyy)

Primary Telephone No.

Address

City

Province/Foreign Info

Country

Po s tal C ode

Employment Information

Employer’s Name

Address

City

Province/Foreign Info

Country

Type of Business

Occupation

Are yo u, your sp ouse, any person(s) living in the sam e hom e, trading authority, or anyone who exercises influence o n thi

acco unt an In ves tm e nt Ind ustr y P ro fess i ona l ?

Yes

Are you an insider o f a r eporting issuer or any other i ss uer who se securities a re p u blicly tr aded?

Yes

If Yes, list below

Do you alone or as part of a group hold more than 20% or have a control block of a reporting issuer or any other issuer

whose securities a re p u blicly tr ad ed?

Yes

If Yes, list below

Primary Financial Institution

- Required only if the Attorney's identification was not verified at the Banking Centre.

Financial Ins t itutio n

Bank Transit

Bank Account No.

Financial Institution Contact Name