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Immigration Screening Clinic Virtual

August 27, 2026 1:00-2:30pm Virtual

Volunteer Lawyers for Justice P.O. Box 32040, Newark, NJ 07102 Phone: (973) 645-1955 Fax: (973) 645-1954 www.vljnj.org

Immigration Legal Screening Clinics August 27, 2026 | 1:00pm-2:30pm Eastern ONLINE CLE This virtual CLE program will provide an overview on various forms of immigration relief available, including family based and humanitarian relief, as well as an overview of immigration court updates. The training includes a review of basic eligibility requirements and the clinic tools that will be used to screen individuals for eligibility. The training will also include an overview on preparing caretaker and financial Power of Attorney documents. At the conclusion of the training volunteers should have increased confidence in conducting immigration screenings, advising clients, and preparing power of attorney documents. SPEAKER • • • •

Alexandra Bravo, Esq. – Senior Staff Attorney, Volunteer Lawyers for Justice Lauren W. Herman, Esq. - Legal Director, Make the Road New Jersey Ariela Herzog, Esq. - Supervising Attorney, Child Advocacy Clinic Rutgers Law School Cheryl Lin, Esq. - Attorney at Law, Cheryl Lin Law, LLC

AGENDA 1:00pm Welcome/Introduction (5 minutes) 1:05pm Immigration Relief Screening (45 minutes) 1:50pm Immigration Court (25 minutes) 2:15pm Caregiver and Financial Power of Attorney (10 minutes) 2:25pm Registration (5 minutes) 2:30pm Q&A and Adjourn

Biographies Alexandra Bravo, Esq. is a Senior Staff Attorney who oversees the Veterans Legal Program, providing holistic services to veterans, and handles issues relating to child support as they arise in other programs. Prior to joining VLJ, Alexandra was an associate at Bastarrika, Soto, Gonzalez, & Somohano, LLP where she practiced family law. Alexandra previously clerked for the Hon. Yolanda Adrianzen, J.S.C. Alexandra received her bachelor’s degree from Seton Hall University and her law degree from Rutgers Law School, where she was a managing editor of the Rutgers Law Journal. Alexandra is also fluent in Spanish. Lauren Herman, Esq. is the legal director at Make the Road New Jersey, a member-led community organization that builds the power of Latinx and working class communities through organizing, policy innovation, transformative education, and survival services. Lauren has worked for MRNJ for the past eleven years where she and her team help clients on a range of immigration, tax, housing, and employment issues. Lauren graduated from Harvard Law School in 2013 and also received a Masters in Theological Studies from Harvard Divinity School in 2014. After law school, Lauren clerked for the Honorable Chief Justice Stuart Rabner at the Supreme Court of New Jersey. Prior to law school, Lauren was trained as a community organizer through JOIN for Justice, the Jewish Organizing Institute and Network for Justice. She worked as a community organizer at the Workers Circle and at the Harvard University Committee on Human Rights Studies. Ariela Herzog, Esq. is supervising attorney at the Rutgers Law School Child Advocacy Clinic in Newark, New Jersey. She supervises a team of legal professionals in their representation of foster children in a wide variety of immigration matters and also works with clients directly on their immigration cases. Prior to her position at Rutgers, Ariela served as Deputy Attorney General in New Jersey, litigating complex child abuse and neglect cases on behalf of the New Jersey Division of Child Protection and Permanency. Ariela also had her own practice in which she represented clients in family and immigration matters. Throughout her career, she has served the immigrant community through educational events and pro bono legal screenings and services. Ariela received her B.A. from Sarah Lawrence College and her J.D. from Benjamin N. Cardozo School of Law. She is admitted to practice law in New York and New Jersey. Cheryl Lin, Esq. is the Managing Member/Founder of Cheryl Lin Law LLC based in Hudson County, New Jersey. She concentrates her practice in immigration law. This includes a wide variety of immigration matters, including but not limited to: family-based adjustment of status, waivers of inadmissibility, removal and deportation proceedings, asylum and withholding of removal, battered-spouse petitions, U visa applications, Special Immigrant Juvenile petitions, and naturalization. In addition, Ms. Lin counsels clients on the immigration consequences of criminal convictions and post-conviction relief in criminal court. Ms. Lin is the daughter of Taiwanese immigrants. At a young age, she was inspired to pursue a career in immigration law while helping her mother fill out her naturalization application. Since then, Ms. Lin has devoted her career to assisting immigrants, beginning as a paralegal at an immigration law firm in Philadelphia, and then as a lawyer in private practice for over sixteen years. A licensed member of the bar in New Jersey and New York, Ms. Lin regularly appears before the Executive Office for Immigration Review and U.S. Citizenship and Immigration Services. She also handles appeals to the Board of Immigration Appeals, the U.S. Court of Appeals for the Second and Third Circuits, and the Superior Court of New Jersey, Appellate Division. Ms. Lin has argued before the Third Circuit, which resulted in successful precedential decisions. Prior to opening her own law firm in August 2020, Ms. Lin was an associate at a Passaic County-based law firm, where she similarly focused her practice in immigration matters. Ms. Lin is fluent in Spanish and conversant in Taiwanese.

August 27, 2026

Immigration Screening Clinic

AGENDA ❖Immigration Relief & Screening ❖Immigration Updates ❖Immigration Court ❖Detention & Habeas ❖Caregiver and Financial POA ❖Alien Registration ❖Q&A

INTROS Alexandra Bravo, Senior Staff Attorney Volunteer Lawyers for Justice Lauren Herman, Legal Director Make the Road New Jersey Ariela Herzog, Supervising Attorney Rutgers Law School, Child Advocacy Clinic Cheryl Lin, Managing Member/Founder Cheryl Lin Law LLC

TYPES OF IMMIGRATION STATUS AND BENEFITS

Affirmative and Defensive Processes

FEDERAL AGENCIES THAT DEAL WITH IMMIGRATION Department of Homeland Security (DHS) United States Citizenship and Immigration Services (USCIS) Custom and Border Patrol (CBP) Immigration and Customs Enforcement (ICE)

Department of Justice (DOJ) Executive Office of Immigration Review

Department of State

Department of Health & Human Services

National Visa Center

Office of Refugee Resettlement

•Immigration Court •Board of Immigration Appeals

US Consulates

PATHS TO RESIDENCY AND CITIZENSHIP

• Family or employer petition • Asylum or refugee status • U and T visas • Special Immigrant Juvenile Status • VAWA Self-Petition

Initial Application or Status

Green Card (Permanent Residency) • “Adjustment of Status” application before USCIS or EOIR • Consular Processing / Immigrant Visa application

• Application for Citizenship • Deriving/acquiring citizenship from parent(s) who naturalize or is/are US citizens • Being born in the United States

Citizenship

What does not lead to a route to citizenship? Tourist visa, Visa waiver, TPS, DACA, Deferred Action, among others

PATHS TO PERMANENT STATUS / HOW TO IDENTIFY ❖ Asylum – affirmative and defensive permanent relief based on fear of

persecution in home country based on a protected ground. Eligible to apply for lawful permanent residency after one year. ❖Granted: EAD with (a)(5) category, Decision from the Asylum Office or Immigration judge ❖Pending: USCIS receipt or court-stamped form, EAD with (c)(8) category

❖

Defined as a person who is unable or unwilling to return to their home country, and cannot obtain protection in that country, due to past persecution or a well-founded fear of being persecuted in the future “on account of race, religion, nationality, membership in a particular social group, or political opinion.”

PATHS TO PERMANENT STATUS / HOW TO IDENTIFY ❖Family-Based Petition and Possible Residency: Family-based petition and

application for residency either with USCIS / EOIR (Adjustment of Status) or the Department of State (consular processing).

❖The “priority date” (if applicable) must be current, and the applicant must either

submit or already have approved any applicable waivers. If not eligible for waivers, it is possible the applicant will not be able to pursue residency despite family petition.

❖Granted: USCIS I-485 Approval Notice, Green Card, I-551 Stamp ❖Pending: USCIS I-485 Receipt Notice, National Visa Center communications, EAD with (c)(9) category ❖Inconclusive: USCIS Receipt or Decision Notice for Form I-130 (family petition), Form I-360 (VAWA SelfPetition; DOS Case Status

FAMILY-BASED PETITIONS: WHO CAN PETITION WHOM? ❖US Citizens for… ❖Spouse ❖Parents ❖Unmarried children under 21 ❖Children over 21 and/or married* ❖Siblings* ❖Lawful Permanent Resident for… ❖Spouse* ❖Unmarried child over or under 21* *There is a waitlist for these groups. See monthly Department of State visa bulletin.

https://travel.state.gov/content/travel/e n/legal/visa-law0/visa-bulletin.html

PATHS TO PERMANENT STATUS / HOW TO IDENTIFY HUMANITARIAN VISA: * These are affirmative applications but can sometimes be used to terminate/admin close/adjourn removal

proceedings.

❖ T Visa: 4-year visa for victims of “severe forms of trafficking.” Eligible to apply for

adjustment of status after three years, and before the end of four years.

❖Granted: USCIS I-914 Approval Notice; USCIS I-94; EAD under the (a)(16) or (c)(25) categories ❖Pending: USCIS I-914 Receipt Notice, USCIS Bona Fide Determination Notice

❖ U Visa: 4-year visa for victims of certain severe crimes who have cooperated with

law enforcement. Eligible to apply for adjustment of status after three years, and before the end of four years. ❖Granted: USCIS I-918 Approval Notice; USCIS I-94; EAD under the (a)(19) or (a)(20) categories ❖Pending: USCIS I-918 Receipt Notice; USCIS U Visa Deferred Action Notice, USCIS Bona Fide

Determination Notice, EAD in the (c)(14) category

PATHS TO PERMANENT STATUS / HOW TO IDENTIFY HUMANITARIAN VISA: ❖Special Immigrant Juvenile Status (“SIJS”): Affirmative petition based on being

under 21, unmarried, and abandoned/abused/neglected/similar basis (death) by one or both parents. Child must receive a family court order first. Eligible to apply for adjustment of status once priority date is current. ❖Granted: USCIS I-485 Approval Notice, Green Card, I551 Stamp

❖Pending: USCIS I-360 Receipt Notice, USCIS I-360 Approval Notice, USCIS I-485 Receipt Notice, EAD

in the (c)(14) or (c)(9) categories

❖Violence Against Women Act (VAWA): Affirmative petition based on abuse at the

hands of a US citizen or LPR spouse or parent, or of a US citizen child over 21. Provides a route to residency and/or deferred action, depending on waiver needs. There is also a defensive version.

❖Granted: USCIS I-485 Approval Notice, Green Card, I-360 VAWA Approval Notice, EAD in the (c)(31)

category ❖Pending: USCIS I-360 Receipt, USCIS I-360 Approval Notice, USCIS I-485 Receipt Notice, EAD in the (c)(31) or (c)(9) cateogries

PATHS TO PERMANENT STATUS / HOW TO IDENTIFY ❖Non-LPR Cancellation of Removal (“10 Years Law”) – defensive route to green

card for people with more than 10 years in the US on their “clock”, no disqualifying convictions, and a USC or LPR parent/child/spouse that would suffer “exceptional and extremely unusual hardship” upon their deportation. Residency is acquired upon grant by immigration judge. ❖Granted: Green Card, Immigration Judge Decision ❖Pending: Court-stamped EOIR42B Form, EAD with (c)(10) category

❖LPR Cancellation of Removal – defensive route to maintain green card when

green card holder becomes “deportable” and is placed into removal proceedings. Green card holder must have been admitted as an LPR for five years on their “clock”, and you have not been convicted of any disqualifying crime (“aggravated felony”) ❖Granted: Immigration Judge Order ❖Pending: Court-stamped EOIR 42A Form

TEMPORARY STATUSES WITHOUT INHERENT RIGHTS TO RESIDENCY/CITIZENSHIP ❖Temporary Protected Status (“TPS”): Temporary status for citizens of certain US-designated countries who

have been in the United States since a certain date and timely applied.

❖Granted: USCIS I-821 Approval Notice, EAD under the (a)(12) category ❖Pending: USCIS I-821 Receipt Notice, EAD under the (c)(19) category; USCIS Receipt or Approval Notices for EADs in the (c)(19) or (a)(12) categories

❖Deferred Action: Temporary “quasi”-status that provides a right to a work permit and temporary protection

against deportation. Is often renewable and can be based on several categories (ex. DACA, DALE, medical) ❖Granted: USCIS I-765 approval notice in the (c)(14) or (c)(33) category, USCIS I-821D Approval Notice, EAD in the (c)(14) or (c)(33) category ❖Pending: USCIS I-765 receipt notice in the (c)(14) category, USCIS I-821D receipt notice

❖Withholding of Removal/Protection under the Convention against Torture: Defensive relief from removal for

individuals that are able to demonstrate risk of persecution/torture upon return to home country. Often, though not always, accompanied by a right to a work permit. ❖Granted: Decision from the Immigration judge, EAD in the (a)(10) category ❖Pending: EOIR-stamped copy of form I589, EAD with (c)(8) category

❖Student Visa: Temporary status for individual to pursue education in the United States. ❖Granted: Student Visa in passport, Form I-20, Approval Notice for Form I-539

❖Tourist Visa/ESTA/Visa Waiver: Temporary status of very limited duration to pursue pleasure or business in the

United States. (Does NOT provide the right to work in the United States). ❖Granted: Visa in Passport, passport from ESTA/visa waiver eligible country, I-94

WORK PERMITS **BEWARE: NO SUCH THING AS AN APPLICATION FOR A WORK PERMIT THAT IS NOT LINKED TO SPECIFIC STATUSES OR PENDING APPLICATIONS***

❖Common Pending Applications with a Right

to a Work Permit:

❖Adjustment of Status ❖Asylum (after 150-180 days on the clock) ❖U Visa/T Visa (with Bona Fide Determination) ❖Non-LPR Cancellation of Removal

❖Common “Statuses” with a Right to a Work

Permit:

❖Deferred Action ❖Parole ❖TPS ❖U Visa ❖T Visa ❖Violence Against Women Act Self-Petition ❖Withholding of Removal/CAT

❖Common “Statuses” with Right to Work Incident to Status: ❖Asylum ❖Lawful Permanent Residency ❖Common “Statuses” and Applications with NO Right to a Work Permit: ❖Pending Family petition ❖Ongoing removal proceedings ❖Time in the US ❖Pending U/T before bona fide determination ❖SIJS ❖Pending VAWA

A NOTE ON DISCRETION AND BURDENS ❖ Many forms of immigration “relief” are discretionary determinations – that is,

even if the applicant is statutorily eligible they must also convince the adjudicator that they merit that relief in a positive exercise of discretion.

❖Generally, though it is the government’s burden to demonstrate that someone

is inadmissible or removable (deportable), it is the individual’s burden to show that they are eligible for and “deserve” most types of immigration relief.

EMPLOYMENT VISAS There is an additional world of immigration relief, for employment-based visas. These are varied, and can include analysis of such things as: job offers, financial resources of proposed employers, educational history, and inadmissibilities, among others. Some employment visas can be processed for some individuals in the US and others cannot. Some lead to a route to a green card, and some do not. We do not practice employment immigration, and are therefore not advising on it as part of this presentation. You will also not be screening for employment-based options. If someone has questions about employment based visas, we can offer referrals to practitioners with more expertise in this area.

HOW YOU SCREEN

Using your form and checking the documents

SCREENING SHEET

HOW CAN YOU TELL? Green Card:

EAD (Work Permit):

HOW CAN YOU TELL? USCIS Notice

CASE STATUS / HOW TO IDENTIFY (USCIS) ❖https://egov.uscis.gov/

HOW CAN YOU TELL? Notice to Appear

HOW CAN YOU TELL? Immigration Judge Decision

Immigration Court Hearing Notice

HOW CAN YOU TELL? Master Calendar Hearing:

Individual Hearing:

Largely administrative hearing for pleadings, case status, among other administrative matters. Will be a group time with little time actually speaking to the judge.

The merits hearing. This is the last or closeto-last hearing in an immigration case, where evidence is presented, testimony taken, arguments are made, and (possibly) a decision is issued.

Bond Hearing:

IAD Hearing:

Hearing before an immigration judge aimed at procuring release from immigration detention. Must be specifically requested.

New type of hearing. Hearing without a judge assigned. Appears to be solely for the purpose of receiving a hearing date with a judge.

CASE STATUS / HOW TO IDENTIFY (EOIR) ❖Call the court at the 1-800 number – 1-800-898-7180 ❖Automated recording with information on NTA filing, hearing dates, case status, and asylum clock

❖Check online at https://acis.eoir.justice.gov/en/

HOW CAN YOU TELL? ICE Check-Ins

IMMIGRATION UPDATES

GENERAL STATUS QUESTIONS

IMMIGRATION UPDATES ❖Temporary Protected Status

o o o o

❖NTA being issued after USCIS denies apps

El Salvador - until Sept. 9, 2026 Venezuela - until Oct. 5, 2026 Ukraine - until Oct. 19, 2026 Haiti - terminated July 27, 2026

❖ DACA

o Still able to renew and theoretically able to file initial applications, but USCIS is not adjudicating them (exception: Texas)

❖Deferred Action for Labor Enforcement o

Appears to have been terminated as a program, renewal not advisable

❖Travel Ban o

Full ban on 75 countries

Should not apply to visas already issued

❖ Parole o

Renewals getting denied, NTAs being issued

❖All Countries - temporary pause on all

consular processing interviews for public charge training

PUBLIC CHARGE UPDATE Certain green card applicants (primarily family-based petitions) are subject to the public charge ground of admissibility. In the past, officers usually considered Petitioner’s income and financial situation, not the applicant’s. Under the INA, officers can consider “alien’s age; health; family status; assets, resources, and financial status; and education and skills”. Under the new policy, officers can consider the above factors, and the applicant’s* receipt of means-tested public benefits. For means-tested public benefits received before Sept. 18, 2026, USCIS will only consider the alien’s receipt of public cash assistance for income maintenance and long-term institutionalization at the government’s expense. For means-tested public benefits received after Sept. 18, 2026, USCIS consider any and all benefits. *From the Policy Manual, “USCIS does not attribute to the alien the receipt of meanstested public benefits if the benefit is received by the applicant’s relatives, including children, or received by the applicant solely on behalf of third parties.”

IMMIGRATION COURT

MASTER CALENDAR HEARING (MCH) ● Preliminary hearings: meet the judge for the first time. ● In non-detained court, can usually request more time to find an attorney for the first hearing (but it’s not guaranteed) ● Will go through “pleadings” as listed on “Notice to Appear” ● Should always try to ask the IJ for more time before going through pleadings -try to have an attorney present before answering. ● IF THE IJ MAKES CLIENT ANSWER: they can say “I neither admit nor deny the allegations and charges“. They should not agree to designate their country of removal if they fear return. ● REMEMBER: proceedings are under penalty of perjury, so should not lie

MCH CONTINUED ● If client appears alone, it is THEIR responsibility to understand and remember what the judge tells them ● Some IJ’s will give deadlines: client HAS to keep them, even if they don’t have an attorney ● If DHS files a motion against client, remember that even if they don’t have an attorney, they still have to respond to the motion within 7-10 days. If they don’t, the IJ can accept DHS’ motion and order you deported. ● If they have a form of relief available, the IJ should ask questions and determine you they are eligible for it. If not, the IJ will likely offer voluntary departure (VD).

RELIEF BEFORE THE IMMIGRATION COURT (EOIR) ● Certain types of relief are available before the IJ (asylum, COR, adjustment). ● Other forms of relief are only available before USCIS (SIJS, U Visa). ● If client is only eligible for relief that is outside EOIR jurisdiction they can ask to have the case terminated, administratively closed, or continued so they can pursue the outside relief. ● Despite their discretion to do so, IJs are very unlikely to grant time for collateral relief. ● Clients should preserve for appeal arguments related to their pending matters (especially if it is victim-based relief: U Visas, T Visas, SIJS).

PRETERMISSION ● Currently, DHS (and sometimes the IJ) is requesting that cases be pretermitted, essentially denied before the person has a hearing. ● Some arguments for pretermission include: the application was not completely filled in, the applicant did not make a prima facie showing of relief, or they did not pay the fees. ● There are counter-arguments (tied to due process concerns) to try to defend against a pretermission or at least build a record for appeal. ○ Should oppose if pretermission is raised orally or not timely ○ Should ask for time to brief the issue and respond ○ Should reserve appeal

VOLUNTARY DEPARTURE (VD) ● IJs are often offering that clients accept voluntary departure rather than have their case pretermitted. ● 2 types: pre-conclusion (prior to or at MCH) and post-conclusion (any time during proceedings) ● Not everyone is eligible for pre-conclusion VD, especially if they have prior criminal contact or are an arriving alien. Requires discretion. ● Benefits include option to leave on their own terms (within 120 days for preconclusion and 60 days for post-conclusion), client does not get a removal order and can then potentially return to the US if they qualify ○ Be wary of the argument about being able to return. Some forms of relief are only available if clients remain in the US ● Drawbacks include requirement to withdraw applications for relief and waive appeal. Still trigger bars upon exit. ● If someone fails to depart after voluntary departure it may convert to a removal order.

INDIVIDUAL/MERITS HEARING (IH) ● FINAL hearing - where client has a chance to explain to the immigration judge why legally they should obtain the form of relief they’ve applied for ● There are often deadlines to submit all evidence in advance of the hearing. ● The IJ will begin by beginning interpretation, and asking questions about any pending application--who prepared it, does client know what it says, and then ask client to sign it. ● Then the judge will enter evidence into the record, including the government’s evidence ● Then the judge will take testimony - client will answer questions, DHS will ask questions, and the judge may ask more ● Judge may make a decision that same day or may set another hearing for the decision.

REMOVAL ORDERS ● If the judge denies a case or pretermits the case, they will issue a removal order. ● If a client does not appear for a hearing, the judge will issue a removal order in absentia. ● If someone has a removal order they are at risk of summary removal and/or detention. ● A removal order may also trigger bars to eligibility for future immigration relief.

DETENTION & HABEAS

DETENTION & WRIT OF HABEAS CORPUS ❖ Detention by ICE continues to be a threat to anyone perceived as an immigrant ❖ ICE detention can also occur as a result of criminal detention ❖ NJ has funds for representation of detained individuals through the Detention and Deportation Defense Initiative (DDDI) ➢ referrals can me made online or by phone through the Office of New Americans DDDI web page ❖ Detention & Habeas – family planning, referral to DDDI ➢ KYR materials – what docs to carry (state ID), what to say or not say ➢ Caregiver & financial POA ➢ General emergency planning, organizing paperwork, emergency contacts for children, passports for all famil members

PLANNING FOR EMERGENCIES/DETENTION ❖ Emergency Planning - especially important for families with

children or other dependants

➢ Emergency contact numbers ➢ Orangize paperwork ➢ Passports for all family members

❖ Know Your Rights materials are important to review - carrying IDs,

what to say to athorities and attorney letter should be considered

❖ Caregiver & Financial POAs

BOND HEARING ❖ If detained, bond can be requested as a way to be released ❖ Legally NOT a hearing within “removal” case--its separate. ❖ If client hires an attorney, they must be sure whether they are retaining them for “bond only” or for “bond and removal” proceedings. ❖ This is to determine whether client merits an immigration bond-whether the IJ can let them out of detention ❖ Judge has 2 considerations: ➢ Whether client poses a flight risk ➢ Whether client poses a danger to the community ❖ Should have a U.S. citizen sponsor--someone who is willing to say that they will take care of the client and ensure they will attend future hearings

BOND & HABEAS ❖ A lot of IJ’s are not accepting jurisdiction to hear bond for certain cases– basically, anyone who entered the US without a visa ❖ In that case, client (or family) should hire an attorney to file a “habeas corpus”, a separate case in FEDERAL COURT (not immigration court) to order the IJ to consider bond ❖ Habeas can also be used to argue for release of a detained immigrant, based on other bases of unlawful detention ❖ If client hires an attorney for habeas, they should try to make sure they will represent the client for the bond hearing as well

CAREGIVER & FINANCIAL POWERS OF ATTORNEY

Caregiver Power of Attorney • Overview of the Caretaker POA •

Emergency planning for care of children in case of detention or other event

•

Who can serve as an attorney-in-fact?

• •

What can the attorney-in-fact do in place of the custodian of the children? How long is the POA valid?

• Volunteer Attorney Preparation •

READ THE FAQ!

• •

Review and get familiar with the POA form Save these documents and share with others!

• At the Clinic •

Explain the purpose of the caretaker POA

•

Offer to complete at the clinic (notary will available)

•

Offer to explain how they can fill it out on later date

•

Warn them that no attorney assistance is needed

Caregiver Power of Attorney

Financial Power of Attorney • What is it? • Designates who can manage financial affairs • Effectively immediately until revoked in writing

• Authority to : • Conduct banking transaction • Manage real and personal property • Conduct and manage businesses • Power to Make Gifts

• Naming an “attorney-in-fact” and alternate • Indemnification Clause

Execution Requirements • Must be signed in front of : • Two witnesses • Notary

• It is important that person named as attorney-in-fact either have copy of document(s) or know how to get them if necessary

REGISTRATION

REGISTRATION ❖On April 11, 2025, the Trump administration began requiring

undocumented immigrants to register with DHS and carry certain documents to prove registration status.

❖ Signing up to register could be very dangerous. The government has

made clear that they intend to use the information from registration to find, arrest, and deport individuals, or pressure them to leave the U.S. on their own.

❖The government has threatened criminal charges for those who fail to

REGISTRATION ❖Who Must Register • • •

All adults and children over 14 yrs who entered the U.S. without permission and have not had contact with immigration authorities Children under 14 yrs would be registered by their parents or guardians All noncitizens must update their address within 10 days of moving

❖Who is Already Registered • • • • • • • •

LPRs People granted parole (even if it expired) People who entered US on a visa (even if expired) People in removal proceedings People granted EAD (even if expired) Refugees People who applied for LPR People with border card or crewmen

REGISTRATION ❖Process to Register • Applicant must create an online account with USCIS. • Fill in and submit Form G-325R (no fee). • Questions include: name, address history for 5 yrs, immigration history & length of intended stay, activities in US, criminal history, information on family members. • Applicant will receive receipt notice and appointment for biometrics (fingerprints, photo etc.). • Children under 14 are not required to be fingerprinted • Proof of Alien Registration document will be available in USCIS online account ❖ Deadline to Register • Children who are required to register must do so within 30 days of their 14th birthday. • Change of address must be reported within 10 days. • No other deadlines specified in rule.

REGISTRATION ❖Proof of Registration • Failure to carry a noncitizen registration document is a federal misdemeanor. • Noncitizens who have proof of registration may want to carry this proof to avoid potential prosecution. • Proofs include: ○Proof of Alien Registration Form ○I-94 Arrival-Departure Record ○Green Card ○Employment Authorization Card ○Notice to Appear and Notice of Referral to Immigration Judge ○Border Crossing Card ○There may be other proofs as well.

REGISTRATION ❖Potential Consequences of Registration • If no prior contact, government could try to arrest and deport. • ICE may send a letter asking person to report. • If in US for less than 2 years could be subject to expedited removal. • Could be charged with migration-related criminal offenses (illegal entry or illegal reentry). ❖ Potential Consequences of Not Registering • Denial of discretionary relief • Potential criminal prosecution for: ○Failure to register ( up to $5k or 6 months imprisonment) ○Failure to carry proof of registration (up to $5k or 30 days imprisonment) ○Failure to notify of COA (up to $200 or 30 days imprisonment)

IMMIGRATION SCREENING FORM Volunteer name:

GENERAL INFORMATION Client Name:

Preferred Language:_________________

Date of Birth:

A#:

Start with an open-ended question to get some general information about the client’s situation from their perspective. If the client has an A#, start by looking it up in EOIR’s Automated Case Information System or

NOTE TO ATTORNEY:

call the EOIR telephonic system at 1800-898-7180.

Removal proceedings? □ Y □ N

Next Court Date

General information and/or problem(s) presented by client: _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Country of birth/nationality: ____________________________________________________________ Any other nationality? __________________________________________________________________ Passport/Government ID? If yes, where is it? Expired?_______________________________________

IMMIGRATION HISTORY Do you currently have/have you ever had, an immigration lawyer? □ Y □ N If yes, current status of representation: _______________________________________________________ Current immigration status: □ No lawful status □ LPR □ TPS □ CHNV Parole □ Other_____________________________________________________________________________ Date status acquired: ________________________________________________________________ Have you filed any immigration paperwork or has anyone filed any immigration paperwork for you? (I130 application, tourist visa application, CHNV parole application, etc.)? □Y□N Based on your recollection, when were these applications filed? ___________________________________ Who helped you file these applications? _______________________________________________________

What were the results of the filing of these applications (Approved, denied, still pending?)________________________________________________________________________________ NOTE TO ATTORNEY: If the client has a receipt # start by looking it up in USCIS Online Case Status

Receipt #: _______________________

Status of filing: _________________________________

Additional details about filings: _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ U.S. ENTRIES / EXITS Date of last entry:__________ Manner (EWI; visa, parole, etc.):______________ Were you admitted into the U.S. as a refugee? □ Y □ N If yes, has your refugee status been terminated □ Y □ N Location of entry (city at border, airport, etc.): ________________________ Were you detained? _____________________ If entry at airport, were you taken to secondary inspection? (Please provide details) __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Use CBP One app? ________________ Prior Entries (if any): Date:_________ Manner: _______ Date left US: __________ Manner/reason leaving: _________ Date:_________ Manner: _______ Date left US: __________ Manner/reason leaving: _________ Date:_________ Manner: _______ Date left US: __________ Manner/reason leaving: _________ Previously detained? If yes, when and where?: _______________________________________________________________________ If released from detention, how were you released (Bond, parole, released on own recognizance?) 2

_______________________________________________________________________________________ If released on your own recognizance, are you on an alternative to detention program? (Meaning ankle shackle, phone monitoring, in-person check-ins with ICE.) _________________________________________ If currently in removal proceedings what has happened to date in your case? (e.g., have you had master calendar hearings only? If so, how many? Has a final hearing been scheduled?) __________________________________________________________________________________________ __________________________________________________________________________________________ Have you been ordered removed from the U.S. by an immigration judge? If so, when? What court (in what state)? What judge? (This information may be available on the EOIR telephonic system at 1800-8987189) __________________________________________________________________________________________ Were you ordered deported in absentia? □ Y □ N Were you represented by counsel at that time? □ Y □ N If yes, what was the name of the attorney or firm? _______________________________________________ Did you or have you filed any applications for relief before the immigration court? If so, what? __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ If you were previously ordered deported, have you made any attempts to reopen your case? □ Y □ N If yes, explain: _____________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ If you were previously ordered deported, have you attempted to appeal your case to the BIA or federal court? □ Y □ N Please explain: _________________________________________________________________________________________ _________________________________________________________________________________________ Have you been previously deported from AND reentered the U.S.? If so, when? __________________________________________________________________________________________

BIOGRAPHIC INFORMATION Spouse/Partner? □ Single □ Partner □ Married □ Widowed □ Divorced

If not single, status of spouse/partner: □ No Status (also applies to outside of U.S.) □ Other status (i.e. visa) □ LPR □ USC □ Unknown

If not single or deceased, spouse/partner in U.S.? □ Yes □ No If divorced or widowed, when did the divorce or death of your spouse take place? ____________________ Do you have an LPR or USC parent?_____________________________________ Is your parent in the U.S.?_____________________________________ Total number of children (including stepchildren):_________________________________ Total number of children in U.S.: ____________________________________________________ Total number of children who are LPRs or have another legal status (Not USC’s): ____________ Total number of children who are USC’s: ____________ Total number of children in the US who are under 18: _____________ Any other family in the U.S? (Name, contact number, relationship, location) _________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Do you have a spouse, parent, or child (living or deceased) who served in U.S. armed forces? ❑ Yes ❑ No If yes, please provide the following information: Branch Rank Active, Reserve, or Veteran

Please describe the health status of you and your family members in the U.S., including any chronic physical illnesses, mental health diagnoses, emotional difficulties, or learning challenges. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________

IMMIGRATION RELIEF CHECKLIST Arrest/police contact outside of U.S.? If yes, list and explain where the arrest(s) occurred, what if any charges were brought and outcomes. _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Arrest/police contact inside the U.S.? If yes, based on your recollection, list and explain where the arrest(s) occurred, what the charges were, and the final outcome(s),, and whether the case is still pending.__________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Have you ever had legal status in any other country? Lived in another country? If so, what was your immigration status in that country? _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ ASYLUM: Are you afraid of returning to your home country? □ Yes

□ No

If you are afraid to return to your country of origin, please explain why: ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Have you or your family been harmed? If so by who and when? __________________________________ _________________________________________________________________________________________ 5

_________________________________________________________________________________________ _________________________________________________________________________________________ Did you ever report harm to police/government authorities in your country of origin? If yes, what were the results? If not, why not? _________________________________________________________________________________________ _________________________________________________________________________________________

Have you filed an asylum application? If so, when? ______________________________________________ Did you ever apply for an employment authorization card (EAD)? If so, when? ______________________ T VISA (TRAFFICKING): Has anyone ever made you work without pay or has an employer ever withheld pay from you? ❑ Yes ❑ No If yes, explain: ____________________________________________________________________________________________ Did you come to the U.S. because of a specific job opportunity? ❑ Yes ❑ No If yes, explain: ____________________________________________________________________________________________ Do you or does your family owe anyone money for helping you come to the U.S.? ❑ Yes ❑ No If yes, explain: __________________________________________________________________________________________ Have you ever been pressured to do anything to pay someone back for your travel to the U.S.? ❑ Yes ❑ No If yes, explain: __________________________________________________________________________________________ Has anyone ever forced you to work against your will or otherwise made you do work that you did not want to do? ❑ Yes ❑ No If yes, explain: __________________________________________________________________________________________ Has any employer ever threatened you with harm (physical, psychological, financial, immigration, reputational, etc.)? ❑ Yes ❑ No. If yes, explain: __________________________________________________________________________________________ 6

Have you ever felt that you were unable to leave a job even though you wanted to leave? ❑ Yes ❑ No. If yes, explain: __________________________________________________________________________________________ Has anyone ever pressured you to engage in any sexual acts that made you uncomfortable? ❑ Yes ❑ No. If yes, explain: __________________________________________________________________________________________ Has anyone ever offered you money, food, water, or a place to sleep in exchange for sex? ❑ Yes ❑ No. If yes, explain: __________________________________________________________________________________________ U VISA: Have you or your minor child under the age of 18 ever been the victim of any violence or crime in the U.S.? □ No □ Yes If no, skip this section o Type of violence/crime: _______________________ City/State: ______________________ o Was it reported? □ No □ Yes To whom?: ____________________________________ o Filed a restraining order against someone? □ No □ Yes Court:______________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ VAWA Cancellation of Removal:  Have you ever been abused by a USC/LPR spouse or (current or former) or parent? □ No □ Yes  Has your child ever suffered abuse by a USC or LPR parent? □ No □ Yes  Have you continuously resided in the U.S. for 3 years? □ No □ Yes  Have you ever been arrested or convicted of a crime (Screener note: Please document the individual’s full criminal history, including charges, convictions, dates, locations, and outcomes, in the section above.) □ No □ Yes VAWA Self-Petition:  Have you ever been abused by USC/LPR spouse (current or former), parent or child over the age of 21? □ No □ Yes  Was your child a victim of domestic violence by a USC/LPR parent? □ No □ Yes Cancellation of Removal for LPRs:  Have you been an LPR for at least 5 years? □ No □ Yes If no, skip this section  Have you continuously resided in the U.S. for 7 years after a lawful admission? □ No □ Yes  Have you ever been arrested or convicted of a crime (Screener note: Please document the individual’s full criminal history, including charges, convictions, dates, locations, and outcomes, in the section above.) □ No □ Yes 7

 Have you ever been granted cancellation of removal before? □ No

□ Yes

Cancellation of Removal for non-LPRs: Have you had continuous physical presence in the U.S. for 10 years? □ No □ Yes If no, skip this section  Do you have a USC/LPR spouse, child (under the age of 21 and unmarried) or parent? □ No □ Yes o Would the spouse, child or parent suffer exceptional and extremely unusual hardship if you were to be removed from the U.S.? □ No □ Yes Why?: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________  Have you ever been arrested or convicted of a crime (Screener note: Please document the individual’s full criminal history, including charges, convictions, dates, locations, and outcomes, in the section above.) □ No □ Yes  Have you ever been granted cancellation of removal before? □ No □ Yes Derivative Citizenship: Do/did you have/had a U.S. citizen parent? □ No □ Yes If no, skip this section  If yes, was it your mother or father? ______________________  Did your parent become a citizen before you turned 18? □ No □ Yes □ Don’t know  Did you live with your U.S. citizen parent at any time? □ No □ Yes □ Don’t know  Did you ever have a green card? □ No □ Yes Adjustment of Status:  Are you the spouse, parent, child (over the age of 21) or sibling of a USC? □ No □ Yes  Are you the spouse or unmarried child (any age) of a LPR? □ No □ Yes  Has an I-130 Petition for Alien Relative been filed for you? □ No □ Yes o Date Filed: ______________________ o Priority date of I-130 (if known):____________________ o Result: _________________________  Were you inspected and admitted upon arrival in the United States? (Screener note: Inspected and admitted means someone legally entered the U.S. after undergoing inspection by an immigration officer and being granted admission or parole □ No □ Yes  Have you ever traveled outside of the United States on advanced parole? □ No □ Yes Special Immigrant Juvenile Status (SIJS): Are you under 21, and ever been abused, neglected, or abandoned by one of your parents? □ No □ Yes If no, skip this section  Are you married or ever been married? □ No □ Yes  Do you live with an adult who is currently caring for you? □ No □ Yes If yes, explain: _________________________________________________________________________________ 8

Deferred Action for Childhood Arrivals (DACA): Did you enter the U.S. before age 16? □ No □ Yes If no, skip this section  Were you under the age of 31 as of June 15, 2012? □ No □ Yes  Have you been in the U.S. five years since June 15, 2007? □ No □ Yes (short travel may be excused)  Are you a high school graduate/GED recipient or currently enrolled in school? □ No □ Yes  Have you ever been arrested or convicted of a crime (Screener note: Please document the individual’s full criminal history, including charges, convictions, dates, locations, and outcomes, in the section above.) □ No □ Yes  Have you applied for DACA before? □ No □ Yes Expires: _____________________ Voluntary Departure Requirements (For individuals currently in removal proceedings):  Do you have a valid travel document? □ No □ Yes  Do you have money to buy a plane ticket? □ No □ Yes  Have you ever been arrested or convicted of a crime (Screener note: Please document the individual’s full criminal history, including charges, convictions, dates, locations, and outcomes, in the section above.) □ No □ Yes

ADDITIONAL ASSISTANCE Start by giving an explanation about current requirements around registration. Are you interested in assistance with Registration? □ No □ Yes Are you interested in assistance with a Caretaker POA? □ No □ Yes Are you interested in assistance with a Financial POA? □ No □ Yes

ADDITIONAL SCREENING NOTES / DETAILS ABOUT ADVICE GIVEN:

__________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ 9

EMERGENCY PLANNING IN CASE OF THE DETENTION OR DEPORTATION OF PARENTS PLANIFICACIÓN DE EMERGENCIAS EN CASO DE DETENCIÓN O DEPORTACIÓN DE PADRES 1.

Make a list that everyone can see of friends and family members that can help in case you are detained.

Haga una lista que todos puedan ver de amigos y familiares que puedan ayudar en caso de que usted sea detenido. 2.

Find someone who will take care of your child or children in case you or spouse is unable. Speak with this person about the responsibilities of caring for your children.

Encuentre a alguien que cuide de su hijo o hijos en caso de que usted o su cónyuge no pueda. Hable con esta persona sobre las responsabilidades de cuidar a sus hijos. 3.

If someone is willing to care for your child or children if you are unable, complete the attached Power of Attorney form. It is recommended that you complete a separate form for each of your children and that you also complete the information sheet. It is strongly advised that you renew the Power of Attorney form every year. Si alguien está dispuesto a cuidar a su hijo(a) o hijos(as) si usted no puede hacerlo, complete el formulario de Poder Legal adjunto. Se recomienda que complete un formulario separado para cada uno de sus hijos(as) y que también complete la hoja de información. Se recomienda encarecidamente que renueve el formulario de Poder Legal cada año.

4. 5.

If it is possible, put some money aside to help with expenses.

Si es posible, ponga un poco de dinero a un lado para ayudar con los gastos. If you have U.S. citizen children, make sure they have U.S. Passports in case your deportation makes it necessary for them to travel outside of the U.S. Forms are available at all U.S. post offices.

Si tiene hijos(as) ciudadanos estadounidenses asegúrese de tener pasaportes estadounidenses en caso de que su deportación los haga necesario que viajen fuera

de los Estados Unidos. Los formularios están disponibles en todos los oficina de correos estadounidenses. 6.

Make photocopies of all of your immigration documents. Keep a copy of all your documents with a trusted friend or family member. Haga fotocopias de todos sus documentos de inmigración. Mantenga una copia de todos sus documentos con un amigo o familiar de confianza.

Do not carry foreign identification documents with you (like a passport from a country other than the U.S.). If you have some lawful status, like asylum or a green card, it is advisable to carry proof of this.

No cargue documentos de identificación extranjeros (como un pasaporte de un país distinto a los EE.UU.). Si usted tiene algún estatus legal, como el asilo o una tarjeta de residencia permanente, es recomendable cargar prueba de esto. 8.

Always carry with you telephone numbers of attorneys and family members you can call in case you are detained.

Siempre cargue números de teléfono de abogados y de miembros de su familia a los que puede llamar en caso de que sea detenido. 9.

Remember, if you are stopped by ICE agents, you have the right to remain silent and do not have to answer any questions! ¡Recuerde, si usted es detenido por agentes de ICE, usted tiene el derecho de permanecer en silencio y no tiene que responder a ninguna pregunta!

10. If an ICE officer arrives at your home, the officer can only enter with a judicial search warrant (signed by a judge, NOT BY ICE) OR if someone in the house allows them to enter. If you suspect that ICE agents are at your home and they do not have a search warrant, DO NOT open the door. Si un oficial de ICE llega a su casa, el oficial sólo puede entrar con una orden de allanamiento judicial (firmada por un juez, NO POR ICE) O si alguien en la casa les permite entrar. Si sospecha que los agentes de ICE que están en su casa y no tienen una orden de allanamiento, NO abra la puerta.

This front page is modified from documents prepared by the Legal Aid Society of New York and by CARECEN Esta primera página es modificada de documentos preparados por the Legal Aid Society of New York y por CARECEN

POWER OF ATTORNEY AND DELEGATION OF AUTHORITY BY PARENT CONCERNING MINOR CHILD (complete one for each child) PODER LEGAL Y DELEGACIÓN DE LA AUTORIDAD POR LOS PADRES CON RESPECTO A EL NIÑO MENOR (complete uno por cada niño) This Power of Attorney is made on this/ Este Poder Legal se hace este ___________ day of/ día de _______________________, 20____. BETWEEN/ ENTRE:__________________________________________________________________________________ (mother, father, guardian, or custodian – circle all that apply), (madre, padre, o tutor – marque todo lo que corresponda),

whose address is/ cuya dirección es _______________________________________________________________ and whose phone number is/y cuyo número de teléfono es_____________________________________ ________________________________________________________________ AND/ Y: _______________________________________________________________________________________________ (alternative caregiver, referred to here as the “Attorney-in-Fact”) (cuidador alternativo, referido aquí como “Apoderado Legal”)

whose address is/ cuya dirección es _______________________________________________________________ and whose phone number is/ y cuyo número de teléfono es _____________________________________

________________________________________________________________

If only one parent is signing, or if a nonparent custodian who shares custody with a parent is signing but the parent is not, please check off reason:

Si sólo uno de los padres está firmando, o si un custodio que no es padre que comparte la custodia con el padre está firmando pero el padre no lo está, por favor marque la razón: ____ Death of one parent / Defunción de uno de los padres

____ Custody has been removed by a court of law/ La custodia ha sido retirada por un tribunal de justicia

____ Mentally or physically unable to give consent/ Mentalmente o físicamente incapaz de dar su consentimiento

____The parent has not been involved in raising or financially supporting the child for two years or a third of the life of the child, whichever is less, immediately preceding the date of the latest signature below/ El padre no ha participado en la crianza o el apoyo financiero del niño durante dos años o un tercio de la vida del niño, lo que sea menor, inmediatamente antes de la fecha de la última firma a continuación.

___ The identity or whereabouts of such parent are unknown to me/ La identidad o el paradero de dicho padre son desconcidos para mi. ___ Despite diligent efforts described below, I was unable to reach such parent/A pesar de los esfuerzos que se describen a continuación, no pude comunicarme con dicho padre. Diligent efforts included/Esfuerzos diligentes incluidos:

____ Other, please explain/ Otro, por favor explique:

________________________________________________________________________________________________________ I/we appoint said Attorney-in-Fact, pursuant to the provisions of N.J.S.A. 3B:12-39, and delegate to said Attorney-in-Fact the following powers concerning the care, custody and property of my/our child/minor ward ________________________________________________________________________(“the

child”),

born

__________ day of _______________________, 20____. Yo/ nosotros designamos a dicho Apoderado Legal, conforme a las provisiones de N.J.S.A. 3B:12-39, y le delego a dicho Apoderado Legal los siguientes poderes en relación con el cuidado, la custodia y la propiedad de mi/ nuestro hijo /pupilo menor ________________________________________________________________________(“el niño”), nacido el __________ día de _______________________, 20____. ____ Care-Giving. The Attorney-in-Fact shall have temporary care-giving authority for the child/minor ward, until such time as the child/ minor ward is returned to our/my physical custody, or his/her custody status is altered by a federal, state, or local agency; or changed by a court of law. Dar Cuidado. El Apoderado Legal tendrá la autoridad temporaria de dar cuidado al niño/pupilo menor, hasta que el niño/pupilo menor sea devuelto a nuestra/mi custodia física, o su estatus de custodia sea alterada por una agencia federal, estatal, o local; o cambiado por un tribunal de justicia.

____ Well-Being. The Attorney-in-Fact shall have the power to provide for the child’s/minor ward’s physical and mental well-being, including but not limited to, providing food and shelter. Bienestar. El Apoderado Legal tendrá el poder de proveer para el bienestar físico y mental del niño/pupilo menor, incluyendo pero no limitado a proporcionar comida y alojamiento.

____ Education. The Attorney-in-Fact shall have the authority to enroll the child/minor ward in the appropriate educational institutions; obtain access to his/her school records; authorize his or her participation in school activities; and make any and all decisions related to his or her education, including, but not limited to, those related to special education.

Educación. El Apoderado Legal tendrá la autoridad para inscribir al niño/pupilo menor en las instituciones educativas apropiadas; obtener acceso a los expedientes académicos; autorizar la participación del niño en actividades escolares; y tomar todas y cada una de las decisiones relacionadas con la educación del niño, incluyendo, pero no limitado a, aquellas relacionadas con la educación especial.

____ Health Care. The attorney in fact shall have the authority, to the same extent that a parent/custodian/guardian would have the authority, to make medical, dental, and mental health decisions; to sign documents, waivers and releases required by a hospital or physician; to access medical, dental, or mental health records concerning the child/minor ward; to authorize the child’s/minor ward’s admission to or discharge from any hospital or medical care facility; to consult with any provider of health care; to consent to the provision, withholding, modification or withdrawal of any health care procedure; and to make other decisions related to the child’s/minor ward’s health care needs. Cuidado de la salud. El Apoderado Legal tendrá la autoridad, en la misma medida en que un padre tendría la autoridad, para tomar decisiones médicas, dentales y de salud mental; a firmar documentos, renuncias y divulgaciones requeridas por un hospital o un médico; acceder a registros médicos, dentales o de salud mental relacionados con el niño/pupilo menor; autorizar la admisión o alta hospitalaria del niño/pupilo menor de cualquier hospital o centro de atención médica; consultar con cualquier proveedor de servicios de salud; consentir a la provisión, retención, modificación o retirada de cualquier procedimiento de atención médica; y tomar otras decisiones relacionadas con las necesidades del cuidado de la salud del niño/pupilo menor.

_____ Travel. The Attorney-in-Fact shall have the authority to make travel arrangements on behalf of the child/minor ward for destinations both inside and outside of the United States by air and/or ground transportation; to accompany the child/minor ward on any such trips; and to make any and all related arrangements on behalf of the child/minor ward, including, but not limited to, hotel accommodations. 3

Viajar. El Apoderado Legal tendrá la autoridad para hacer arreglos de viaje en nombre del niño/pupilo menor para destinos tanto dentro como fuera de los Estados Unidos por medio de transporte aéreo y / o terrestre; acompañar al niño/pupilo menor en tales viajes; y para hacer todos y cada uno de los arreglos relacionados en nombre del niño/pupilo menor, incluyendo, pero no limitado a, alojamiento en un hotel. _____Financial Interests. The Attorney-in-Fact may handle any and all financial affairs and any and all personal and legal matters concerning the child/minor ward. Intereses Financieros. El Apoderado Legal puede manejar todos y cada uno de los asuntos financieros y cualquier y todos los asuntos personales y legales con respecto al niño/pupilo menor.

_____ All Other Powers. The Attorney-in-Fact shall have the authority to handle and engage in any and all other matters relating to the care, custody and property of the child/minor ward which are permitted pursuant to applicable state law.

Todos los Otros Poderes. El Apoderado Legal tendrá la autoridad para manejar y ocuparse de todos y cada uno de los asuntos relacionados con el cuidado, la custodia y los bienes del niño/pupilo menor que están permitidos de acuerdo con la ley estatal aplicable.

By this delegation, I/we provide that the Attorney-in-Fact's authority shall take effect upon the following activating event(s). Check all that apply: Por esta delegación, Yo/Nosotros disponemos que la autoridad del Apoderado Legal surtirá efecto sobre el/los siguiente evento(s) activador(es):

___The execution of this document on the latest date below; or

La ejecución de este documento en la última fecha; o a continuación

___My attending physician concludes that I am incapacitated, and thus unable to care for my child/minor ward; or

Mi médico tratante concluye que estoy incapacitado, y por lo tanto no puedo cuidar de mi hijo/pupilo menor; o

___My attending physician concludes that I am physically debilitated, and thus unable to care for my child/minor ward; or Mi médico tratante concluye que estoy descapacitado físicamente, y por lo tanto no puedo cuidar de mi hijo/pupilo menor; o

___I am detained in immigration detention, removed, or deported; or Estoy detenido en detención de inmigración, removido, o deportado; o ___I am incarcerated based on criminal charges, including pending charges, or conviction; or Estoy encarcelado por cargos criminales, incluyendo cargos pendientes, o condena; o

___I am deployed in military service; or

Estoy desplegado en el servicio militar; o

___Upon my death, if I have made no more permanent care arrangements for my minor child/minor ward; or A mi muerte, si no he hecho más arreglos de cuidado permanente para mi hijo/pupilo menor; o

___Other (specify reason).

Otro (especifique el motivo)

In the event that the person designated above is unable or unwilling to act as Attorney inFact to my child/minor ward, I hereby name – En el caso de que la persona designada anteriormente no pueda o no quiera actuar como Apoderado Legal para mi hijo/pupilo menor, por la presente nombro – ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ (put name, address, and telephone number of alternate Attorney-in-Fact), as alternate Attorney-in-Fact of my old child/minor ward.

____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ( ponga el nombre, dirección, y número de teléfono del Apoderado Legal alternativo), como Apoderado Legal alternativo de mi hijo/pupilo menor. I/we understand that this delegation will expire one year from the execution of this document on the latest date below, and that the authority of the Attorney-in-Fact, if any, will cease, unless by that date (i) I renew this delegation, by the same process applicable to the original delegation, or ; (ii) a court of competent jurisdiction appoints a custodian, guardian, or standby guardian for the child/minor ward; or (iii) exigent circumstances 5

make it impossible for me to renew this delegation, and I have not made alternative care arrangements for my child/minor ward.

Yo/nosotros entendemos que esta delegación expirará un año después de la ejecución de este documento en la última fecha a continuación, y que la autoridad del Apoderado Legal, si lo hubiera, cesará, a menos que para esa fecha (i) Renuevo esta delegación, por el mismo proceso aplicable a la delegación original, o; (ii) un tribunal de jurisdicción competente designe un custodio, tutor, o tutor en espera para el niño/pupilo menor; o (iii) circunstancias apremiantes me imposibilitan renovar esta delegación, y no he hecho arreglos alternativos de cuidado para mi hijo/pupilo menor. I/we hereby authorize that the Attorney-in-Fact as set forth above shall be provided with a copy of my/our attending physician’s statement(s), if applicable. Yo/nosotros autorizamos que el Apoderado Legal como se establece anteriormente se le proporciona una copia de mi/nuestra declaración del médico tratante(s), si corresponde.

In the event that an activating event occurs and a Power of Attorney is activated pursuant to this statement, I declare that it is my intention to retain full parental rights to the extent consistent with my condition and circumstances and, further, that I retain the authority to revoke the Power of Attorney consistent with my rights herein at any time.

En el caso de que ocurra un evento activante y se active un Poder Legal de conformidad con esta declaración, declaro que es mi intención conservar todos los derechos parentales en la medida en que sea consistente con mi condición y circunstancias y, además, que conservo la autoridad para revocar El Poder Legal consistente con mis derechos en este documento en cualquier momento. Signatures of Parent(s), Guardian or Custodian/ Firma del Padre(s), Tutor, o Custodio ______________________________________________ Signature of Parent/ Firma de Madre

____________________________________________ Date signed by Parent/ Fecha firmada por Madre

______________________________________________ Signature of other Parent/ Firma de Padre

_____________________________________________ Date signed by other Parent/ Fecha firmado por Padre

______________________________________________ Signature of Guardian/ Firma de Tutor

_____________________________________________ Date signed by Guardian/ Fecha firmado por Tutor

_________________________________________________ Signature of Custodian/Firma del Custodio

______________________________________________ Date signed by Custodian/Fecha firmada por el custodio

Signatures of Witnesses/ Firma de Testigos ____________________________________________ Signature of Witness #1 Firma de 1er Testigo

_____________________________________________ Date/ Fecha

Address of Witness #1/Dirección del Testigo #1 ___________________________________________ Signature of Witness #2 Firma de 2do Testigo

Address of Witness #2/Dirección del Testigo #2

___________________________________________ _____________________________________________ Date/ Fecha

___________________________________________

STATE OF NEW JERSEY COUNTY OF ___________

ss.: :

BE IT REMEMBERED, that on __________________, 20__, before me, the subscriber, a Notary

Public of the State of New Jersey, personally appeared ______________________, who, I am

satisfied, is the person named in and who executed the foregoing Durable Power of Attorney, and he/she did acknowledge that he/she executed it as his/her voluntary act for the uses and purposes expressed therein.

______________________________

Notary Public

ESTADO DE NUEVA JERSEY : ss.: CONDADO DE ___________

QUE SE RECUERDE, que en __________________, 20__, ante mi, el suscriptor, un Notario Público del Estado de Nueva Jersey, personalmente compareció ______________________, quien, Estoy satisfecho, es la persona nombrada en y quien ejecutó el Poder Legal Duradero anterior, y él/ella reconoció que él/ella lo ejecutó como su acto voluntario para los usos y propósitos expresados en el mismo.

______________________________ Notario Público

INFORMATION SHEET (complete one for each child/ward) HOJA DE INFORMACIÓN (complete una por cada niño/pupilo menor) Date/ Fecha: _____________________________________

Parent’s Name/ Nombre de la Madre:_______________________________________________________________

Other Parent’s Name/ Nombre del Padre: __________________________________________________________ Parent’s Phone/ Teléfono de la Madre:_______________________________________ Other Parent’s Phone/ Teléfono del Padre:________________________________________ Emergency Contact #1/ 1er Contacto de Emergencia:

Name/ Nombre:_______________________________________________________

Relationship to family/ Relación con la Familia: ____________________________________ Phone/ Teléfono:___________________________

Emergency Contact #2/ 2do Contacto de Emergencia:

Name/ Nombre: ______________________________________________________

Relationship to family/ Relación con la Familia: ____________________________________ Phone/ Teléfono:___________________________ Child’s school/ Escuela del niño

______________________________________________________

Child’s favorite or primary teacher/ El maestro favorito o primario del niño __________________ Family Doctor/ Doctor de Familia: _______________________________________________ Phone/ Teléfono:_____________________________

Health Insurance Co./ Compañia de Seguro de Salud:_____________________________________________

Insurance Policy Name and #/ Nombre de Póliza de Seguros y #:________________________________ Known Medical Conditions of Child/ Condiciones Médicas conocidas del Niño:

_________________________________________________________________________________________________________ Any medications that child takes/ Cualquier medicamento(s) que el niño toma:

_________________________________________________________________________________________________________

Any allergies of child/ Cualquier alergias del niño:_________________________________________________

Last tetanus immunization/ Última inmunización contra el tétanos:______________________________

A# of parent (if any)/ Número A de la madre (si alguno)___________________________________________

A# of other parent (if any)/ Número A del padre (si alguno)_______________________________________ A# of child (if any)/ Número A del niño (si alguno)_________________________________________________ Any other important information about child?/ Cualquier otra información importante sobre el niño? ________________________________________________________________________________________________ 9

Commonly Asked Questions Preguntas Más Frecuentes 1)

What is a Power of Attorney? A Power of Attorney is a document that allows you to give someone else the authority to care for and make decisions about your child or children.

¿Qué es un Poder Legal? Un Poder Legal, también conocido como un Poder Legal o Carta Poder, es un documento que te permite darle la autoridad para cuidar y tomar decisiones sobre su hijo o hijos a otra persona. When is a Power of Attorney applicable? Alternative caregiving arrangements are triggered when a caregiver has become or may become unable to provide care to a child. Some examples include illness, incapacitation, immigration enforcement, incarceration, or military deployment.

¿Cuándo se aplica un Poder Legal o Carta Poder? Los arreglos alternativos de cuidado se activan cuando un cuidador se ha convertido en o puede llegar a ser incapaz de proporcionar atención a un niño. Algunos ejemplos incluyen enfermedad, incapacidad, aplicación de la ley de inmigración, encarcelamiento o despliegue militar.

Do I need to complete a separate form for each of my children? YES

¿Necesito completar un formulario separado para cada uno de mis hijos(as)? SÍ In the Power of Attorney, what is the person who would get the authority to care for my child or children called? An “Attorney-in-Fact” 1

En el Poder Legal o Carta Poder, ¿Cómo se llama la persona que obtendría la autoridad para cuidar a mi hijo o hijos? Un "Apoderado Legal" o “Un Abogado de Hecho”

Does the “Attorney-in-Fact” have to be an attorney? Does the “Attorney-inFact” have to be a person with legal immigration status? NO – An “Attorney-in-Fact” does not have to be an attorney. You can appoint any adult (18 years of age or over) whom you trust and with whom your child or children would feel comfortable. It is preferable to appoint someone with legal immigration status, but it is not necessary. ¿El "Apoderado Legal" tiene que ser un abogado? ¿El "Apoderado Legal" tiene que ser una persona con algún estatus migratorio legal? NO – Un "Apoderado Legal" no tiene que ser un abogado. Puede designar a cualquier adulto (18 años de edad o más) en quien confíe y con quien su hijo se sienta cómodo. Es preferible escoger a alguien con estatus migratorio legal, pero no es necesario.

What can an “Attorney-in-Fact” do? The Power of Attorney allows you to give someone else the authority to do the following: (1) care for and provide for your child, (2) make educational decisions, (3) make health care decisions, (4) approve and arrange for travel plans, (5) and handle any financial matters which may involve your child. You can specify which of these matters you wish to delegate. You can check some or all of them. However, if you want the person to be able to fully care for your child if you are not able to do so, then you should check off all of the specific matters.

¿Qué puede hacer un "Apoderado Legal"? El Poder Legal le permite otorgar a otra persona la autoridad para hacer lo siguiente: (1) cuidar y proveer a su hijo, (2) tomar decisiones educativas, (3) tomar decisiones de atención médica, (4) aprobar y organizar planes de viaje, (5) y manejar cualquier asunto financiero en el que su hijo pueda estar involucrado. Puede especificar cuál de estos asuntos desea delegar. Sin embargo, si desea que la persona pueda cuidar completamente a su hijo si usted no puede hacerlo, entonces debe marcar todos los asuntos específicos. 2

Does the Power of Attorney have to be signed by both parents? It is best if The Power of Attorney is signed by both parents. However, if that is not possible, you should still complete the form to the best of your ability. The form includes a section where one parent can explain why the other is not signing.

¿El Poder Legal tiene que ser firmado por ambos padres? Es mejor si El Poder Legal sea firmado por ambos padres. Sin embargo, si eso no es posible, aún debe completar el formulario lo mejor que pueda. El formulario incluye una sección donde uno de los padres puede explicar por qué el otro no está firmando. Does the Power of Attorney have to be witnessed? In order to ensure the validity of the Power of Attorney, it should be witnessed by two people. The person used to notarize the document cannot count as a witness. These people do not have to have any immigration status, but they should be over 18 years old. However, if you cannot find any adult to witness your signature, or can only find one adult, you should still complete the form to the best of your ability.

¿El Poder Legal tiene que ser presenciado? Para garantizar mayor validez del Poder Legal, debe tener dos testigos. La persona que notariza el documento no puede ser testigo. Los dos testigos no necesitan tener ningún estatus migratorio, pero deben ser mayores de 18 años. Sin embargo, si tiene un solo testigo o no puede encontrar ninguno, aún debe completar el formulario.

Does the Power of Attorney have to be notarized? In order to ensure the validity of the Power of Attorney, it should be notarized. However, if this is not possible, you should still complete the form to the best of your ability. A notary is someone appointed by a state government authorized to act as an impartial third party and witness signatures on documents. Getting someone to notarize a document should cost no more than $2.50, and in many cases will be free. Many banks and UPS stores have notaries on staff who will notarize documents for this small fee. Even some libraries have notaries on staff who can notarize 3

documents for free. In addition, any attorney in New Jersey is able to serve as a notary.

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¿El Poder Legal tiene que ser notariado? Para garantizar mayor validez del Poder Legal, debe de ser notariado Sin embargo, si no es posible, aún debe completar el formulario lo mejor que pueda. Un notario es una persona autorizada por el gobierno estatal para funcionar como una tercera parte imparcial para testificar las firmas en los documentos. Conseguir a alguien para notariar un documento no debe costar más de $2.50, y en muchos casos, será gratis. Muchos bancos y tiendas de UPS tienen notarios en el personal que harán este servicio por esta pequeña cuota. Hasta algunas bibliotecas tienen notarios en el personal que lo harán de forma gratuita. Además, cualquier abogado en el Estado de Nueva Jersey puede servir como notario.

Does the Attorney-in-Fact need to sign the Power of Attorney? NO ¿El NO

Apoderado

Legal

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Poder

Legal?

Can someone other than a parent initiate a Power of Attorney? YES – A person who has legal custody or guardianship can enter into a Power of Attorney. You should complete the form if you are concerned about who will care for the child or children in your care if you are unable to do so.

¿Puede alguien que no sea un padre iniciar un Poder Legal? SÍ – Una persona que tiene custodia legal o tutela puede entrar en un Poder Legal. Si le preocupa quién cuidará al niño en su cuidado si no puede hacerlo, debe completar el formulario.

If I am an ORR sponsor, can I initiate a Power of Attorney? IT DEPENDS– An ORR sponsor who is not a parent and who has no Family Court order authorizing him or her to care for the child cannot enter into a Power of Attorney. However, an ORR sponsor who goes to Family Court and becomes the child’s legal custodian or guardian can initiate a Power of Attorney. 4

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¿Si soy un patrocinador de ORR, puedo iniciar un Poder Legal? DEPENDE– Un patrocinador de ORR que no es un padre y que no tiene una orden de la Corte de Familia que autorice cuidar al niño no puede entrar en un Poder Legal. Sin embargo, un patrocinador de ORR que acude a la Corte de Familia y se convierte en el tutor legal o que gana la tutela del niño puede iniciar un Poder Legal.

Do I need to go to a lawyer to complete a Power of Attorney? NO – You do not need the assistance of an attorney to complete the Power of Attorney, but it may be helpful to consult a lawyer.

¿Necesito ir a un abogado para completar un Poder Legal? NO – Usted no necesita la ayuda de un abogado para completar el Poder Legal, pero puede ser útil consultar a un abogado.

For how long is the Power of Attorney in place? The Power of Attorney is good for one year, but it can be renewed. It may be extended for up to 6 months in extreme circumstances which make the caretaker unable to renew.

¿Por cuánto tiempo está vigente el Poder Legal? El Poder Legal es válido por un año, pero se puede renovar. Puede extenderse hasta seis meses en circunstancias extenuantes que hacen que el cuidador no pueda renovar.

Do I lose my authority as a parent if I enter into a Power of Attorney? NO – While a Power of Attorney is in place, both the parent(s) and the “Attorney-in-Fact” can make decisions on behalf of the child.

¿Pierdo mi autoridad como padre si entro en un Poder Legal? NO – Mientras exista un Poder Legal vigente, tanto los padres como el Apoderado Legal pueden tomar decisiones en nombre del niño.

How can I end a Power of Attorney? You can end (“revoke”) the Power of Attorney at any time. To revoke, you simply put in writing that you are revoking the Power of Attorney. It is 5

best if the revocation is witnessed and notarized just like the Power of Attorney, but this is not necessary.

You should give a copy of the revocation to the person you appointed as Attorney-in-Fact and try to get the original Power of Attorney back. It would also be a good idea to give a copy of the revocation to any individual or institutions such as doctors and schools who received a copy of the Power of Attorney. This is not necessary but is the best way to let people know that the Power of Attorney is no longer in effect.

¿Cómo puedo cancelar un Poder Legal? Puede finalizar ("revocar") el Poder Legal en cualquier momento. Para revocar, simplemente ponga por escrito que está revocando el Poder Legal. Es mejor si la revocación tiene dos testigos y es notariada al igual que el Poder Legal, pero no es necesario.

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Debe entregar una copia de la revocación a la persona que fue designada como Abogado de Hecho así como tratar de recuperar el Poder Legal Original. También sería una buena idea dar una copia de la revocación a cualquier persona o institución como un médico o una escuela que recibió una copia del Poder Legal. No es necesario, pero es la mejor manera de informar a las personas que el Poder Legal ya no está en vigor.

Once a Power of Attorney form is finalized, who should keep the original document? The Attorney-in-Fact should keep the original notarized document and the parent should keep a copy. It may also be useful to give copies to the children and other close family friends or relatives.

¿Una vez que se haya finalizado el Poder Legal, quién debe conservar el documento original? El Apoderado Legal debe conservar el documento notariado original y el padre debe conservar una copia. También puede ser útil dar copias a los niños y amigos cercanos de la familia o parientes. Will the Power of Attorney keep the Division of Child Protection and Permanency (“DCPP”) Child Welfare Officials from taking custody of my child? 6

The Power of Attorney shows that you made a plan for someone else to care for your child if you are unable to do so. However, if DCPP has concerns about the welfare of your child, it may still act to protect the child and take custody.

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¿Podrá el Poder Legal impedir que La División de Protección y Permanencia de la Niñez (“DCPP”) Oficiales de Bienestar Infantil tome custodia de mi hijo? El Poder legal muestra que usted hizo un plan para que otra persona cuidara de su niño en caso de que usted no pudiera. Sin embargo, si DCPP tiene preocupaciones sobre el bienestar de su hijo, aún puede actuar para protegerlo y tomar custodia.

Is this Power of Attorney good in other states? NO – This Power of Attorney is only good for New Jersey. Do not share it with family members in other states. If you have family members outside of New Jersey, they should look for similar documents in their home state.

¿Este Poder Legal es válido en otros estados? NO – Este Poder Legal sólo es bueno para Nueva Jersey. No lo comparta con sus familiares que residen en otros estados. Si tiene familiares fuera de Nueva Jersey, ellos deben buscar documentos similares en su estado de origen.

If my child is a U.S. Citizen should I get him or her a passport? YES – If possible, parents should get U.S. passports for their U.S. citizen children. It is difficult for anyone other than the parents to obtain a passport for a child. Therefore, you should get a passport for your child if you want to make sure the child can travel to another country (including any country to which you or other family members might return). The Power of Attorney allows you to authorize the Attorney-in-Fact to make travel arrangements and purchase airline tickets for the child, but the Attorney-in-Fact will probably not be able to get the child a passport.

¿Si mi hijo es un ciudadano estadounidense debo conseguirle un pasaporte? Sí – Cuando sea posible, los padres deben obtener pasaportes estadounidenses para sus hijos ciudadanos estadounidenses. Es difícil 7

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para cualquier persona que no sea un padre obtener un pasaporte para un niño. Por lo tanto, debe obtener un pasaporte para su hijo si desea asegurarse de que el niño pueda viajar a otro país (incluyendo cualquier otro país al cual usted u otros familiares puedan regresar). El Poder Legal le permite autorizar al Apoderado Legal hacer arreglos de viaje y comprar boletos de avión para el niño, pero el Apoderado Legal probablemente no será capaz de obtenerle un pasaporte al niño.

How can I get a U.S. Passport for my child? You can get a passport at the Post Office and other places that advertise that they accept passport applications. For information on how to get a passport for a child under 16 years of age, please go to this website: https://travel.state.gov/content/passports/en/passports/under-16.html

¿Cómo puedo obtener un pasaporte estadounidense para mi hijo? Puede obtener un pasaporte en la oficina de correos y en otros lugares que anuncian que aceptan solicitudes de pasaporte. Para obtener información sobre cómo obtener un pasaporte para un niño menor de 16 años de edad, por favor visite este enlace: https://travel.state.gov/content/passports/en/passports/under-16.html

What are the necessary steps to get a passport? 1. Fill out Form DS-11 2. Provide Proof of U.S. Citizenship (e.g. U.S. Birth Certificate) 3. Bring a Photocopy of the front and back of the Proof of U.S. Citizenship 4. Show Parental Relationship (e.g. U.S. Birth Certificate, Adoption, Divorce, or Custody decree) 5. Present your own ID (a current foreign passport is acceptable) 6. Bring a Photocopy of the front and back of your ID 7. Show Parental Consent (Both parents must consent unless one parent has sole legal custody. It is best if both go to the passport office. If this is not possible, a parent can consent by completing Form DS-3053. If a parent cannot be located, then form DS-5525 should be submitted) 8. Provide a 2x2” Portrait Photo of the Child 9. Pay the fees (The total is usually $110+) 8

10. Submit Your Completed Application 11. Track your application: https://travel.state.gov/content/travel/en/passports/needpassp ort/status.html

¿Cuáles son los pasos necesarios para obtener un pasaporte? 1. Llene el formulario DS-11 2. Proporcione prueba de la ciudadanía estadounidense del niño (por ejemplo, Certificado de Nacimiento de los EE. UU.) 3. Traiga una fotocopia de los dos lados de la prueba de Ciudadanía de los EE. UU. 4. Demuestre una Relación Parental (Certificado de Nacimiento de los Estados Unidos, decreto de adopción, decreto de divorcio/custodia) 5. Presente su propia identificación (se acepta un pasaporte extranjero vigente) 6. Traiga una fotocopia de los dos lados de su identificación 7. Demuestre el consentimiento de los padres (ambos padres deben dar su consentimiento a menos que uno de los padres tenga la custodia legal exclusiva. Lo mejor es que ambos padres vayan a la oficina de pasaportes. Si no es posible, un padre puede dar su consentimiento a través del Formulario DS-3053. Si uno de los padres no puede ser localizado, entonces el Formulario DS-5525 debe ser presentado.) 8. Proporcione una foto de retrato 2x2” del niño. 9. Pague los honorarios (el total es generalmente $110+) 10. Envíe la solicitud completada. 11. Realice un seguimiento de su aplicación: https://travel.state.gov/content/travel/en/passports/needpassport/sta tus.html

DURABLE GENERAL POWER OF ATTORNEY OF [NAME] (Financial) PODER GENERAL DE DURACIÓN INDEFINIDA DE [NOMBRE] (Financiero) I, _____________, residing at _________________, County of ____, State of New Jersey, hereby make, constitute and appoint _______________, as my true and lawful attorneyin-fact. Yo, _____________, con domicilio real en _________________, Condado de ____, Estado de Nueva Jersey, por medio del presente designo e instituyo a _______________ como mi apoderado verdadero y legítimo. AUTHORITY OF ATTORNEY-IN-FACT AUTORIDAD DEL APODERADO My attorney-in-fact, including any successor attorney-in-fact acting hereunder, shall have all rights, power and authority to act in, manage and conduct all of my estate and affairs, and for that purpose for me and in my name, place and stead, and for my use and benefit, and as my act and deed, to do and execute, or to concur with persons jointly interested with myself therein in the doing or executing of, all or any acts, deeds and things that I might do if personally present and acting, including, without limiting the generality of the foregoing, the right, power and authority in the sole discretion of my attorneys-in-fact, as follows: Mi apoderado, que incluye a cualquier sucesor del apoderado que actúe en virtud del presente, tendrá todos los derechos, facultades y autoridad para actuar en, administrar y manejar todo mi patrimonio y mis asuntos y, para tal fin por mí y en mi nombre y representación, y para mi uso y beneficio, como si se tratara de un acto propio de mi parte, para hacer y otorgar o para actuar en forma solidaria con otras personas interesadas junto conmigo para hacer u otorgar, todos los actos, documentos y cosas que yo podría hacer u otorgar si estuviera personalmente presente y si pudiera actuar, incluidos, sin limitar la generalidad de lo antes expuesto, el derecho, la facultad y la autoridad, a exclusiva discreción de mi apoderado, de realizar todo lo expuesto a continuación: 1. Banking Transactions. To conduct banking transactions as set forth in Section 2 of P. L. 1991, c.95 (C. 46:2B-11) of the laws of the State of New Jersey, as amended from jurisdiction in which I may have a bank account, and including but not limited to the power to make deposits or investments in, or withdrawals from, any account, holding or interest which I may now or hereafter have, or to which I may be entitled, in my name individually or jointly with another, in any banking, trust, investment or other financial institution; to exercise any right, option or privilege pertaining thereto; and to open or establish accounts, holdings or interests of whatever kind or nature with any such institution, in my name or in the name of my attorneys-infact; 1. Transacciones bancarias. Realizar transacciones bancarias tal como se establece en la Sección 2 de P. L. 1991, c.95 (C. 46:2B-11) de las leyes del Estado de Nueva Jersey, y sus

modificatorias, de la jurisdicción donde yo tenga cuenta bancaria, incluida, entre otras cosas, la facultad para hacer depósitos o inversiones en y retiros de fondos de cualquier cuenta, tenencias o intereses que yo pueda tener actualmente o en el futuro, o a los que pueda tener derecho, en mi nombre individualmente o en forma solidaria con otro, en cualquier banco, institución fiduciaria, de inversión o en otra entidad financiera; ejercer cualquier derecho, opción o privilegio perteneciente e éstos y abrir o crear cuentas, tenencias o intereses de cualquier tipo o naturaleza con dicha entidad, en mi nombre o en nombre de mis apoderados; 2. Investments. To invest, keep invested, and from time to time to change the investment or to reinvest the whole or any portion of my securities and other personal property in any form of investment, real or personal; to exercise all of the rights of ownership, including instructions as to the sale or other disposition thereof, over any securities or other personal investments owned by me; and to incur and pay for the cost of custodial and investment advisory services; 2. Inversiones. Invertir, mantener inversiones y, periódicamente, modificar inversiones o reinvertir la totalidad o una parte de mis títulos valores y demás bienes muebles en cualquier tipo de inversión, mueble o inmueble; ejercer todos los derechos de titularidad, que comprenden instrucciones de venta o de otro acto de disposición, sobre cualesquiera títulos valores u otras inversiones personales bajo mi titularidad; e incurrir y pagar el costo de servicios de asesoramiento de depósito e inversión de bienes; 3. Transfers. To transfer all cash, bank deposits, certificates of deposit, stocks, bonds and other cash, cash equivalents and securities of whatever nature; 3. Transferencias. Transferir todo el dinero en efectivo, depósitos bancarios, certificados de depósito, acciones, bonos y demás dinero en efectivo, equivalencias de efectivo y títulos valores de cualquier naturaleza; 4. Receipt of Property. To receive, receipt for and deposit or otherwise dispose of any debts, funds or claims payable to me, including, without limitation, interest, dividends, legacies and governmental benefits; 4. Recepción de bienes. Recibir, recibir y depositar o de otra manera disponer de deudas, fondos o créditos pagaderos a mi nombre, incluidos, entre otros, intereses, dividendos, legados y beneficios gubernamentales; 5. Borrowing and Security. To borrow money on my behalf and to mortgage, pledge or create liens upon any of my property or any interest therein as security therefore; 5. Pedido de préstamos y garantías. Pedir dinero en préstamo en mi nombre y constituir hipotecas, prendas o derechos de retención sobre cualesquiera de mis bienes y sobre cualquier derecho de propiedad sobre mis bienes en garantía de éstos;

6. Voting Rights. To vote at all meetings of any entity in which I may have an interest, whether incorporated, unincorporated or otherwise, to sign proxy statements or forms in my name, and otherwise to act as my attorneys-in-fact or proxy in respect of my shares of stock or other securities or investments which now or hereafter shall belong to me, notwithstanding that my attorneys-in-fact may have conflict of interest in connection therewith; 6. Derechos de voto. Votar en todas las asambleas de cualquier entidad en la que pueda tener un interés, ya sea incorporada, no incorporada o de otro tipo, firmar informes o formularios para los accionistas en mi nombre, y de otra manera actuar como mi apoderado con respecto a mis acciones o a otros títulos o inversiones que pueda poseer actualmente o en el futuro, sin perjuicio de que mi apoderado pueda tener un conflicto de interés con relación a dichas acciones, títulos o inversiones; 7. Options. To sell or exercise stock subscription or conversion rights of any kind (including, without limitation, stock options); 7. Opciones. Vender o ejercer derechos de suscripción o conversión de acciones de cualquier tipo (incluidas, entre otras, opciones); 8. Safe Deposit Boxes. To establish and enter into any safe deposit box standing in my name individually or jointly with another, to withdraw any and all property therefrom and to deposit any property therein, and to close out and surrender any such safe deposit box; 8. Cajas de seguridad. Abrir e ingresar a cualquier caja de seguridad que esté a mi nombre, individualmente o en forma solidaria con otro, para retirar los bienes de dicha caja y para depositar bienes en dicha caja, y cerrar y restituir dicha caja de seguridad; 9. Management of Property. To manage all my property, real personal and mixed, including but not limited to the authority to (a) pay all carrying charges (including, inter alia, taxes, insurance, utilities, mortgage interest and principal amortization payments, and the cost of repairs) in connection with such property, (b) authorize repairs and improvements to the property, (c) enter into leases on my behalf and collect rents from tenants, (d) eject, remove or relieve tenants or other persons from the property and to establish reasonable regulations in connection with tenants’ occupancy and enjoyment of the property, if applicable, (e) apply to the appropriate municipality for farmland assessment qualification with respect to that portion of the property, if any, devoted to agriculture or horticultural use, and (f) subdivide and develop any said property; 9. Administración de bienes. Administrar todos mis bienes, inmuebles y mixtos, incluidos, entre otros, la autoridad para (a) pagar todos los gastos de mantenimiento (incluidos, entre otros, impuestos, seguros, servicios públicos, intereses hipotecarios y pagos de amortización de capital y el costo de reparaciones) con relación a dichos bienes, (b) autorizar reparaciones y mejoras a los bienes, (c) firmar contratos de arrendamiento en mi nombre y

cobrar alquileres a inquilinos, (d) desalojar, retirar o liberar inquilinos u otras personas de la propiedad y establecer reglamentos razonables con relación a la tenencia y disfrute de la propiedad por parte de los locatarios, si corresponde, (e) solicitar a la municipalidad correspondiente para la calificación de evaluación de tierras agrícolas con respecto a aquella parte de la propiedad, si la hubiera, dedicada a uso agrícola u hortícola, y (f) subdividir y desarrollar dichas propiedades; 10. Real Estate. To purchase, lease, sell, convey, mortgage, grant easements and rights of way, or otherwise encumber or dispose of, or contract or agree for the purchase, lease, sale, mortgage or other disposition of any real estate, or any interest in real estate, which I may own, including but not limited to the authority to (a) negotiate the price and all other terms and conditions of the purchase, lease or sale, (b) execute a contract of purchase, lease or sale, (c) execute all documents, including note and mortgage, deed, affidavit of title, closing statement and other documents, necessary to effectuate said transaction, and (d) generally to do and perform any and all other acts relating to the purchase, lease or sale of real estate; 10. Bienes inmuebles. Comprar, alquilar, vender, transferir, hipotecar, otorgar servidumbres y derechos de paso, o gravar o disponer de otra manera de, o contratar o acordar la compra, venta, hipoteca u otro acto de disposición de cualquier bien inmueble, o de cualquier derecho de propiedad inmueble, del que yo pueda ser titular, incluida, entre otras, la autoridad para (a) negociar el precio y todos los demás términos y condiciones de la compra, alquiler o venta, (b) firmar contratos de compra, alquiler o venta, (c) firmar todos los documentos, entre ellos, pagarés e hipotecas, escrituras, declaraciones juradas de títulos, declaraciones finales y demás documentos, necesarios para efectivizar dicha transacción y (d) en general hacer y realizar todos los demás actos relacionados con la compra, el alquiler o la venta de bienes inmuebles; 11. Personal Property. To purchase, sell or otherwise exchange, either at public or private sale, for such consideration and upon such terms as my attorneys-in-fact shall deem advisable, including but not limited to the authority to (a) give good and effectual receipts for all or any part of the purchase price or other consideration, and (b) apply for, or endorse for sale or transfer, any certificate of title with respect to any motor vehicle, boat or airplane, and represent in any transfer or assignment that title to a motor vehicle, boat or aircraft is free and clear of all liens and encumbrances except those specifically set forth in such transfer or assignment; 11. Bienes muebles. Comprar, vender o permutar de otro modo, en venta pública o privada, a cambio de una contraprestación y en los términos que mis apoderados lo consideren aconsejable, incluida, entre otras, la autoridad para (a) dar recibo suficiente por la totalidad o parte del precio de compra o por otra contraprestación recibida y (b) solicitar o endosar para la venta o transferencia, cualquier certificado o título con respecto a un vehículo automotor, barco o aeronave, y declarar en cualquier transferencia o cesión que ese título sobre un vehículo

automotor, barco o aeronave está libre de todo gravamen y derecho de retención, excepto de aquellos específicamente establecidos en dicha transferencia o cesión; 12. Conduct of Business. To operate, manage, conduct and otherwise deal with any business or business interest which I may own, whether such business is conducted as a sole proprietorship, partnership, limited liability company, corporation or otherwise, as my attorneysin-fact may deem advisable; 12. Gestión de negocios. Operar, administrar, llevar adelante o de otra manera manejar cualquier negocio o participación en un negocio del que yo pueda ser titular, ya sea que dicho negocio sea operado como sociedad unipersonal, sociedad colectiva, sociedad de responsabilidad limitada, corporación o de otra manera, de acuerdo a lo que mis apoderados puedan considerar aconsejable; 13. Partnership Interests. To act on my behalf as a partner of any partnership or partnership association, or as general or limited partner of any limited partnership, in which I may have an interest, and to participate in its affairs, including but not limited to, the dissolution thereof; 13. Derechos societarios. Actuar en mi nombre en carácter de socio de cualquier sociedad colectiva o de personas, o en carácter de socio comanditado o comanditario de una sociedad de responsabilidad limitada en la que yo pueda tener una participación, y participar en sus asuntos, incluida, entre otras cosas, en la disolución de dicha sociedad; 14. Employment and Retirement Benefits. To receive, collect, roll over and otherwise deal with any benefits to which I may be entitled under any pension, profit-sharing, individual retirement account, or any other retirement plan as my attorneys-in-fact may deem advisable; 14. Relación laboral y beneficios de retiro. Recibir, cobrar, transferir o manejar de otra manera beneficios a los que yo pueda tener derecho en virtud de un plan de jubilación, participación en las utilidades, cuenta de jubilación individual o en cualquier otro programa de retiro que mis apoderados puedan considerar aconsejable; 15. Business Agreements. To enter into any buy-sell, shareholders’ or partnership agreement as my attorneys-in-fact may deem advisable; 15. Contratos comerciales. Entrar en cualquier contrato de compraventa, acuerdo de accionistas y contrato societario que mis apoderados puedan considerar aconsejable; 16. Insurance Policies and Benefits. To exercise any right, benefit, option or privilege granted by any policy of insurance, including but not limited to the authority to (a) continue any policy as paid up insurance, (b) surrender any policy for cash, (c) convert any policy to paid up insurance, (d) apply dividends in payment of premiums or in the purchase of paid up additional insurance, (e) allow dividends to accumulate in the hands of the insurance company until such

policies become fully paid, (f) borrow against any policy, (g) increase the amount of insurance carried, (h) extend the term of any policy, (i) make, file and settle proofs of claim under any policy or for compensation or benefits of any character, (j) apply for reinstatement of any lapsed life insurance policy, and (k) make loans or apply for advances for the purpose of payment of premiums thereon or for any other purpose; 16. Pólizas de seguro y beneficios. Ejercer cualquier derecho, beneficio, opción o privilegio otorgado por cualquier póliza de seguro, incluida, entre otras cosas, la autoridad para (a) prorrogar cualquier póliza como seguro pagadas, (b) entregar una póliza a cambio de dinero en efectivo, (c) convertir una póliza en seguro pagadas, (d) aplicar dividendos al pago de primas o a la compra de seguro adicional con primas pagadas, (e) permitir que se devenguen dividendos a favor de la compañía de seguro hasta que la póliza quede totalmente pagadas, (f) pedir dinero en préstamo sobre cualquier póliza, (g) aumentar el monto del seguro, (h) prorrogar el plazo de la póliza, (i) hacer, presentar y liquidar reclamos en virtud de cualquier póliza o a cambio de compensación o beneficios de cualquier tipo, (j) solicitar la reposición de una póliza de seguro de vida vencida y (k) otorgar préstamos o solicitar adelantos a los fines del pago de primas de pólizas o para cualquier otro fin; 17. Tax Obligations. To prepare, execute on my behalf, and file any federal, state, foreign and local gift, income and other tax return, claims for refund covering all or a portion of any taxes paid and all other governmental reports, declarations, applications, requests and documents in connection with any such taxes; 17. Obligaciones impositivas. Elaborar, firmar en mi nombre y presentar declaraciones de impuestos federales, estatales, extranjeros y locales a las donaciones, a las ganancias y de otra naturaleza, reclamar reembolsos sobre la totalidad o parte de impuestos pagados, y preparar todos los demás informes, declaraciones, solicitudes, pedidos y documentos relacionados con dichos impuestos; 18. Tax Proceedings. To represent me and appear on my behalf before the United States Government or any foreign, state or local government or any department, bureau, or other subdivision or representative thereof, in connection with any matter involving federal, foreign, state or local gift, income or other taxes for any year, with full authority to act on my behalf in all matters, including but not limited to the authority to (a) receive refund checks, (b) execute waivers of any statute of limitations or other relevant time periods, (c) execute closing agreements, and (d) engage legal counsel or accountants to represent me in connection therewith, with full power of substitution and revocation at any time; 18. Procesos tributarios. Representarme y comparecer en mi nombre ante el Gobierno de los Estados Unidos o ante cualquier gobierno extranjero, estatal o local o ante cualquier departamento, oficina u otra subdivisión o representación de dicho gobierno, con relación a cualquier asunto relacionado con impuestos federales, extranjeros, estatales o locales

a las donaciones, a las ganancias o de otra naturaleza correspondientes a cualquier año fiscal, con plena autoridad para actuar en mi nombre en todos los asuntos, incluida, entre otras cosas, la autoridad para (a) recibir cheques de reembolso, (b) firmar renuncias a prescripción o a otros plazos pertinentes, (c) firmar acuerdos de cierre y (d) contratar abogados o contadores para representarme con relación a éstos, con plena facultad de sustitución y revocación en cualquier momento; 19. Legal and Other Proceedings. To institute, defend, prosecute, compromise, arbitrate and dispose of all legal, equitable and administrative claims, actions, suits, attachments, distresses or other proceedings, and to otherwise engage in litigation in connection with the protection or preservation of my rights or property; 19. Procesos legales y de otra naturaleza. Iniciar, proveer a la defensa de, perseguir, conciliar, arbitrar y disponer de todos los reclamos, acciones, demandas, embargos, secuestros u otros procedimientos, y participar de otro modo en acciones judiciales relacionadas con la protección o conservación de mis derechos o bienes; 20. Gifts. To make gifts of my property, whether real, personal or mixed, in my name and on my behalf, from any source, to any person my attorneys-in-fact may deem advisable, including but not limited to, a custodian for any person under the Uniform Transfers to Minor Act, a trust for the benefit of any person, and any charitable organization, provided that (i) any such gifts are consistent with prior practice, or (ii) any such gifts shall not be in excess of the amount allowable from time to time as a present interest exclusion under Section 2503 (b) of the Code; and to the extent permitted by law, to exercise any power of appointment in my name or my behalf; 20. Donaciones. Hacer donaciones de mis bienes, inmuebles, muebles o mixtos, en mi nombre o en mi nombre y representación, de cualquier origen, a cualquier persona que mis apoderados consideren aconsejable, incluido, entre otros, un tutor de cualquier persona en virtud de la Ley Uniforme de Transferencias a Menores de los Estados Unidos, un administrador fiduciario en beneficio de cualquier persona y cualquier institución benéfica, con la condición de que (i) dichas donaciones sean coherentes con las acciones previas realizadas o (ii) dichas donaciones no superen el monto permitido periódicamente en concepto de exclusión de intereses actuales en virtud de la Sección 2503 (b) del Código de los Estados Unidos; y en la medida permitida por ley, para ejercer cualquier facultad de designación en mi nombre o representación; 21. Employment Powers of Agents. To engage and dismiss agents, accountants, investment advisors, legal counsel and employees, including but not limited to, secretarial and bookkeeping personnel, and to appoint and remove from time to time any substitute for, or agent of, my said attorneys-in-fact upon such terms as my attorneys-in-fact shall deem advisable;

21. Facultades de contratación de empleados de los apoderados. Contratar y despedir representantes, contadores, asesores de inversión, abogados y empleados, incluidos, entre otros, secretarios y personal contable, y designar y remover periódicamente a cualquier suplente o representante de mis apoderados en los términos y condiciones que mis apoderados consideren aconsejable; 22. Fiduciary Positions and Offices. To renounce or effect my resignation from any position to which I have been or may be appointed or elected, including but not limited to, personal representative, trustee, conservator, guardian, attorney-in-fact, or other fiduciary position, officer or director of any corporation or other form of business enterprise, and any governmental, political or other office or position, and to take all actions deemed advisable by my said attorneys-in-fact in connection therewith, including but not limited to authority to render and file an account with a court of competent jurisdiction or settle an account on a receipt and release or such other nonjudicial means; 22. Puestos y cargos fiduciarios. Renunciar o efectivizar mi renuncia a cualquier cargo al que haya sido asignado o para el que haya sido elegido, incluidos, entre otros, el de representante personal, administrador fiduciario, conservadora, tutor, apoderado, o cualquier otro cargo fiduciario, o de funcionario o directo de una sociedad o de otra empresa comercial, y a cualquier otro cargo o puesto gubernamental, político o de otra naturaleza, y realizar todas las acciones que mis apoderados consideren aconsejables con relación a dichos cargos o puestos, incluida, entre otras, la autoridad para rendir y presentar cuentas ante un tribunal competente o liquidar una cuenta en base a un recibo y exención de compromiso o por otra vía extrajudicial; 23. Renunciation, Disclaimer, Release and Abandonment. To renounce and disclaim, either in whole or in part, any property or any interest in property, or any power to which I may become entitled for any reason, whether by gift, inheritance or other means; to release or abandon any property or any interest in property or any power to which I may now or hereafter become entitled, including but not limited to, an interest in or right over any trust, and in making any such determination my attorneys-in-fact may take into account all relevant circumstances, including but not limited to, any prospective reduction in estate or inheritance taxes on my estate, and the effect of any such renunciation or disclaimer upon persons interested in my estate and persons who would receive such property; 23. Renuncia, exoneración de responsabilidad, remisión y abandono. Renunciar y liberar de toda responsabilidad, en todo o en parte, por cualquier bien o derecho de propiedad, o por cualquier facultad a la que pueda tener derecho por cualquier motivo, ya sea por donación, herencia u otra vía; liberar o abandonar bienes o derechos sobre bienes o cualquier facultad a la que pueda tener derecho actualmente o en el futuro, incluido, entre otros, un interés o derecho sobre un fideicomiso, y al tomar esta determinación mis apoderados podrán tomar en cuenta todas las circunstancias pertinentes, incluidas, entre otras, cualquier reducción

futura de impuestos sucesorios o hereditarios sobre mi acervo hereditario, y el efecto de dicha renuncia o liberación sobre las personas interesadas en mi sucesión y sobre las personas que tendrían derecho a recibir dichos bienes; 24. Dower, Curtesy and Elective Share. To exercise, renounce or release any dower, curtesy, statutory or other right, title or interest in any lands, tenements or hereditaments; and to exercise, renounce or release any right to claim an elective share in any estate or under any will; 24. Dote, usufructo viudal y parte legítima. Ejercer, renunciar o liberar cualquier dote, usufructo viudal, derecho legal o de otra naturaleza, título o derecho de participación en cualquier terreno, propiedad o bienes heredables; y ejercer, renunciar o liberar cualquier derecho a reclamar una parte legítima en cualquier sucesión o en virtud de cualquier testamento; 25. Trust Agreements. To enter into a living trust agreement, whether or not such trust may extend beyond my life, and from time to time, to transfer to any such trust any and all assets, real, personal or mixed, to withdraw any property transferred to such trust, whether real, personal or mixed, and to alter, amend, modify, revoke, or terminate such trust agreement for me and on my behalf, whether as grantor or otherwise; 25. Fideicomisos. Entrar en un fideicomiso entre vivos, ya sea que dicho fideicomiso tenga validez después de mi muerte o no y, periódicamente, transferir a dicho fideicomiso todos y cada uno de los activos, inmuebles, muebles o mixtos, retirar cualquier bien transferido a dicho fideicomiso, ya sea inmueble, mueble o mixto, y cambiar, enmendar, modificar, revocar o rescindir dicho fideicomiso por mí o en mi nombre, ya sea en calidad de fideicomitente o en otro carácter; 26. Execution of Documents. To execute all agreements, assignments, bills of sale, contracts, deeds, notes, mortgages, receipts, stock and bond powers, and any other document, in my name or on my behalf; 26. Otorgamiento de documentos. Firmar todos los acuerdos, cesiones, contratos de compraventa, contratos, escrituras, pagarés, hipotecas, recibos, derechos sobre acciones y bonos y cualquier otro documento, en mi nombre o representación; 27. Access to Electronic Documents. To control of, conduct, continue, or terminate any of my accounts on any social networking website, any microblogging or short message service website, any e-mail service website, or any website that maintains my personal identifiable information including but not limited to my name, social security number, address, image, or financial information. 27. Acceso a documentos electrónicos. Controlar, administrar, mantener o cerrar cualquiera de mis cuentas en cualquier red social, blog o sitio de Internet que tenga servicio de

mensajes cortos, cualquier sitio de Internet que tenga servicio de correo electrónico o cualquier sitio de Internet que mantenga mi información de identificación personal, incluidos, entre otros, mi nombre, mi número de seguro social, mi dirección, mi imagen o mi información financiera. 28. Living Arrangements. To do all acts necessary for maintaining my customary standard of living, including but not limited to the authority to (a) provide living accommodations by purchase, lease or other arrangement, or by paying the costs of my existing living accommodations, (b) provide domestic help for the operation of my household, (c) provide food, clothing, medicine, transportation and incidentals, (d) make all necessary arrangements, contractual or otherwise, for me and on my behalf at any nursing home, convalescent home, hospice or other continuing care facility, or in my residence, as my attorneys-in-fact may deem advisable, and (e) provide and pay for all my essential needs and living expenses of every kind and character. 28. Arreglos de medio de vida. Realizar todos los actos que sean necesarios para mantener mi nivel de vida acostumbrado, incluida, entre otras cosas, la autoridad para (a) proporcionar alojamiento mediante compra, alquiler o por otro acuerdo, o mediante el pago de los costos de mi alojamiento existente, (b) proveer ayuda doméstica para el funcionamiento de mi hogar, (c) proporcionar comida, ropa, medicamentos, transporte y cubrir imprevistos, (d) hacer todas las gestiones necesarias, contractuales o de otra naturaleza, para mí y en mi nombre, en cualquier asilo de ancianos, casa de convalecencia, hospicio u otra comunidad para adultos mayores con asistencia continua, o en mi residencia, que mis apoderados puedan considerar aconsejable y (e) proveer y pagar todas mis necesidades esenciales y gastos fijos de todo tipo y carácter. APPOINTMENT OF SUCCESSOR ATTORNEYS-IN-FACT DESIGNACIÓN DE APODERADOS SUCESORES If all of the above named attorneys-in-fact are unwilling or unable to serve, then I nominate, constitute and appoint ___________________, as my attorney-in-fact. In addition, I authorize and empower the last surviving attorney-in-fact named herein, and any successor attorney-in-fact, to designate and appoint a successor attorney-in-fact, who shall have all of the rights, powers and authority as if originally named by me, including the power to designate and appoint a successor attorney-in-fact. Si todos los apoderados arriba mencionados no quieren o no pueden desempeñarse, entonces yo nombro, instituyo y designo a ___________________, como mi apoderado. Además, autorizo y faculto al último apoderado supérstite nombrado en el presente, y a cualquier apoderado que lo suceda, para que nombre y designe un apoderado sucesor, quien tendrá todos los derechos, facultades y autoridad como si hubiera sido nombrado originalmente por mí, incluso la facultad para nombrar y designar un apoderado sucesor.

RELIANCE ON AUTHORITY CONFIANZA EN LA AUTORIDAD DEL APODERADO Anyone dealing with my attorneys-in-fact, including any surviving attorney-in-fact or successor attorney-in-fact appointed pursuant to the terms of this Power of Attorney, may rely upon the authority of such persons to act hereunder and shall be fully protected without investigation or inquiry into the death of any prior named attorney-in-fact, or the inability or unwillingness of any prior named attorney-in-fact to act hereunder. Cualquier persona que trate con mis apoderados, incluido cualquier apoderado supérstite o apoderado sucesor designado de acuerdo con los términos y condiciones del presente Poder, podrá confiar en la autoridad de dichas personas para actuar en virtud del presente y tendrá la protección total sin investigación ni indagación respecto de la muerte de cualquier apoderado anteriormente designado, o de la incapacidad o falta de voluntad de cualquier apoderado anteriormente designado para actuar en virtud del presente. POWER OF ATTORNEY NOT AFFECTED BY DISABILITY OR LAPSE OF TIME PODER NO AFECTADO POR DISCAPACIDAD NI POR EL PASO DEL TIEMPO This Power of Attorney shall not be affected by any disability or incapacity of mine suffered subsequent to the date hereof or the mere lapse of time. El presente Poder no se verá afectado por discapacidad o incapacidad mía posterior a la fecha del presente o por el mero paso del tiempo. BINDING EFFECT EFECTO VINCULANTE Any act or thing done by my attorneys-in-fact in my name or on my behalf shall be binding on all persons, whether the same shall have been done before or after my death or other termination or revocation of this Power of Attorney, unless and until my said attorneys-in-fact shall receive actual notice of my death or written revocation of this Power of Attorney. The rights, powers and authority conferred upon my attorneys-in-fact shall continue in full force and effect until the same is terminated or revoked, and written notice of such termination or revocation shall be delivered to my attorneys-in-fact. Cualquier acto o cosa hecho por mis apoderados en mi nombre o representación será vinculante para todas las personas, ya sea que haya sido hecho antes o después de mi muerte o antes o después de otra rescisión o revocación de este Poder, a menos que y hasta tanto mis apoderados reciban notificación efectiva de mi muerte o revocación escrita de este Poder. Los derechos, facultades y autoridad conferidos a mis apoderados continuarán teniendo plena

vigencia y produciendo todos sus efectos hasta que dicho Poder sea rescindido o revocado, y hasta que se entregue notificación escrita de dicha rescisión o revocación a mis apoderados. INDEMINIFICATION INDEMNIZACIÓN I agree, on my behalf and on behalf of my executors, administrators and assigns, to indemnify and hold my attorneys-in-fact and any persons dealing with my said attorneys-in-fact harmless from any loss, claim, demand or liability resulting from or arising out of any act or omission when made in good faith and in reliance upon this Power of Attorney. Acepto, en mi nombre y en nombre de mis albaceas, administradores y cesionarios, indemnizar y mantener indemnes a mis apoderados y a las personas que traten con mis apoderados por cualquier pérdida, reclamo, demanda o pasivo que resulte o que surja de cualquier acto u omisión de buena fe y en base a lo dispuesto en este Poder. REVOCATION REVOCACIÓN This Power of Attorney may be revoked by me, in whole or in part, at any time by written instrument, duly executed and acknowledged by me, and delivered to my said attorneys-in-fact. Este Poder podrá ser revocado por mí, en todo o en parte, en cualquier momento mediante documento escrito, debidamente otorgado y reconocido por mí, y entregado a mis apoderados. PROTECTIVE PROCEEDINGS PROCESO DE PROTECCIÓN If protective proceedings are commenced for me or on my behalf or on behalf of my estate, I nominate and appoint my attorneys-in-fact acting hereunder as my guardian, conservator, or other representative, and I request that due regard for this wish be given by any court of competent jurisdiction or other tribunal in any such proceedings. Si se inicia por mi o en mi nombre o en representación de mi sucesión un proceso de protección, nombro y designo a mis apoderados para que actúen en virtud del presente en carácter de tutor, albacea u otro representante, y solicito que cualquier tribunal competente u otro tribunal que actúe en dicho proceso tenga debida cuenta de este deseo personal aquí expresado. RELIANCE ON COPIES COPIAS AUTÉNTICAS

Any person dealing with my attorneys-in-fact may rely upon a duly executed copy or counterpart of this instrument, or a duplicate copy certified by my attorneys-in-fact to be a true copy of the original hereof, as fully and completely as if such person had received the original executed copy of this instrument. Cualquier persona que trate con mis apoderados podrá basarse en la copia o ejemplar debidamente firmado de este documento, o en un duplicado certificado por mis apoderados como copia auténtica del original del presente, con la misma validez que si dicha persona hubiera recibido la copia original firmada del presente documento.

IN WITNESS WHEREOF, I have hereunto set my hand and seal this _____th day of ____ 2025 EN PRUEBA DE CONFORMIDAD, he firmado y sellado el presente a los _____días del mes de ____ de 2025 __________________________________________ [CLIENT NAME] __________________________________________ [NOMBRE DEL CLIENTE] Signed, sealed and delivered in the presence of: Firmado, sellado y entregado en presencia de:

Witness Testigo Witness Testigo

State of New Jersey

) )

County of

)

Estado de Nueva Jersey

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Condado de

SS.:

)

BE IT REMEMBERED, that on this ____th day of _____________ 2025 , before me, the subscriber, a Notary Public of the State of New Jersey, personally appeared __[client name]____, who I am satisfied, is the person named in the within Power of Attorney and I having first made known to said person the contents thereof, said person did thereupon acknowledge that the within Power of Attorney is signed, sealed and delivered as and for said person’s voluntary act and deed for the uses and purposes therein expressed. TÉNGASE PRESENTE que, a los ____ días del mes de _____________ 2025, por ante mí, Notario Público del Estado de Nueva Jersey, compareció personalmente __[nombre del cliente]____, quien, doy fe, es la persona mencionada en este Poder y, después de leerle el contenido del presente, dicha persona reconoció que este Poder fue firmado, sellado y entregado por medio del acto voluntario de dicha persona a los fines expresados en dicho Poder.

____________________________________ NOTARY PUBLIC OF NEW JERSEY My commission expires: ____________________________________ NOTARIO PÚBLICO DE NUEVA JERSEY Mi mandato vence: