POWER OF ATTORNEY FORM
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What is power of attorney? A POA is a legal document that grants another adult the right to act on your behalf for a limited or broader purpose and length of time. These documents are governed by state law.

TYPES OF POA FORMS AND LETTERS: 

  • General or Conventional - a written document authorizing a person to act on your behalf.
  • Durable - the power of attorney remains effective after the onset of a disability.
  • Medical - attorney-in-fact has power to make health care decisions on your behalf at a later date if you became medically unfit.
  • Other Types - limited power of attorney, enduring power of attorney, financial power of attorney, real estate power of attorney, special power of attorney, corporate power of attorney, revoke power of attorney, irrevocable power of attorney, irs power of attorney, custom power of attorney, property power of attorney, canadian power of attorney, childcare power of attorney.

USES OF A POWER OF ATTORNEY FORM DOCUMENT:

  • Ensures the grantor's future independence in the event of incapacity or illness.
  • Protects people's financial interests if a time comes when they are unable to act or decide for themselves.
  • Without a POA a person will risk having his or her affairs managed by a court-appointed guardian.
  • It ensures that an individual's wishes will be respected if he/she is not able to act.
  • The attorney-in-fact has power to make health care decisions.


POWER OF ATTORNEY


BE IT KNOWN, that I/WE (grantor(s) ______________________________________ the undersigned Grantor(s), resident(s) of ___________________________________, City of ________________________, County of ____________________________, State of _________________ has made and appointed, and by these presents does make and appoint (Appointee's name) ______________________________________ a resident(s) of _______________________________, City of ______________________, County of _______________________, State of ___________________true and lawful attorney-in-fact (agent) for him/her and in his/her name, place and stead, giving and granting to said attorney-in-fact, general, full and unlimited power and authority to do and perform each and every act and thing which may be necessary, or convenient, in connection with any of the foregoing, as fully, to all intents and purposes, as could be done if Grantor(s) might or could do if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that said attorney-in-fact shall lawfully do or cause to be done by virtue hereof.

Dated this ____ day of _________, 20___, I hereby agree to accept the appointment as Attorney-in-fact, pursuant to the foregoing Power of Attorney.

_______________________________
Appointee's Signature

IN WITNESS WHEREOF, I/WE have hereunto set my hand and seal this _______ day of _______________________, 20____.


___________________________    ____________________________
Grantor's Signature                                 Grantor's Signature

___________________________    ____________________________
Print or type name                                 Print or type name

Signed, sealed and delivered in the presence of:

Witness 1 _______________________ Witness 2 _____________________

State of _____________ )
County of ____________ )

The foregoing instrument was acknowledged by me, a Notary Public, this ______ day of _____________, 20 ____ by:_______________________________ who is/are personally known by me or who has/have produced:_____ ______________________ as identification and who did not take an oath.

Witness my hand and official seal.

________________________________ (SEAL)
Notary Public 
State of __________________

My Commission Expires: 

UNITED STATES BY REGION:

New England Region: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
Great Lakes States: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin
Middle Atlantic States: Delaware, New Jersey, New York, Pennsylvania
Atlantic Coast and Appalachian States: Kentucky, Maryland, North Carolina, Tennesse, Virginia, West Virginia
Southeast and Gulf States: Alabama, Florida, Georgia, Mississippi, South Carolina
Mountain States: Colorado, Idaho, Montana, Utah, Wyoming
Plains States: Iowa, Kansas, Missouri, Nebraska, North Dakota, South Dakota
South Central States: Arkansas, Lousiana, Oklahoma, Texas
Southwest Desert States: Arizona, Nevada, New Mexico
Pacific States: Alaska, California, Hawaii, Oregon, Washington

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