Durable Power of Attorney
This Durable Power of Attorney ("Document") is created by the undersigned Principal on this ____ day of __________, 20__, to grant certain powers to the designated Agent as laid out below. By this Document, the Principal intends to create a Durable Power of Attorney that will remain effective even in the event of the Principal's incapacity, in accordance with the laws governing the State in which the Principal resides.
1. Principal Information
Name: ____________________________________
Address: __________________________________
State of Residence: ________________________
2. Agent Information
Name: ____________________________________
Address: __________________________________
Contact Number: __________________________
3. Powers Granted
The Principal grants the Agent the following powers, to be exercised in the Principal's name and on the Principal's behalf concerning the following areas:
- Real property transactions
- Tangible personal property transactions
- Stock and bond transactions
- Commodity and option transactions
- Banking and other financial institution transactions
- Business operating transactions
- Insurance and annuity transactions
- Estate, trust, and other beneficiary transactions
- Claims and litigation
- Personal and family maintenance
- Benefits from social security, Medicare, Medicaid, or other governmental programs, or military service
- Retirement plan transactions
- Tax matters
4. Special Instructions
Any special instructions limiting or extending the powers granted to the Agent are listed below:
____________________________________________________________________________
____________________________________________________________________________
5. Durable Power of Attorney Effective Date
This Durable Power of Attorney is effective immediately upon signing and will continue to be effective regardless of the Principal's subsequent incapacity or disability.
6. Termination
This Durable Power of Attorney will remain in effect until it is revoked by the Principal or upon the Principal's death. The Principal may revoke this Document at any time by providing written notice to the Agent.
7. Governing Law
This Durable Power of Attorney shall be governed by the laws of the State of ___________________________.
8. Signatures
Principal's Signature: ___________________________ Date: ___________
Agent's Signature: ___________________________ Date: ___________
Witness #1 Signature: ___________________________ Date: ___________
Witness #2 Signature: ___________________________ Date: ___________
Acknowledgment by Notary Public
State of ____________
County of ___________
On this, the ____ day of ____________, 20__, before me, a Notary Public, personally appeared _______________________________, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
______________________________________
Notary Public
My Commission Expires: _________________