This is an agreement that allows an attorney to act on behalf of a client. This
agreement is primarily used to allow an attorney to act on behalf of a mentally or
physically deteriorating client. The attorney agrees that he or she will act in the client’s
best interests to the best of the attorney’s abilities. This document should be used by
attorneys or clients that want to allow an attorney to act on their behalf.
FULL POWER OF ATTORNEY
I, _______________ [NAME OF PERSON GIVING THE POWER OF ATTORNEY] of
______________ [PROVIDE FULL ADDRESS], hereby appoint __________ [NAME OF
PERSON RECEIVING THE POWER] of ____________________ [PROVIDE FULL
ADDRESS] as my attorney in fact to act in my capacity to do every act that I may legally do
through an attorney in fact. This power shall be in full force and effect, starting on
_____________, 201___ [PROVIDE STATE GRANTOR WISHES THE POWER OF
ATTORNEY TO BE GIVEN TO THE OTHER PERSON], the date below written and shall
remain in full force and effect until __________, 20___ [PROVIDE DATE POWER WILL
END], or unless specifically extended or rescinded earlier by either party.
{Instruction and caution: Grantor should carefully consider the benefits and drawbacks of
providing an ending date that is near in the future, or, is far off in the future. If a grantor
trusts the person receiving the power, then setting an end date years, or decades in the future,
can protect the grantor in case of physical or mental disability. However, if grantor gives the
power to someone who may abuse the power, then setting an earlier end-date can minimize the
problems. Of course, unless the grantor is declared incompetent or is otherwise incapacitated,
grantor can always shorten a long-term power, or, can extend a short-term power. Each
person's situation is different, and therefore, there is no one correct answer to this difficult
issue.}
Dated __________, 201____. In the County of ______________, in the State of ________.
By: __________ [SIGNATURE OF GRANTOR]
NOTARIAL ACKNOWLEDGEMENT
STATE OF __________COUNTY OF __________
BEFORE ME, the undersigned authority, on this __________ day of __________,
201__, personally appeared __________ to me well known to be the person described in and
who signed the foregoing, and acknowledged to me that he executed the same freely and
voluntarily for the uses and purposes therein expressed.
Powers conferred on said attorney-in-fact shall not be restricted or limited by the
aforementioned specifications regarding situation of representation. The rights, powers and
authority of said attorney-in-fact granted in this instrument shall commence and be in full force
and effect on ____________, _____, 20__ and such rights, powers and authority shall remain
in full force and effect thereafter until I give notice in writing that such power is terminated.
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It is my desire, and I so freely state, that this power of attorney shall not be affected by any
subsequent disability or incapacity that may befall me.
FURTHERMORE, upon a finding of incompetence by a court of appropriate jurisdiction, this
power of attorney shall be irrevocable until such time as said court determines that I am no
longer incompetent.
__________________________________
Signature
WITNESS my hand and official seal the date aforesaid.
NOTARY PUBLIC
My Commission Expires:
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and no general information or forms or like the kind Docstoc provides can always correctly fit every circumstance.
Note: Carefully read and follow the Instructions and Comments contained in this document for your customization to suit your specific
circumstances and requirements. You will want to delete the Instructions and Comments from open bracket (“[“) to close bracket (“]”)
after reading and following them. You (or your attorney) may want to make additional modifications to meet your specific needs and the
laws of your state. The Instructions and Comments are not a substitute for the advice of your own attorney.
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