Durable (Financial) Power of Attorney

Who are you GIVING power of attorney to?

Who is this Power of Attorney for?

First

Last

The "Principal" also known as the individual GIVING financial powers to another person.

Mailing Address

Principal's Mailing Address

Street Address

Address Line 2

City

State

ZIP Code

Who will be RECEIVING powers to act on the Principal's behalf?

First

Last

Also known as the "Agent" or "Attorney-in-Fact"

Mailing Address of the Agent

Street Address

Address Line 2

City

State

ZIP Code

Please enter your address.

2nd Agent

Would you like to have a 2nd Agent?

YesNo

This is someone who may work with the 1st Agent or if the 1st Agent is not able to perform their duties.

Name of 2nd Agent

First

Last

2nd Agent's Address

Street Address

Address Line 2

City

State

ZIP Code

The Agents (Decision-Making)

Would you like the 2 Agents to Act JOINTLY or SEPARATELY?

JOINTLYSEPARATELY

JOINTLY - For most decisions acting on my behalf I would like the Agents to act together.

SEPARATELY - The Agents may act separately with the 2nd Agent having full authority if the 1st Agent is not able to perform their duties.

Durable

Would you like this Power of Attorney Form to remain VALID if you should become Incapacitated?

Yes, I would like it to remain validNo, I would not like it to remain valid

Incapacitation is described as being in a medical condition where you cannot speak for yourself such as suffering from: a Coma, Dementia, Alzheimer's, etc.

Initial (Electronically or Hand-Written)

Do you wish to Initial this form Electronically or After Printing?

Initial ElectronicallyInitial after Printing

Absolute Financial Power

Do you wish to grant Absolute and Unlimited Financial Powers to your Agent(s)?

YesNo

This would be in regards to:

Real Property transactions
Tangible personal property transactions.
Stock and bond transactions.
Commodity and option transactions.
Banking and other financial institution transactions including complete access to any bank safe deposit box in my name and the authority to withdrawal or add to the contents.
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 civil or military service.
Retirement plan transactions.
Tax matters.

E-Initials

Initial ONLY the Powers you would like your Agent(s) to have

Initial to give Absolute and Unlimited Financial Power to Your Agent(s)

Clear

With your Initials above, you are authorizing that the Agent(s) will have the power to do all of the following:

Real Property transactions

Tangible personal property transactions.

Stock and bond transactions.

Commodity and option transactions.

Banking and other financial institution transactions including complete access to any bank safe deposit box in my name and the authority to withdrawal or add to the contents.

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 civil or military service.

Retirement plan transactions.

Tax matters.

Real Property Transactions

Clear

Tangible personal property transactions.

Clear

Stock and bond transactions.

Clear

Commodity and option transactions.

Clear

Banking and other financial institution transactions.

Clear

Business operating transactions.

Clear

Insurance and annuity transactions.

Clear

Estate, trust, and other beneficiary transactions.

Clear

Claims and litigation.

Clear

Personal and family maintenance.

Clear

Benefits from social security, medicare, medicaid, or other governmental programs, or civil or military service.

Clear

Retirement plan transactions.

Clear

Tax matters.

Clear

Special Instructions

Will there be any Special Instructions given to the Agent(s)?

YesNo

In addition to the Powers already given, the Agent has special instructions to:

Signing

Under California law, you are required to sign in one (1) of the following ways:

Notary Public (recommended)Two (2) Witnesses

If Two (2) Witnesses sign, they must (a) The witnesses shall be adults. (b) The attorney-in-fact may not act as a witness. (c) Each witness signing the power of attorney shall witness either the signing of the instrument by the principal or the principal's acknowledgment of the signature or the power of attorney.

I understand

California Durable (Financial) Power of Attorney

Who are you GIVING power of attorney to?

Mailing Address

2nd Agent

The Agents (Decision-Making)

Durable

Initial (Electronically or Hand-Written)

Absolute Financial Power

E-Initials

Special Instructions

Signing