Durable (Financial) Power of Attorney

Who are you GIVING power of attorney to?

A spouse or partnerA parent or family memberA child (adult child)A friend or trusted individualOther

Principal

Who is this Power of Attorney for?

First

Last

The "Principal" is the person GIVING financial powers to someone else.

Principal's Address

Street Address

Address Line 2

City

State

ZIP Code

Principal's address is required in the State of New York.

Agent

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

First

Last

Known as the "Agent" or "Attorney-in-Fact."

Agent's Address

Street Address

Address Line 2

City

State

ZIP Code

Agent's address is required in the State of New York.

2nd Agent

Will there be 2nd Agent?

Will there be 2nd Agent? YesNo

2nd Agent's Name

First

Last

2nd Agent's Mailing Address

Street Address

Address Line 2

City

State

ZIP Code

Agents Acting Separately

Under New York law, a Power of Attorney must state whether the Agents shall act together or separately on behalf of the Principal.

Your finalized form will allow you to initial beside a statement that requires the agents to act separately. If you intend on the agents to act together, do not initial beside the statement.

Do you agree to provide or omit your initials pursuant to NY law for the purposes described above?

Do you agree to provide or omit your initials pursuant to NY law for the purposes described above? I understand and agree

Successor Agents

A Successor Agent is a person that is called on to act if the Agent(s) is not available to act on behalf of the Principal.

Will there be any Successor Agents?

Will there be any Successor Agents? No1 Successor Agent2 Successor Agents

Successor Agent's Name

First

Last

Successor Agent's Mailing Address

Street Address

Address Line 2

City

State

ZIP Code

2nd Successor's Name

First

Last

2nd Successor Agent's Mailing Address

Street Address

Address Line 2

City

State

ZIP Code

Will the Successor Agents be required to act separately?

Will the Successor Agents be required to act separately? YesNo

Under New York law, as is the case with the Agents, the Principal must state whether successor agents are required to act together or separately.

Succession Rules

Succession Rules describe under what circumstance the Successor Agent(s) may act on behalf of the Principal.

Would you like to make Succession Rules?

Would you like to make Succession Rules? YesNo

For example: "The Successor Agent may act if the Agent is not able to be reached within 24 hours."

What are the Succession Rules?

Agent's Powers

Once the form is generated, 15 different powers will appear on your finalized form. Each power will represent several ways in which the Agent can act on your behalf.

Simply initial besides the power you wish to grant, such as, those with respect to real estate transactions or banking transactions. If you wish to authorize broad powers, you may initial only beside the "(P)" bracket.

I agree to initial beside the corresponding powers or beside the "(P)" bracket:

I agree to initial beside the corresponding powers or beside the "(P)" bracket: I Agree

Gifts

Would you like your Agent to make Gifts?

Would you like your Agent to make Gifts? YesNo

Gifts may NOT exceed an annual total of $5,000.

Compensation of Agent(s)

Note that the Agent(s) may already be eligible to reimburse themselves for expenses. You can describe in detail any reimbursements or compensation in the "Modifications" section.

Would you like the Agent(s) to be compensated for their work?

Would you like the Agent(s) to be compensated for their work? YesNo

Modifications

"Modifications" are additional limitations or special provisions you wish to add.

Are there any Additional Limitations or Provisions that you would like to add?

Are there any Additional Limitations or Provisions that you would like to add? YesNo

Here, you may add:

- Language to limit or supplement the authority granted to your Agent

- If the Agent is allowed to make Gifts, you may limit or supplement the authority granted to your agent to make gifts to himself or herself, and/or language to grant your agent the specific authority to make other gift transactions and/or changes to interests in your property.

- Your Agent is entitled to be reimbursed from your assets for reasonable expenses incurred on your behalf. If you ALSO wish your agent(s) to be compensated from your assets for services rendered on your behalf, and/or you wish to define “reasonable compensation”, you may do so here.

Please explain any additional or special instructions:

Monitor

Would the Principal like to have a Monitor?

Would the Principal like to have a Monitor? YesNo

A Monitor is a person that has the authority to audit the Agent in order to monitor each of the financial transactions they authorize.

Name of Monitor

First

Last

Monitor's Mailing Address

Street Address

Address Line 2

City

State

ZIP Code

Signing Requirements

The Principal understands that this Power of Attorney must be signed with a Notary Public and Two (2) Witnesses.

The Principal understands that this Power of Attorney must be signed with a Notary Public and Two (2) Witnesses. I Understand

The Notary Public may also act as one (1) of the witnesses. A witness cannot be someone who is acting in this Power of Attorney or someone that will benefit from the estate of the Principal.

The Principal also understands the Agents of this Power of Attorney must sign before a Notary Public.

The Principal also understands the Agents of this Power of Attorney must sign before a Notary Public. I Understand

Agents do not need to sign at the same time. However, this Power of Attorney is not effective in terms of the Agent's powers until said Agent signs and executes this document before a notary public.

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New York Durable (Financial) Power of Attorney

Who are you GIVING power of attorney to?

Principal

Agent

2nd Agent

Agents Acting Separately

Successor Agents

Succession Rules

Agent's Powers

Gifts

Compensation of Agent(s)

Modifications

Monitor

Signing Requirements