Limited Power of Attorney Form

State of Juridiction

State of Jurisidiction

This is the State where the Limited Power of Attorney will be Executed.

Principal

Name of Person that is going to be GIVING their power

First

Last

This person is also known as the "Principal", this will be the person that will be giving the responsibility of acting on their behalf to someone else.

Mailing Address

Principal's Mailing Address

Street Address

Address Line 2

City

State

ZIP Code

Attorney-in-Fact/Agent

Name of Person who will be RECEIVING the power and responsibility

First

Last

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

Mailing Address

Attorney-in-Fact Address

Street Address

Address Line 2

City

State

ZIP Code

Powers

What powers will the Attorney-in-Fact have?

Be as detailed as possible

Start Date

Date when the power of attorney will start

Termination

When will the power of attorney end?

When does the power of attorney end?

Execution

Under State law, the Principal is required to sign in the presence of a Notary Public.

Under State law, the Principal is required to sign in the presence of a Notary Public. I Understand

Under State law, the Principal is required to sign this document in the presence of Two (2) Witnesses.

Under State law, the Principal is required to sign this document in the presence of Two (2) Witnesses. I Understand

Under State law, the Principal is required to sign with either Two (2) Witnesses or a Notary Public.

Under State law, the Principal is required to sign with either Two (2) Witnesses or a Notary Public. I Understand

Under State law, the Principal is required to sign in the presence of One (1) Witness and Notary Public.

Under State law, the Principal is required to sign in the presence of One (1) Witness and Notary Public. I Understand

Under State law, the Principal is required to sign in the presence of Two (2) Witness and Notary Public.

Under State law, the Principal is required to sign in the presence of Two (2) Witness and Notary Public. I Understand

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