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Arkansas General (Financial) Power of Attorney Form

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Arkansas General Power of Attorney grants certain financial powers to a designated trusted person to manage your affairs in your best interest. This document is set up so that it will become void if the principal (the person granting the powers) becomes somehow incapacitated. In other words, it is NOT a durable power of attorney. If you are looking to have the powers continue in the event you become incapacitated, do NOT use this form. Use the durable power of attorney form instead.

How to Write

1 – Download The Form On This Page

This form, the Arkansas General Power of Attorney, should be downloaded to your machine then filled out. Make sure that, while you print this paperwork, enough copies will be available when it is time to Sign it. If an appropriate editing program is not available, you may print this form then fill it out neatly.

2 – Document The Principal And the Attorney-In-Fact

This form will need to identify all the parties involved in order to be fully effective. The first party to be identified will be the individual granting this power of attorney (Principal). Enter the Full Name of the Principal on the blank line beneath the title of this document (following the word “of”).

Next, the Principal’s Name must also be supplied on the first line of this paragraph. Use the first space to enter the Principal’s Name.

Continue the report on the Principal by entering the Principal’s Residential Address on the next blank space.

Conclude this report on the Principal by entering the State where the Principal resides on the third blank space in this paragraph.

Fill in the Full Name of the individual who will attain the power defined in this document (Attorney-in-Fact or Agent) on the space after the word “…designate.”

Report the Attorney-in-Fact’s Address in the space on the third line of this paragraph

The State where the Attorney-In-Fact’s Address is located must be entered on the blank space in the fourth line of this paragraph

3 – Conferring Powers To The Attorney-in-Fact

The next area, “I. Powers,” contains seventeen items. Each of these items will set forth a definition to an area in the Principal’s matters along with powers and actions the Attorney-in-Fact may engage on behalf of the Principal. Each of these definitions will contain a blank space before the item number. The Principal must initial the space before an item number in order for the Attorney-in-Fact to assume the right to act in that Principal Matter.

Item 1 must be initialed if the Attorney-in-Fact must assume the power to Make or Collect Payments.

Item 2 must be initialed if the Attorney-in-Fact will have the power to Acquire/Lease/Sell the Principal’s Personal Property

Item 3 should be initialed so the Attorney-in-Fact may have the power to Acquire/Lease/Sell the Principal’s Real PropertyItem 4 enables the Attorney-in-Fact to act with have Management Powers (tangible, intangible, real, or personal property), if it is initialed by the Principal

Item 5 should be initialed by the Principal if the Attorney-in-Fact must have Banking PowersItem 6 will require the Principal’s initials should the Attorney-in-Fact be expected to act on his or her behalf regarding Motor Vehicles

Item 7 must bear the Principal’s initials in order for the Attorney-in-Fact to have powers in the Principal’s Tax matters

Item 8 must display the initials of the Principal so the Attorney-in-Fact should be granted access and powers regarding the Principal’s Safe-Deposit Boxes

Item 9 should present the Principal’s initials so the Attorney-in-Fact is expected to enact any Gift Making Powers on the Principal’s behalf

Item 10 will enable the Attorney-in-Fact to enact Lending and Borrowing Powers, on behalf of the Principal, only if it is initialed by the Principal

Item 11 must be initialed by the Principal if the Attorney-in-Fact is expected to act on the Principal’s behalf, with Principal Power, regarding Contracts/Agreements

Item 12 requires the Principal’s initials for the Attorney-in-Fact to enact powers in the Principal’s Health Care

Item 13 grants Principal Power to the Attorney-in-Fact regarding the Health Insurance Portability and Accountability Act of 1996 (Pub. L. No. 104-191)

Item 14 enables the Attorney-in-Fact with the Power to Hire and Pay for Services, in the name of the Principal, if the Principal initials this itemItem 15 provides Reimbursement of Attorney-in-Fact if it is initialed by the Principal

Item 16 gives the Attorney-in-Fact the Principal Power to Sue Third Parties Who Fail To Act Pursuant to Power of Attorney.

Item 17 provides several blank lines. This gives the Principal an opportunity to freely define any provisions, additions, or conditions that apply to the Attorney-in-Fact’s behavior and use of Principal Power when it is enacted. The Principal will need to initial this item then provide a report on such matters

4 – Specify the Effective Period of this Power of Attorney

The next area, titled “Effective Date and Termination,” will seek a definition to when this document’s effect, in granting Principal Power to the Attorney-in-Fact, begins and when it will end.

If this document is to go into effect the moment it is signed by the appropriate parties, the Principal should initial the first blank space.

If this document is to go in effect on a specific date, the second item must be initialed by the Principal. In addition to the Principal’s initials, the exact Date this document goes into effect must be entered using the blank spaces in this item.

Next, it is important to define when this document’s effect will cease. If the power of this document is to terminate on a specific day, the Principal must initial the first blank space, after the phrase “…which of the following occurs first,” then enter the exact Date of Termination for this document.

If it is intended the Attorney-in-Fact’s Principal Power should remain in effect, once it is enabled, until the Principal revokes it, the Principal’s initials must be supplied just before the words “When I have made…”

If this document’s effect is to remain active until the Principal has been rendered incapacitated (by physician diagnosis) then make sure the Principal initials the blank space preceding the words “When and if I become incapacitated….”

5 – Providing Authorization

The Principal who is granting the powers and authority listed in this document for the period of time defined in this document to the Attorney-in-Fact named in this document must verify their consent by providing an authorized signature in the presence of two witnesses and a notary public. The same must be done by the Attorney-in-Fact named in this document.

The Principal must read section “IV Third Party Reliance,” then enter the Date this document is being signed in the last statement.

In the area titled “Principal’s Signature” the Principal must Sign then Print his or her name

The next page will begin with the “Acceptance of Appointment” statement. Provide the Full Name of the Attorney-in-Fact in the blank line in this statement then, below the Acceptance Statement, the Attorney-in-Fact must Sign and Print his or her NameJust below the Attorney-in-Fact’s Acceptance Statement will be a Witness Statement which must be read, then Signed by each Witness. Additionally, each Witness must also report his or her Address on the corresponding “Address” lines for each Signature line.

Finally, the “Acknowledgment of Notary Public” section has been provided for the use of the Notary Public


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