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Connecticut Power of Attorney Forms

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The Connecticut Power Of Attorney is a form that legally allows a person to specify another person to act as an agent in the carrying out of certain specified business. These forms are often used in situations where the person appointing the agent (the “principal”) anticipates being unavailable either physically or mentally and wants to make sure that he or she has a trusted person to act in his or her stead. Because you are granting power to another person to transact your business in your best interest, it is vitally important that you trust the person you are appointing. In Connecticut, the power of attorney laws are currently located at C.G.S.A. P.A. 15-240.

Types

Appointment of Health Care Representative – A person can select a friend or relative to determine what healthcare actions should be taken, in the event that the individual can not communicate for themselves. It is important that you let your agent know your medical treatment wishes.

Durable Power of Attorney – This form allows an individual to appoint someone to be their agent and make financial decisions on their behalf, even if the principal becomes ill and can no longer make decisions for him or herself.

General Power of Attorney – This type will become void if the principal becomes incapacitated and can no longer act on his or her own behalf.

Limited Power of Attorney – This form can be used for specific transactions or business where the principal anticipates being unavailable for a certain period of time. It is important to describe with specificity the acts for which the agent can act.

Parental (Minor Children) Power of Attorney – This form allows a parent to designate a trusted friend or relative to take care of and make decisions on behalf of the parent’s children in the event they will be away temporarily.

Real Estate Power of Attorney – The usage of an Attorney-in-Fact to help with either the buying, selling, or managing of property for the benefit of the owner.

Revocation of Power of Attorney – This form can be used to revoke any power of attorney you may have created. It is very important that you make sure everyone that is aware or in on notice about your old document, knows that you have revoked it.

Tax Power of Attorney (LGL-001) –  In the event you want an accountant or another financial agent to take care of tax filings on your behalf, this is the form you use.

Vehicle Power of Attorney – In the event that you want someone to handle the purchase, sale, titling or registration of your vehicle, you should use this form.

How to Write

1 – Obtain The Short Form

In order for a Principal to reliably appoint one or more Attorney-in-Fact with the Authority to act in his or her affairs, that Principal will need to adequately document his or her intent and provide a signature as verification. To begin, open or print the short form provided through the buttons below the image. This form may have the requested information entered directly on-screen with an up to date browser with the proper extensions or the appropriate program.

2 – Principal Declaration

Several items must be supplied in the empty spaces below the statement beginning with “Know All People…”

Enter the Full Name and Complete Address of the Principal on the line labeled “Insert Name and Address of Principal.”

On the space labeled “Insert Name and Address(s) of Agent(s)” record the Full Name and Complete Residential Address of each Agent being granted Principal Authority.

If the Principal is granting Authority to more than one Agent, he or she must define how these parties will interact or if they should. This may be done on the blank space in the statement beginning with the words “My Agent(s) to Act:” If the Principal wishes the Agents to act independently, the word “severally” or “separately” must be entered. If this line is left blank or the word “jointly” is entered, the appointed Agent(s) will need to confer before acting with Principal Authority. 

3 – Define Any Restrictions On Powers Granted

The next segment of this form will provide a list of subdivision power. Each named subdivision will be labeled with a letter (A through M) and have a blank line on the opposite end of the line. Here, the Principal must use this section to either verify whether an Agent is being granted that power or is restricted from having authority in that matter. If the Principal wishes to grant a sub-divisional power to the Agent, then he or she does not need to alter that power. If the Principal wishes to restrict that Agent from having a sub-divisional power in this list, then he or she must draw a horizontal line through the words making up that line and initial the corresponding blank line. It should be noted that once a subdivision (A-M) will automatically eliminate subdivision N from the Agent’s Authority.

If the Principal wishes to restrict the Agent(s) listed above from acting with Authority in matters of Real Property then he or she must draw a line through the words “Real Property,” in Item A, and initial the blank space on that line.

The Principal may wish to restrict the Agent(s) from affecting his or her Tangible Personal Property. If so, then he or she must cross out the words “Tangible personal property,” in Item B and initial the available blank line.

The Principal may restrict the Agent(s) from acting with authority regarding his or her Stocks and Bonds by crossing out the words in Item C and initialing the blank space at the end of the line.

The Agent will be restricted from acting on the Principal’s Commodities and Options if the Principal crosses out Item D then, provides his or her initials on the corresponding empty space.

If the Principal wishes the Agent to not have the power to affect the Operation of any of his or her Business Entities, then he or she must strike through Item E then initial the blank space available.

 

Item F must be crossed out, and initialed, by the Principal if he or she does not wish to grant the Agent the Power to act in respect to the Principal’s Operation of any Business Entities.

The Principal may refrain from granting the Agent the Authority to act in regard to his or her Insurance and Annuities by crossing out the words “Insurance and annuities,” in Item G, then entering his or her initials on the blank space provided.

Item H must be crossed out and initialed if the Principal does not wish to give the Agent authority regarding his or her Estates, Trusts, and other Beneficial Interests.

The Agent will be restricted from Principal Authority in the Principal’s Claims and Litigation when the Principal crosses out Item I and initials the appropriate blank space.

The Principal can restrict the Agent(s) from matters in his or her Personal and Family Maintenance. To do this the Principal must cross out Item J and provide his or her initials on the blank space.

If the Principal wishes to restrict the Agent(s) from acting with Principal Power in his or her Benefits from Governmental Programs or Civil or Military Service, then he or she must cross out Item K and initial the blank space.

Item L will concern itself with the Principal’s Retirement Plans. If he or she wishes to restrict the Agent from having any authority over this, then Item L must be crossed out and initialed by the Principal.

If the Agent should not have power over the Principal’s Taxes, the Principal must cross out Item M and supply his or her initials on the blank space provided.

The Principal may wish to grant all these sub-divisional powers but none other. If so, then he or she must cross out and initial Item N. If the Principal has restricted the Agent from any of these powers, then only the powers in this list that have not been crossed out and initialed will be considered granted to the Agent. There will be several blank lines below the words “All other matters” to define which other powers the Agent is limited from.

4 – Enable the Successor Agent Option

The next few statements (First through Fourth) should be read by the Principal and understood. The Fifth Statement will give the Principal the option of naming a Successor Agent. This is an individual who may take over the Primary Agent’s role as someone who acts with Principal Authority on behalf of the Principal if, and only if, the Primary Agent is unable to or does not wish to fulfill the role of Principal’s Agent. Use the blank space labeled “Name of Successor Agent” and “Successor Agent’s Address” to report the Identity and Location of any Successor Agent the Principal wishes to Name.

The Principal may also name a second Successor Agent, in case both the primary Agent and First Successor Agent cannot act as such. Use the blank spaces labeled “Name of Second Successor Agent” and “Second Successor Agent’s Address” to provide both the Identity and Residential Address of the Second Successor Agent.

If the Principal does not wish to name a Successor Agent, he or she may leave this section blank.

5 – Effective Date And Execution

The Principal will need to sign this document in order to verify his or her intent on delivering Authority to the Agent listed above. First, locate the statement beginning with the words “In Witness…” The three blank spaces that follow require the Calendar Date/Month/Year of signing entered (respectively).

Below this statement will be two blank lines labeled “Witness” and one labeled “Signature of Principal.” On the line designated “Witness,” the individual watching the Principal sign this document must sign his or her Name.

The “Signature of Principal” line must be signed by the Principal in the presence of the Signature Witnesses and the Notary.

The last segment of this form has been reserved for the exclusive use of the Notary Public who will provide his or her seal and credentials after verifying the signing. Make sure this area is filled out and stamped by this entity.


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