Updated June 07, 2022
A Georgia durable statutory power of attorney form is a document used to delegate a principal’s legal authority to another person regarding their financial affairs. The recipient of this authority is often referred to as an “agent” or “attorney-in-fact”. The form is used when a person wants to make sure his or her obligations will be met when absent or incapacitated. It is important that the person that you choose to represent you is trustworthy and responsible as your agent will have access to your affairs and will have the authority to make decisions on your behalf.
Table of Contents |
Versions (5)
Download: Adobe PDF, MS Word, OpenDocument
Download: Adobe PDF
Download: Adobe PDF
Download: Adobe PDF
Personal Care Physicians of Atlanta Version
Download: Adobe PDF
Laws
Title 10, Chapter 6B (Uniform Power of Attorney Act)
Definition of “Durable”
“Durable” means not terminated by the principal’s incapacity (§ 10-6B-2(2).
Definition of “Power of Attorney”
“Power of attorney” means a writing or other record that grants authority to a person to act in the place of an individual, whether or not such term is used (§ 10-6B-2(7).
Signing Requirements
The principal is required to authorize in the presence of one (1) witness and a notary public (§ 10-6B-5). Note that, under an executive order issued by the Georgia governor in April 2020, remote attestation, such as via video, is temporarily permitted to effectuate powers of attorney.
Statutory Form
The Georgia Code contains a statutory form for a durable power of attorney available at § 10-6B-70.
How to Write
Download: Adobe PDF, Microsoft Word (.docx) or Open Document Text (.odt)
1 – Download The Statutory Form Power Of Attorney To Appoint An Agent In Georgia
The files available on this page will each deliver access to the power of attorney template required to grant principal power to an agent that will remain in effect even during the Principal’s incapacitation. This document is available as an Adobe PDF document or as a word processing file and may be downloaded by clicking on the appropriately labeled button (or link). It should be noted that some information, direct approval from the Principal, and a few signature parties will all be required to complete and execute this document. You may enter the information directly onscreen with compatible software and may print it at your discretion when direct attention is required.
2 – The First Page Requires Attention
Fill in the name of the Georgia county where this document is being executed (and notarized) on the blank line after the words “County Of” at the top of the page. 
The Principal read the information presented on the first page before proceeding. 
3 – Prepare This Document With The Agent’s Information
Before the Principal approves the power being granted in this document, we must identify the individual(s) who will accept the attorney-in-fact role and represent the Principal as his or her Agent. Locate the heading “Designation Of Agent” since this section contains the necessary language to declare a granting of principal authority and it will need some information to complete it. Begin furnishing this information by entering the full name of the Principal on the first blank space. 
This declaration statement will lead directly info four more blank lines (each one concerns the Agent). Produce the full name of the Agent, his or her residential address, along with the Agent’s contact information (telephone number and e-mail address) on the appropriately labeled blank spaces in this area. 
The next area “Designation Of Successor Agent(s) (Optional)” should only be tended to if the Principal has indicated that a Successor Agent should be set in place. A Successor Agent will not have the authority to wield principal power at the onset of this document. The effective date of his or her ability to represent the Principal will be the first calendar date that the original Agent becomes unable, unwilling, or ineligible to represent the Principal. Otherwise, he or she will only be held in reserve. If the Principal has indicated that such an entity will be put in place here, then report the Successor Agent’s full name on the “Name Of Successor Agent” line. Continue reporting on this entity by inputting the “Successor Agent’s Address,” telephone number, and e-mail address on the next three blank spaces. 
If a second Successor Agent will be set up with the potential to assume principal power, then we must supply his or her information. As the name suggests, the Second Successor Agent is the party that will assume the principal authority required to represent the Principal if, and only if, both the original Agent and (first) Successor Agent are no longer able to represent the Principal. To set such an entity in place, record the Second Successor Agent’s full name, address, telephone number, and e-mail address on the next four blank spaces. 
4 – The Principal Must Personally Approve The Granted Powers
Three sections have been included so that the Principal can easily approve and deliver the authority he or she wishes to grant the Agent. Only the Principal signing this document can attend to the next two sections.
You, as the Principal, must determine, report, and approve of the authority you wish to give the Agent. To do this, locate the heading “Grant Of General Authority.” Read through each item on the list presented here. If you would like the Agent to be able to act on your behalf in one of these subjects, then you must initial the blank space corresponding to it. If you do not wish the Agent to be able to use your authority in one of these subject matters, then do not initial that item. 
The first two items on this list will deal with your property. You can give your Agent the ability to act on your behalf with “Real Property” and/or “Tangible Property” by initialing the appropriately labeled blank spaces. You may initial one of these items, both items, or you can leave both unaltered. If you do not initial these items, the Agent will not have the authority to act on your behalf in either of these matters. 
You can give your Agent the right to represent you in dealing with “Stocks And Bonds,” “Commodities And Options,” and/or “Banks And Other Financial Institutions” by initialing the any or all the next three items. Any item you initial here will indicate you wish the Agent named above to act on your behalf in that subject matter. Conversely, you should not initial an item you wish to restrict the Agent from using principal power with. 
If you are responsible for the “Operation Of Entity Or Business” and wish the Agent to represent you in creating, managing, or terminating such operations, then initial the sixth blank space. 
The seventh matter in this list will enable the Agent to wield the same authority at your disposal regarding “Insurance And Annuities,” if you initial the corresponding blank space by the time this paperwork is signed. 
The Agent can be granted to right to use your name and power when dealing with any “Estates, Trusts, And Other Beneficial Interests” within your control, if you initial the eighth statement. 
The authority to handle your “Claims And Litigation” matters can be conferred to the Agent once you initial the ninth blank space. 
Your “Personal And Family Maintenance” can be managed by the Agent with the same power your name holds if you initial the tenth item. 
If desired, you may authorize the Agent to act in your name with “Benefits From Governmental Programs Or Civil Or Military Service” and/or “Retirement Plans” using the next two statements. Place your initials on the blank space(s) you wish to place within the scope of the Agent’s principal powers. If you do not wish to deliver the authority the Agent requires to represent you in one or both items, then do not initial the restricted statement(s). 
You can give the Agent the ability to represent your interests with your Tax matters by initialing the thirteenth item. Keep in mind, if you expect your Agent to represent you before a tax entity, it is likely that additional paperwork will need to be created and submitted to that entity. You can restrict the Agent from behaving in this area altogether by not initialing this statement. 
You can give the Agent the right to represent you in all these areas by initialing the blank space just before the item “All Preceding Subjects.” If you do initial this item, make sure you have not initialed any other item on this list. 
In addition to the general type of authority being delivered to the Agent above, you may need to tend to the “Grant Of Specific Authority (Optional)” section depending on the purpose you are granting him or her power. You do not need to select any of the items in this next list, however, if you do not initial an item here then, regardless of the above list, the Agent will not be able to engage in that task. This is because all of the statements here will deliver a specific type of authority that must be approved of with the wording provided in order to grant the right to perform that action in the Principal’s name. Begin by reading and deciding upon the first statement: “Create, Fund, Amend, Revoke, Or Terminate An Inter Vivos Trust.” If you would like the Agent to engage in this behavior then, initial the blank space that precedes it. If not, then leave it blank. Your initials as the Principal is the only way the Agent will be authorized to take such action. 
The Agent can “Make A Gift…” in your name if you initial the second statement. 
If you wish to give the Agent the right and authorization to “Create Or Change Rights Of Survivorship” on your behalf then initial the second item. 
The right to use your name to “Create Or Change A Beneficiary Designation” can be granted to the Agent by initialing the blank space corresponding to the third statement. 
The ability “Authorize Another Person To Exercise The Authority Granted Under This Power OF Attorney” will be authorized to the Agent if you initial the fourth item. 
If you, as the Principal, would like the Agent to have the authority to “Waive The Principal’s Right To Be A Beneficiary Of A Joint And Survivor Annuity, Including A Survivor Benefit Under A Retirement Plan” then initial the fifth statement of this list. 
You may approve the Agent’s right to “Excise Authority Over The Content Of Electronic Communications Sent Or Received…” in your name as if he or she were you by initialing the sixth blank space. 
If the Agent should be able to use your authority to “Exercise Fiduciary Powers That The Principal Has Authority To Delegate ANd That Are Expressly And Clearly Identified…” in your name, then initial the seventh statement. 
You can bestow the principal power to “Renounce An Interest In Property, Including A Power Of Appointment” on your behalf by initialing the blank space that precedes the final item on this list. 
The next section will address the “Limitation On Agent’s Authority” and will be held as part of this document’s appointment. It would be inadvisable to alter this section. 
The “Special Instructions (Optional) statement can be supplied either by a Preparer or the Principal, however, it will remain a direct report on the Principal’s intentions. If there are any additional provisions tor instructions that should be included in this paperwork regarding how the Agent may use the principal authority being granted, then they must be included. The blank lines in “Special Instructions (Optional)” will supply a nominal amount of room to include such instructions. If there is not enough room for all the Principal’s directives here, then either add more lines using your editing software or simply report these directives in a separate document that is cited as an attachment. Make sure any such paperwork is attached before the Principal signs this document. If the Principal has no additional provisions or instructions to add to this appointment then, indicate this by entering the word “None.” 
The next section shall name the “Effective Date” of the principal powers here as starting immediately. If the Principal does not wish this to be the case, then make sure to include when precisely the Agent may use principal authority using the “Special Instructions…” section. 
5 – The Principal Retains The Right To Nominate A Future Conservator If Required
Sometimes, an individual may be rendered incapable and the courts will decide that a Conservator of the Principal’s estate must be appointed. This paperwork will allow the Principal issuing it to nominate a specific party for this position. This will not obligate the courts to honor the Principal’s nominee, however, often, such a nomination in such a position is usually taken very seriously. If the Principal wishes to nominate a Conservator then the Nominee’s full name, address, telephone number, and e-mail address must be recorded on the blank spaces in the section “Nominations Of Conservator (Optional).” Make sure to supply each item of information where it is requested if this section is filled out. This section is not required for the appointment being made to be executed. 
6 – A Valid Signature Is Required Of The Principal
Now that all the relevant party identities have been established in their roles and the Principal has approved and supplied his or her definitions to the powers being granted, it will be time to review the finished product. If this document can be verified by the Principal as being accurate then, he or she must execute it by signature. Such a signature must be performed in the presence of a Witness and a Notary Public. In addition, the Agent will have some information to review. You, as the Principal, must sign your name to the blank space labeled “Your Signature” and enter the “Date” when you performed this action in the “Signature And Acknowledgment” section. Additionally, you must print your name on the “Your Name Printed” line. 
You must continue this execution process by supplying “Your Address,” “Your Telephone Number,” and “Your E-Mail Address” on the next three blank spaces. Once this task has been completed relinquish this document to the Witness present at the time. 
The Witness statement requires some preparation in that the Principal’s signature date and full name must be supplied to the first and second blank spaces (respectively). 
The Witness must verify the Principal’s act of signing by reading the Witness statement, then proving his or her signature, printed name, addresse, telephone number, and e-mail address on the blank spaces labeled “Witness Signature,” “Witness’ Name Printed,” “Witness’s Address,” “Witness’s Telephone Number,” and “Witness’s E-Mail Address.” 
The Notary Public overseeing these signatures will take control of this document to subject it to the notarization process. He or she is the only entity that can supply any information the next area. This will consist of a testimony to the location, date, and his or her credentials. 
The next area will be geared to the Agent. He or she should read the “Important Information For Agent” then locate the two blank spaces in this area. These lines allow the Agent to print the Principal’s name and sign his or her own name as a demonstration of how he or she must act as the Principal. 
Related Forms
Download: Adobe PDF
Download: Adobe PDF