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Indiana Durable (Financial) Power of Attorney Form

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Indiana Durable (Financial) Power of Attorney Form should be employed to appoint a representative or “agent” to exercise control over your finances on your behalf. This is useful for a number of reasons. For instance, you may need your spouse to act as your agent so he or she can handle things in your absence, or in the event that you succumb to mental disability. This is a “durable” designation of authority therefore, it will remain in effect even in the circumstance where you do not have the capacity to revoke it. That’s why it is so important to choose someone who has your best interest at heart.

LawsTitle 30, Article 5 (Powers of Attorney)

Health Care and Appointment of Representative – Use this form to impart power to a trusted individual to make judgments on your healthcare when you become unable to do so yourself.

How to Write

1 – Set Up The Form For Entry

You may obtain this form through the buttons on this page under the image. Make sure you have the appropriate material for this document (i.e. Principal Information, Preferences, Attorney-in-Fact(s)). Once you are ready, you may choose to either open this form and enter information directly onscreen or you may print it then fill it in manually.

2 – Introduce The Parties Involved

The first section will present itself in the form of two simple tables: “Principal” and “Attorney-in-Fact.” You will need to present the information requested in each column accurately.

In the “Principal” table, the first column should have the Principal’s Full Legal Name entered. This will be followed by the Principal’s Address for his or her Place of Residence. Finally, the third column sets the Principal’s Date of Birth as a final method for identification.

The next table, “Attorney-in-Fact/Agent” will request similar information regarding the entity who will be appointed Principal Power by the Principal listed through this document. Enter the Attorney-in-Fact’s Complete Name in the first column, his or her Address of Residence in the second column, and his or her Birthday in the last column.


3 – Carefully Review The Default Powers Of Authority Granted Through This Document


The statement immediately below the table is required for the purposes of this document and should be left unmarked. However, the numbered paragraphs that follow will define the Principal Authority this document will deliver to the Agent upon the Principal’s Signature. The Principal retains the option to strike out any of these statements, or parts of, to prevent and restrain the granting of the Powers or Actions defined from being delivered to the Agent.

Paragraph 1 delivers the power to handle and affect the Principal’s Bank Accounts. The Principal will approve this deliverance of Authority to the Agent if this paragraph is left unmarked. If the Principal crosses out this paragraph, the Agent will not be able to use Principal Authority in such matters. If the Principal crosses out only part of this paragraph, the Agent will not be able to perform the actions or wield the Powers of the crossed out statement.

Paragraph 2 will empower the Agent with the Principal’s Authority regarding the Real Property of the Principal. If the Principal wishes to designate the Authorities in this statement to the Agent, he or she should leave this paragraph unaltered, however, any part of it, or all of it, may be crossed out to withhold those Authorities and/or Actions from the Agent


Paragraph 3 defines what the Agent may do, in the Principal’s Name, with the Principal’s Personal Property. Any part of this paragraph or the entirety may be crossed out by the Principal if he or she wishes to limit or restrict the Agent from wielding such Authority in such matters.


Paragraph 4 shall give the ability to handle Loans (Lending and/or Borrowing) on behalf of the Principal to the Agent or Attorney-in-Fact. The Principal may choose to limit or restrict this ability by crossing out this statement or parts of it.

Paragraph 5 shall give the Agent the Principal Power to conduct the Principal’s Business Affairs. The Principal should review this paragraph carefully. If he or she wishes to grant such Powers to the Agent, it should be left unmarked. If the Principal wishes to restrict the Agent form some or all of the Powers defined then, he or she should strike out any of the statements or terms that should not be included in this document.


Paragraph 6 gives the Agent the right to perform any of the defined approved actions on the Premises as necessary or appropriate. If this should be restricted from the Agent, the Principal may cross out this paragraph.


The Principal must provide his or her Signature at the end of this section on the “Signature of Principal” line.

4 – The Principal’s Defined Wishes Must Be Substantiated

The Principal must sign this document before a Witness and a Notary Public to fully utilize its power. The final area of this document will contain three sections for this purpose. Let us tend to the first paragraph below the statement beginning with the words “The Power of Attorney is…”

Here, after the “I” and before the term “the Principal…,” the Full Name of the Signature Principal must be presented in print.

Next, on the three blank spaces of the Principal statement, the Date of Signature should be recorded by entering the Calendar Day just before the word “day…” then entering the Signature Month and Year (after the word “…of”).

Finally, the Principal should sign his or her Name on the blank space above the words “Signature of Principal.”

The next statement will be that of the Witness who has physically seen the Principal sign this document. The Witness, upon viewing the signing, will print his or her Name on the first blank line, Once this task is completed, he or she must enter the Date he or she is signing this document using the next three empty spaces.

Finally, the Witness must sign his or her Name on the “Signature of Witness” line.

The last section of this form will be for the Notary Public attending the Principal signing. This entity will verify such facts as the location, date, and parties attending then, provide his or her credentials.