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Kentucky Durable (Financial) Power of Attorney Form

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The Kentucky Durable (Financial) Power of Attorney Form provides a method by which a person can transfer his or her authority to act on his or her behalf to another person – usually, a spouse, trusted friend or relative. The person transferring the power is called the “principal” while the person who is given the authority to act is called the “agent” or “Attorney-in-fact”. This form is called “durable” because the authority granted to the agent continues even beyond the principal’s mental or physical incapacity.

Laws – § 457.040

Advance Directive (Medical POA) – This form is used to transfer authority to a trusted representative to make medical decisions on the Principal’s behalf.

How to Write

Download in Adobe PDF, Microsoft Word (.docx) or Open Document Text (.odt).

1 – The Kentucky Paperwork To Assign A Durable Power Of Attorney Should Be Downloaded

The document displayed with the “PDF,” “Word,” and “ODT” buttons can be downloaded once you determine the file version you prefer. Select one of these versions then save this file to your machine.

2 – Some Preparation To The Opening Statement Must Be Performed

The first paragraph statement of this page will seek the Full Name of each party involved along with their Addresses. It is imperative that we provide accurate definitions to each concerned party.

The first piece of information this paragraph requests is the Name of the Principal. Use the blank space between the word “I…” and the term “…The Principal” to report the First, Middle, and Last Name of the individual issuing this document. Continue reporting on the Principal by filling in his or her Street Address and State of residence on the second and third blank spaces accordingly.

Once you have clearly identified the Principal in the first part of this statement, you will need to introduce the concerned Attorney-in-Fact or Agent. This is the individual who will decide and act on matters named by the Principal with the Principal Authority to do so. Find the word “…Designate,” then place the First, Middle, and Last Name of the individual who should wield Principal Authority on the blank line that follows.  Complete this statement by providing the Agent’s Street Address and State of residence to the last two blank spaces (in that order).

3 – Declare The Predetermined Date Of Effect For These Powers

The event that causes the mandates in this document to become active, thereby going into Effect, must be determined and approved by the Principal. The first section heading, “Effective Date” will address this requirement with the presentation of two paragraph choices. The Principal will need to read both statements, decide which better describes his or her preferences, then initial the blank line preceding the appropriate one.

If Principal Authority should be available to the Agent immediately upon the Principal Signing of this paperwork then paragraph “A” should be initialed by the Principal. If the Principal prefers the Agent only be able to wield Principal Power on the Calendar Date that he or she is declared disabled (or incapacitated) by a Physician, then he or she must initial the second paragraph instead.

4 – The Principal’s Attention Is Required To Officially Delegate Authority

The section titled “Powers Of Attorney-in-Fact” will serve as a list of financial matters submitted for Principal review. Each paragraph definition in this list can either be considered a description of what the Agent may do with Principal Power or a description of what the Agent is not allowed to do with Principal Power. This will depend on whether the Principal initials the paragraph statement. If he or she does, then the Agent will be able to act in such a matter. If not, then the Agent will not have the approval required to conduct activities in that matter.

The “Banking” affairs of the Principal can be placed within the scope of the Principal Powers granted to the Agent, once the Principal initials the blank line that precedes the label “Banking.” If the Agent should not be able to use the Principal’s name to perform the actions listed in this statement, then it should be left alone and unmarked. The Principal’s Name regarding safe deposit boxes can be used by the Agent to perform any of the actions defined in the second paragraph so long as the Principal places his or her initials on the blank line attached to the label “Safe Deposit Box.” The Principal may wish for the Agent to engage in actions such as making loans or borrowing money using the Principal’s Name and Authority. If so, the Principal must initial the “Lending Or Borrowing Statement.” If the Principal intends to give the Agent the approval to handle his or her “Government Benefits” then he or she should initial the fourth paragraph in this list. This will allow the Agent to apply for, receive, and make decisions on behalf of the Principal with Government Benefits such as Medicare. The Agent can wield the authority to handle the Principal’s Retirement Plans by making such decisions and taking such actions once the Principal provides approval. This will exclude the Power to change beneficiaries to Retirement Plans or IRA’s. If the Principal wishes to grant this Power to the Agent, then he or she should initial the “Retirement Plan” paragraph. If the Agent is to represent the Principal before Tax Entities with the Principal Authority to do so, then the Principal must initial the paragraph labeled “Taxes” to delegate this Power to the Agent. The Principal’s “Insurance” matters can be placed within the scope of Principal Powers granted to the Agent if the Principal initials the seventh paragraph. If the Principal has determined that his or her Authority regarding “Real Estate” should be designated to the Agent, then the eighth paragraph must bear the Principal’s initials. The Principal can give the Agent the Power to represent him or her where “Personal Property” is concerned by initialing the ninth paragraph. The “Power To Manage Property” on behalf of the Principal will be delivered to the Agent once the Principal initials the blank space attached to the tenth paragraph of this list. The Agent can be given the Principal Power to make “Gifts” in the Principal’s Name with the Principal Act of initialing the blank line corresponding to the “Gifts” statement. It should be noted, this will enable the Agent to forgive debts owed to the Principal on behalf of the Principal. If the Agent should have the ability to represent the Principal’s interest in matters of “Legal Advice And Proceedings” then the Principal must initial the twelfth paragraph. The Principal can choose to limit or extend any of the Powers initialed above. If so, then report such limitations and extensions on the blank lines in the “Special Instructions” section. If the Principal does not any such instructions or directives he or she wishes applied to the Agent, then simply write the word “None” on these lines.

5 – Only A Witnessed And Notarized Principal Signature Has The Power To Execute This Paperwork

It is strongly recommended that the Principal and Agent both read this document once it has been filled out before signing it. When it is time execute this document, the Principal must enter the current Calendar Day, Month, and Year when he or she signs this document on the blank spaces in the last statement. The Principal must sign the “Principal’s Signature” line below the “In Witness Statement…” above. The next section will require the attention of the Witnesses attending the Principal Signing. Each one must read the statement beginning with the words “We, The Witnesses, Each Do Hereby…” Once this task is completed both Witnesses must deliver their Signatures and Addresses to the blank lines labeled “Witness’s Signature” and “Address.” Once the Principal and both witnesses have supplied the required signatures, this document should be surrendered to the Notary public in attendance. Only he or she can supply the proper verification and seal for this document to be notarized. Finally, once the Agent or Attorney-in-Fact has read and decided to agree to all the contents of this document, he or she should print his or her Name on the first blank space in the “Specimen Signature And Acceptance Of Appointment” section. This paragraph should also be read by the Agent. If he or she agrees to it, then the Agent must sign the “Attorney-in-Fact’s Signature” line and give this paperwork to the Notary Public. This entity will notarize the Agent Signature using the section underneath it.


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