Kentucky Limited Power of Attorney Form

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Kentucky Limited Power of Attorney Form is a method by which you are able to designate a personal representative to handle a specific transaction. The form should be written to be effective only for that transaction so that it cannot be confused as a broader POA. As always, it is important that your representative, or agent, represent your best interests, so it is important that you choose someone that you trust.


Statutes – Uniform Power of Attorney Act (§§ 457.010 — 457.460)

Authority (KRS § 457.245) – An agent under a power of attorney may act on behalf of the principal and exercise limited (special) authority as expressly granted by the agreement.

Signing Requirements (KRS § 457.050) – Notary Public.

How to Write

1 – The Correct Kentucky Authority Form Should Be Opened Here

Locate this form’s preview image on the right. Once, you are ready to enter information on this form then, you may use the button below this image to open a PDF version. Information may be entered directly onscreen with a form-friendly browser and the document may be edited with the appropriate software. If preferred, you may print this form then fill it out manually.

2 – The Grantor Assigning Limited Authority Must Make A Statement

The first statement in this form will be intended as one from the Principal or Grantor of Power. Find the first blank space then, enter the Grantor of Power’s Legal Name. On the blank space after the words “whose address is,” record the Physical Address of the Grantor’s Residence. The Grantor’s statement will continue but requires information on the third blank space. Here, enter the Name of the individual the Principal is granting his or her Authority to. This entity is known as an Agent or Attorney-in-Fact and will agree to the Principal terms in assuming and wielding the Principal Powers described below.3 – An Appropriately Worded Definition Of Authority Should Be Supplied

The Grantor of Power must describe (specifically) what the Attorney-in-Fact may do. For example, how he or she will be expected to act and the responsibilities the Grantor expects fulfilled. There will be a set of numbered blank lines (1 & 2) where such instructions may be delivered. If there is not enough room, you may add more lines using the appropriate software. If this is unavailable, you may also make an attachment with these instructions.4 – This Order Must Be Substantiated Through The Witnessed Signature Of The Grantor

The Grantor of this Power must make sure to document the Date he or she signs this form. This must be done in the statement with the words “In Witness Whereof…” Here, you will use the first blank space to report the Calendar Day. Then report the Month on the second blank space. Finally, report the two-digit year of this document’s signing on the third blank space. The Principal should sign this statement

Below this will be two columns, labeled “Witness” and “Address,” respectively. The Two Witnesses present at the Principal signing will each sign his or her Name on a blank line under the word “Witnesses” then, record his or her residential address on the corresponding blank lines to their signature. Make a copy for your agent and for any other parties who may need to know that you have an agent representing you.