Carefully word the agent’s responsibilities to ensure that they have the right to act in your place for only the tasks needed. If the task is for a one-time use or has a specific end date, the power of attorney should include this.

It’s important to choose someone that can be trusted and usually involves a family member or friend. If the responsibility involves a higher-valued asset it’s recommended to select someone that is the beneficiary in the estate.

Download in PDF, MS Word, or OpenDocument (.odt).

Use the Instructions and fill in with the agent who will be used in the document, and be sure to inform them of the responsibilities and terms of the document. There should be at least two copies of the form made for each of the parties.

If this form is used for “financial” purposes, it must be authorized in accordance with State Durable Laws. This usually means the form must be signed by the principal in front of a notary public, witness(es), or both.

Like any other power of attorney assignment, whenever the agent uses their right to act in the presence of the principal this form must be presented to the other party. Otherwise, the agent is not legally allowed to act for the principal.

If the agent is signing a document on behalf of the principal, they must sign and then use the phrase “Acting as POA” below the signature line.

When not in use, the completed and signed limited power of attorney form should always be kept in a safe and easily accessible place.

By default, death, incapacitation, or signing a Revocation Form can cancel a power of attorney designation. Although, there are two ways a principal can automatically cancel by entering specific language in the form:

1. Entering an End Date. Enter a revocation date into the form. Upon the specified date, the document will no longer be valid and your agent will no longer be able to act on stated powers.
2. Action is Complete. When the agent’s action or the responsibility has been completed, the limited power of attorney will cease to be valid.