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Limited (Special) Power of Attorney Form

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Limited (Special) Power of Attorney Form

Updated February 01, 2024

Limited power of attorney is a legal document that allows an individual (principal) to assign a specific act or responsibility to someone else (agent) on a temporary basis. It becomes void after the action has been completed or on a specified date.

Table of Contents

By State

How to Get Limited POA (5 steps)

  1. Decide the Powers
  2. Select the Agent
  3. Write the POA
  4. Signing the Form
  5. Acting as an Agent

1. Decide the Powers

Make sure to carefully word the responsibilities of the Agent to ensure that he or she has the right to act in your place for only the tasks needed. If the task is for a one (1) time use or has a specific end date, the power of attorney should have this included.

2. Select the Agent

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.

3. Write the POA

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

Use the Instructions and fill in with the agent that will be used in the document and be sure to inform them the responsibilities and terms of the document. There should be at least two (2) copies of the form made for each of the parties.

4. Signing the Form

Sign this form falls under “financial” related use, it must be authorized in accordance with State ‘Durable’ Laws. Which usually means the form must be signed with the principal in front of a notary public, witness(es), or both.

5. Acting as an Agent

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 below the signature line “Acting as POA”.

The completed and signed limited power of attorney form should always be kept in a safe and easy to access place while not in use.

Revoking Limited POA

By default, death, incapacitation, or signing a Revocation Form can cancel a power of attorney designation. Although, there are two (2) 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.

Signing Requirements

State Signing Requirements Statute
 Alabama Notary Public

Ala.Code 1975 § 26-1A-105

 Alaska Notary Public

AS § 13.26.600


One (1) Witness and Notary Public

A.R.S. § 14-5501


Notary Public

A.C.A. § 28-68-105


Two (2) Witnesses or Notary Public

Prob. Code § 4121


Notary Public

C.R.S.A. § 15-14-705


Two (2) Witnesses and Notary Public

C.G.S.A. § 1-350d


One (1) Witness and Notary Public

12 Del. C. § 49A-105


Two (2) Witnesses and Notary Public

F.S.A. § 709.2105


One (1) Witness and Notary Public

Ga. Code Ann., § 10-6B-5


Notary Public

HRS § 551E-3

 Idaho Notary Public

I.C. § 15-12-105


One (1) Witness and Notary Public

755 ILCS 45/3-3


Two (2) Witnesses or Notary Public

IC 30-5-4-1


Notary Public

I.C.A. § 633B.105


Notary Public

K.S.A. 58-652


Notary Public

KRS § 457.050


Principal Only

La. Civ. Code art. 2993


Notary Public

18-C M.R.S.A. § 5-905


Two (2) Witnesses and Notary Public

MD Code, Estates and Trusts, § 17-110

MD Code, Estates and Trusts, § 17-203


Two (2) Witnesses

M.G.L.A. 190B § 5-103


Two (2) Witnesses or Notary Public

M.C.L.A. 700-5501


Notary Public

M.S.A. § 523.01

 Mississippi Principal Only

Miss. Code Ann. § 87-3-101, et seq.


Notary Public

V.A.M.S. 404.705

 Montana Notary Public

MCA 72-31-305

 Nebraska Notary Public

Neb. Rev. St. § 30-4005

 Nevada Notary Public

N.R.S. 162A.220

 New Hampshire Notary Public

N.H. Rev. Stat. § 564-E:105

 New Jersey Notary Public

N.J.S.A. 46:2B-8.9

 New Mexico Notary Public

N. M. S. A. 1978, § 45-5B-105

 New York Two (2) Witnesses and Notary Public

G.O.B. Law § 5-1501B

 North Carolina Notary Public

N.C.G.S.A. § 32C-3-303

N.C.G.S.A. § 32C-1-105

 North Dakota Principal Only



Notary Public

R.C. § 1337.25

 Oklahoma Notary Public

58 Okl. St. Ann. § 3005

15 Okl. St.Ann. § 1003

 Oregon Principal Only



Two (2) Witnesses and Notary Public

20 Pa. C.S.A. § 5601

 Rhode Island Notary Public

Gen. Laws 1956, § 18-16-2

 South Carolina

Two (2) Witnesses and Notary Public

S.C. Code § 62-8-105

 South Dakota Notary Public

SDCL § 59-12-4

 Tennessee Principal Only


 Texas Notary Public

V.T.C.A., Estates Code § 751.0021

 Utah Notary Public

U.C.A. 1953 § 75-9-105


Notary Public

14 V.S.A. § 4005

 Virginia Notary Public

VA Code Ann. § 64.2-1603


Two (2) Witnesses or Notary Public

RCWA 11.125.050

Washington D.C. Notary Public

§ 21–2601.05

West Virginia Notary Public

W. Va. Code, § 39B-1-105

 Wisconsin Notary Public

W.S.A. 244.05

 Wyoming Notary Public

W.S.1977 § 3-9-105



How to Write

Download: PDF, MS Word, OpenDocument

Step 1 – Basic Information of Principal and Agent

In the first (1st) portion of the document, the principal should enter their full name and social security number (SSN). Afterward, the attorney-in-fact’s full name including their address and telephone number (preferably their cell phone) should be written.

Step 2 – Powers

The principal should enter the details of what their agent is allowed to handle (up to three (3)). The principal should initial and state how the form may be revoked, whether it can be by a revocation being authorized, when the task or objective has been completed, and/or at a particular date. Each option that is selected must be initialed and the box must be checked.

Below enter the State of jurisdiction the attorney-in-fact will be performing his actions and the principal should sign the bottom of the page.

Step 3 – Revocation

A limited power of attorney will automatically be revoked upon death or incapacitation by default. Additionally, you need to explain how you want the powers to be revoked when you no longer need your agent to act on your behalf. Your Limited Power of Attorney can be revoked in the following ways:

  • By the Principal at any time by authorizing a Revocation.
  • When the stated Power has been completed.
  • On a specified date.

Step 4 – State Law

Whichever state the Principal resides, should be the state entered into the document. The laws of your state will be the governing laws overseeing your limited power of attorney.

Step 5 – Acceptance of Appointment

The Acceptance of Appointment is required in some States for the attorney-in-fact to confirm their duties to act in accordance with the written document. The signature (along with the principal’s on the first (1st) page) should be authorized in front of either two (2) witnesses or a notary public (including their Seal).

Once complete the form may be used until the acts are complete or on an expiration date.

Step 6 – Witnesses

The Principal should obtain two witnesses to attest to the Principal’s signature as this step is a requirement in most states. Both witnesses must sign, print name, and give addresses.

Step 7 – Notary Public

Once the form has been completed by all parties, the Principal should bring their limited power of attorney form to their local Notary. A Notary can be found at your local bank and they will most often give their services for free or at a small charge.