Limited (Special) Power of Attorney Form

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Updated July 05, 2022

Limited (special) power of attorney is a document that allows an individual to specify a responsibility that can be handled by someone else. The document cancels itself either after the action has been completed or on a future date.

Use for Handling

  • Safety deposit boxes;
  • Bank accounts;
  • Real estate;
  • Retirement benefits;
  • Tax filings; or
  • Other special responsibilities.

Table of Contents

By State

How to Get Limited POA (5 steps)

Step 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.

Step 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.

Step 3 – Write the POA

Download in Adobe 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.

Step 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.

Step 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

 Arizona

One (1) Witness and Notary Public

A.R.S. § 14-5501

 Arkansas

Notary Public

A.C.A. § 28-68-105

 California

Two (2) Witnesses or Notary Public

Prob. Code § 4121

 Colorado

Notary Public

C.R.S.A. § 15-14-705

 Connecticut

Two (2) Witnesses and Notary Public

C.G.S.A. § 1-350d

 Delaware

One (1) Witness and Notary Public

12 Del. C. § 49A-105

 Florida

Two (2) Witnesses and Notary Public

F.S.A. § 709.2105

 Georgia

One (1) Witness and Notary Public

Ga. Code Ann., § 10-6B-5

 Hawaii

Notary Public

HRS § 551E-3

 Idaho Notary Public

I.C. § 15-12-105

 Illinois

One (1) Witness and Notary Public

755 ILCS 45/3-3

 Indiana

Two (2) Witnesses or Notary Public

IC 30-5-4-1

 Iowa

Notary Public

I.C.A. § 633B.105

 Kansas

Notary Public

K.S.A. 58-652

 Kentucky

Notary Public

KRS § 457.050

 Louisiana

Principal Only

La. Civ. Code art. 2993

 Maine

Notary Public

18-C M.R.S.A. § 5-905

 Maryland

Two (2) Witnesses and Notary Public

MD Code, Estates and Trusts, § 17-110

MD Code, Estates and Trusts, § 17-203

 Massachusetts

Two (2) Witnesses

M.G.L.A. 190B § 5-103

 Michigan

Two (2) Witnesses or Notary Public

M.C.L.A. 700-5501

 Minnesota

Notary Public

M.S.A. § 523.01

 Mississippi Principal Only

Miss. Code Ann. § 87-3-101, et seq.

 Missouri

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

N/A

 Ohio

Notary Public

R.C. § 1337.25

 Oklahoma Notary Public

58 Okl. St. Ann. § 3005

15 Okl. St.Ann. § 1003

 Oregon Principal Only

N/A

 Pennsylvania

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

N/A

 Texas Notary Public

V.T.C.A., Estates Code § 751.0021

 Utah Notary Public

U.C.A. 1953 § 75-9-105

 Vermont

One (1) Witness and Notary Public

14 V.S.A. § 3503

 Virginia Notary Public

VA Code Ann. § 64.2-1603

 Washington

Two (2) Witnesses or Notary Public

RCWA 11.125.050

Washington D.C.

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

 

Video

How to Write

Download: Adobe 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.