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Nebraska Power of Attorney Forms

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A Nebraska Power Of Attorney provides a method by which a person can legally allow someone to take his or her place in certain situations. There are the forms that allow you to appoint someone to handle and represent your financial matters or more specific matters. For instance, one form enables you to appoint someone to represent your health matters while another form serves to appoint someone to handle your tax matters. In all cases, you are giving someone power over your decision making power and (in some cases) your property, so it is vitally important that the person you choose is someone you trust to act in your place.

LawsChapter 30 of the Revised Statutes


Durable (Statutory) Power of Attorney – Appoint a person to take over your property and finances and act on your behalf. This form continues in effect even if you become unable to make your own decisions.

General Power of Attorney – Appoint someone to manage your finances and property and act in your stead. However, unlike the durable form, this POA becomes void if you become incapacitated.

Health Care Power of Attorney – To be used to appoint a friend or relative to make your health care decisions in the event you are unable to.

Limited Power of Attorney – Can be used to appoint someone for any specific or limited transaction.

Minor Child Power of Attorney – Allows you to delegate your parental authority over your children to another in the event you will be away or unavailable for a period of time.

Revocation of Power of Attorney – Used to revoke any POA that may have been entered into in the past.

Real Estate Power of Attorney – For the use of hiring a representative to handle the management, private sale, or purchase of real property between the buyer/seller and another party. The agent selected must act in the best interests of the principal and all proceeds shall forward to the beneficiary.

Tax Power of Attorney Form – Use to appoint a tax professional or another to handle your taxes.

  • Download: Adobe PDF
  • Signing Requirements: Principal Only

Vehicle Power of Attorney – Use to appoint another to handle the titling and registration of your car or other motor vehicle.

  • Download: Adobe PDF
  • Signing Requirements: Notary Public

How to Write

1 – Open This Form Then Review The Introduction

The form on this page will deliver the structure and language required to successfully designate an Attorney-in-Fact with Principal Authority. It is strongly recommended that all the reference material required to fill out this form be gathered and organized before downloading it. Once you are ready to fill it out, you may open it and work on it immediately onscreen or you may download it to fill in the requested information at your convenience. You may also print this document and fill it out manually if you lack the required software.

2 – The Principal Must Formally Declare The Identity Of All Concerned Agents

Once the Principal and any involved Preparer have read the initial pages to this form, locate the first section (“Designation Of Agent”). Here, several items will be requested so the language provided may be properly applied to the designation at hand. Begin by entering the Principal’s First, Middle, and Last Name on the first blank space (preceding the label “Name Of Principal”) Now, three successive blank lines, (“Name Of Agent,” “Agent’s Address,” and “Agent’s Telephone Number”) will follow the phrase “…The Following Person As My Agent”). Utilize these lines to record the Full Name of the Attorney-in-Fact, his or her Address, and his or her Telephone Number. The Attorney-in-Fact will be the individual assuming Principal Powers as a result of this paperwork. The Principal may have decided upon having one or two Agent’s waiting in the wings just in case the Primary Agent or Attorney-in-Fact is not able to carry out the instructions in this document. Since some of the Powers granted may require time-sensitive Principal Action taken by the Agent, the Principal will want any back-up Agent’s to have their Principal Authority set if such an event occurs. These Successor Agents may be declared in the optional section “Designation Of Successor Agent.” There will be enough room to appoint two Successor Agents. These parties will be able to assume the Principal Powers listed in this form in the order they are reported in the next two sections.

The first Successor Agent who should assume Principal Power when the Primary Agent has relinquished it, had his or her Principal Power revoked, or is no longer available should be reported using the first set of lines. Enter the Full Name of the Successor Agent on the line labeled “Name Of Successor Agent.” Then, on the lines labeled “Successor Agent’s Address” and “Successor Agent’s Telephone Number,” report the Successor Agent’s Home Address and operable Phone Numbers. Make sure that all the Successor Agent’s Numbers are well maintained by this entity and are a reliable way of reaching this party. The Second Successor Agent able to assume Principal Powers (when both of the previously mentioned Powers cannot or will not) should have his or her Legal Name, Complete Residential Address, and Current Telephone Number documented on the blank spaces labeled “Name Of Second Successor Agent,” “Second Successor Agent’s Address,” and “Second Successor Agent’s Telephone Number.”

3 – Each General Subject Of Authority Must Bear Principal Approval To Be Granted

The next segment of this document, “Grant Of General Authority,” will require a clear summarization of the Principal Powers that will be granted by the Principal and included in the Agent’s Principal Authority. Such a definition may be achieved nicely with a simple list of items, each a general topic of Authority, which can be appointed to the Agent with the Principal Act of initialing the blank space preceding that Subject of Authority.

The first subject is that of “Real Property.” If the Principal wishes the Agent to have access to and wield Principal Authority regarding “Real Property,” using his or her Name, the Principal will need to initial the blank space just before the list item “Real Property.” If this item is not initialed, the Agent will not be able to make any decisions or actions in this area on behalf of the Principal.

The second topic will be that of “Tangible Personal Property.” The Principal will need to initial the blank space corresponding to this item if he or she intends to grant this Principal Power to the Agent. If the Principal wishes to empower the Agent to wield Principal Authority in his or her “Stocks And Bonds,” the Principal must initial the blank space in the third Authority Subject of this list. If the Agent should wield Principal Power regarding the Principal’s “Commodities And Options,” the fourth item will need to be initialed by the PrincipalThe Agent can wield act on behalf of the Principal with “Banks And Other Financial Institutions,” if the Principal initials the fifth Subject Matter in this list.

The sixth item will allow the Agent to act as the Principal, wielding Principal Authority, regarding the Principal’s “Operation Of Entity Or Business,” once the Principal initials the blank space preceding it.“Insurance And Annuities” concerning the Principal can be affected by the Principal Power granted to the Agent in the seventh item, if the Principal initials the space just before the words “Insurance And Annuities”The Principal may deliver the Power the Agent needs to take Principal Actions with the Principal’s “The Estates, Trusts, And Other Beneficial Interests” by initialing the blank space in corresponding to the eighth item. The Agent can use Principal Power to engage in “Claims And Litigation” in the Name of the Principal, once the Principal initials the ninth item. The Principal Power to act with the Principal’s “Personal And Family Maintenance” of the Principal can be delegated to the Agent with the Principal’s initialing of the tenth Subject of Authority“Benefits From Governmental Programs Or Civil Or Military Service” will fall under the Principal Powers designated to the Agent if the Principal initials the eleventh item. If the Principal has decided to grant Principal Power to the Agent regarding “Retirement Plans,” he or she should initial the blank space in the twelfth item. The Principal may delegate Principal Authority in his or her Taxes should he or she initial the thirteenth line item. The Principal may choose to grant Principal Authority to the Agent in “All Preceding Subjects” of this list. If so, this may be done with the Principal Act of initialing the blank space before the words “All Preceding Subjects.” None of the other Subjects should be initialed if the Principal initials the last Subject of Power.

4 – The Principal Must Review And Approve Every Special Authority It Can Be Delegated

The next area will also require the direct attention of the Principal granting Authority through this document. Here, we will discuss the Principal Actions the Agent may take on behalf of the Principal in the Subjects listed above. This section is conditional upon the Principal’s Preferences. That is, if the Principal wishes to define what exactly the Agent may do with Principal Authority, it may be done so here. To this end, Five Action Statements will be provided below the heading “Grant Of Specific Authority (Optional).” The Principal will need to initial the blank space preceding the statement that defines Principal Actions the Agent may engage in with Principal Authority.

The Principal may assign the Principal Power to “Create, Amend, Revoke, Or Terminate An Inter Vivos Trust” to the Agent by initialing the blank line in the first item (just before the words “Create, Amend, Revoke, Or Terminate…” The Agent will be able to engage in Gifts and the act of Gifting on behalf of the Principal, if the Principal initials the second item. It is worth noting the only limits placed on these actions are those of the Nebraska Uniform Power Of Attorney Act and those stated in this form’s “Special Instructions” section below. If the Agent should have the Principal Authority to “Create Or Change Rights Of Survivorship” on behalf of the Principal, the Principal will need to initial the third statement. The Principal can deliver the Principal Authority the Agent requires to “Create Or Change Beneficiary Designation” using the Principal’s Name if the Principal initials the fourth statement. The Agent will gain the Principal Authority required to “Delegate To Another Person” any of the Principal Powers defined in this document once the Principal initials the blank space in the fifth statement. If the Agent should have the Principal Authority to “Waive The Principal’s Right To Be A Beneficiary Of A Joint And Survivor Annuity, Including Survivor Benefit Under A Retirement Plan,” the Principal will need to initial the sixth statement in this list. The Agent will be enabled to “Exercise Fiduciary Powers That The Principal Has Authority To Delegate” in the Name of the Principal (with Principal Authority), once the Principal initials the seventh Action Statement. If the Agent is to have the Principal Authority to “Renounce Or Disclaim An Interest In Property, Including A Power Of Appointment,” the Principal will need to initial the last statement.

5 – Provide Any Additional Definitions Necessary For This Delegation Of Power

The “Special Instructions” section gives a distinct area where Principal Preferences may be defined. This should be an accurate report of what the Principal requires of this document’s Effect. The Principal may deliver instructions on a variety of subjects. He or she may limit the Powers granted here, define a specific Date of Effect or Termination, Grant Additional Powers, etc. If there is not enough room provided here, you may add more space with a compatible software program or as an attachment.

6 – Optional Nominations Of A Guardian Or Conservator May Be Included Here

The “Nomination Of [Conservator Or Guardian] (Optional)” section has been provided for the convenience of naming a Nominee to be the Principal’s Guardian or Conservator in case it is ever deemed necessary. This is optional, however, if the Principal does wish to let the Courts know he or she has a specific person in mind to serve these roles, it may be done so here.

The Principal Nomination For his or her Conservator Or Guardian of his or her estate should be documented on the blank line by declaring the Name, Address, and Telephone Number on the blank spaces labeled “Name Of Nominee For [Conservator Or Guardian] Of My Estate,” “Nominee’s Address,” and “Nominee’s Telephone Number.” If the Principal wishes to Nominate a separate party for the Conservator of Estate and his or her Guardian of Person, the Nomination for the Principal’s Guardian of Person will be made by entering the Nominated Guardian’s Name, Address, and Phone Number on the blank spaces designated as “Name Of Nominee For [Guardian] Of My Person,” “Nominee’s Address,” and “Nominee’s Telephone Number.”

7 – The Principal Must Sign This Form To Satisfy Its Production

Once the Principal has reviewed this form and any attachments that may be present then verified it as an accurate description of the Principal Powers it will set in Effect, he or she must Sign and Date the two blank lines under the words “Signature And Acknowledgment.” Below his or her Signature, the Principal must Print his or her Name on the blank line labeled “Your Name Printed.”Finally, the Principal must report his or her Telephone Number and Home Address on the blank lines labeled “Your Telephone Number” and “Your Address.”The Principal’s Signature will need to be Notarized. The Notary Public may use the section directly below the Principal’s Signature to provide this service and substantiate the Principal Signing through the act of Notarization.

8 – Several Items Have Been Documented For The Agent’s Attention

The next section will document several facts regarding the Agent and the Agent’s use of Principal Power. The Attorney-in-Fact should read these pages then, in the “Optional Signature Of Agent” section, he or she should sign his or her Name on the “Agent’s Signature” line and report the Date of Signature on the next blank line. While this Signature item is optional, it is recommended to have the Agent provide it after reading and acknowledging the passage regarding the Agent’s Duties and Liabilities. The final section requiring a Notarized Signature. Locate the heading “Agent’s Certification As To The Validity Of Power Of Attorney And Agent’s Authority.” Keep in mind this section also requires the attention of the attending Notary Public. If this entity has additional instructions, they must be followed.

The County where this Power Document is being executed should be recorded on the blank line after the words “County Of”On the first blank line of this paragraph, enter the Agent’s Full Name. The next blank space must have the Principal’s Full Name recorded on it. The Execution Date of the Power Attorney being issued must be reported on the last blank space of this paragraph

The Agent should read through the numbered list. If there are any additional statements that could and should be verified by the Agent at the time of the Agent Signing, these statements must be documented on the blank lines provided in Item 4 for them to apply. The Agent must sign his or her Name on the space labeled “Agent’s Signature,” then enter the Date he or she is signing this verification statement.

The Agent’s Printed Name, Address, and Telephone Number should be documented in the appropriate areas below his or her Signature. Next, the Notary Public will notarize the Agent Statement.