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Nebraska Durable (Financial) Power of Attorney Form

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Nebraska Durable (Financial) Power of Attorney Form is a type of form that allows you to transfer the power to manage your property, including money, to another party or agent. Why would anyone do this? Generally, this “durable” form is used by people who are looking to make sure their spouse or another trusted relative has the ability to manage financial matters when incapacitated or otherwise unable to communicate. It is often used as a long-term planning tool. This type of document is called “durable” because it stays in effect even after incapacity or (if preferred) it can spring into effect upon your incapacity.

Laws – § 30-4041


Health Care Power of Attorney – This document can be completed to provide your agent with the ability to represent you and carry out your health care preferences once it becomes impossible to do so yourself.

How to Write

1 – You May Begin The Appointment Process By Opening This Form

The form to assign Durable Powers to an Agent can be downloaded through the buttons directly under the preview picture of the form on this page.

2 – The Official Delegation Of Power Must Be Formally Proclaimed

The introduction will contain quite a bit of information for the Principal. He or she should read this introduction and make sure it is fully comprehended before proceeding with the preparation of this paperwork. When it is time to move forward, locate the first blank space under the heading “Designation Of Agent,” then enter the Principal’s entire Legal Name.

Immediately following the required wording, use the next three blank spaces to fill out the Agent’s (or Attorney-in-Fact) information. Enter the Agent’s Legal Full Name after the words “Name Of Agent.”

Next, enter the Agent’s Legal Address onto the blank line after the label “Agent’s Address”

Finally, use the line labeled “Agent’s Telephone Number” to record the Attorney-in-Fact’s up-to-date and well-maintained Telephone Number (Home, Cell, and/or Work Numbers).

3 – Any Existing Successor Agents Should Be Documented

If any Successor Agents have been determined, their Identity and Contact Information should be properly documented. This is an optional designation that is usually made for a little insurance in case the Agent named above cannot fulfill his or her Principal Duties. You may utilize the three bank lines beneath the heading “Designation Of Successor Agent (Optional) to enter the First Successor Agent’s Name, Address, and Telephone Number. If the Principal has taken the additional precaution of determining a Second Successor Agent, in case the First Successor Agent cannot carry out Principal Duties, the Identity and Contact Information should be documented on the three blank spaces below the statement “If My Successor Agent Is Unable Or Unwilling…”

4 – A Delegation Of General Authority And Powers Must Be Made

The purpose of this paperwork will be to grant the Principal Agent, named above, with the required Principal Approval to use Principal Authority in certain areas or a broad range of areas. The Principal Matters granted to the Agent will need to be defined through the Principal’s Approval. Such Approval will be provided with the Principal Act of initialing the Subject Matters the Agent has Principal Authority within the section labeled “Grant Of Authority.”

The Agent may be assigned with the Principal Authority to make decisions on behalf of the Principal regarding “Real Property, if the Principal initials the blank space just before the words “Real Property.”The Principal will grant the Agent the Authority to act upon his or her Personal Property when the Principal initials the “Tangible Personal Property” matter. The Agent will be able to utilize Principal Authority regarding the Principal’s Stocks and the Principal’s Bonds, if the Principal initials the subject matter “Stocks and Bonds.”If the Principal intends to deliver Principal Power over his or her “Commodities And Options” to the Agent, the fourth item on this list will need to be initialed by the Principal. The fifth Subject Matter, “Banks And Other Financial Institutions” will give the Agent the Principal Power to act as the Principal with Financial Institutions. The Principal will need to initial this item if the Agent is to have the Principal Authority to behave in such a manner. The next Subject Matter, “Operation Of Entity Or Business,” will enable the Agent to engage in the same Decision-Making Actions regarding Business Entities under the Principal’s Authority, as if he or she were the Principal when the Principal initials the sixth Subject Matter. If the Principal wishes to grant the Agent the ability to utilize Principal Powers to act on his or her behalf with “Insurance And Annuities,” the seventh list item must be initialed by the Principal.

If desired, the Principal can also grant the Agent Principal Power regarding his or her “Estates, Trusts, And Other Beneficial Interests”  by initialing the blank space just before the word “Estates…”

The Agent may represent the Principal with Principal Powers in matters of “Claims And Litigation” if this statement is initialed by the Principal.

The Principal’s “Personal And Family Maintenance” matters will be within the scope of Principal Powers given to the Agent when he or she initials the blank line corresponding to the eighth Subject Matter. If the Principal has determined the Agent should be able to act with the same Authority he or she does regarding “Benefits From Governmental Programs Or Civil Or Military Service” then, he or she must initial the ninth list item presented.

The Principal will need to initial the tenth Subject Matter to give the Agent Principal Powers regarding his or her “Retirement Plans.”The Agent exerts Principal Authority in terms of the Principal’s Tax Matters, once the Principal initials the blank line preceding the word “Taxes.”In the event the Principal has decided to grant Principal Authority in all the previous Subject Matters, then he or she should leave all the previous items unmarked and initial the blank space just before the words “All Preceding Subjects.”

5 – The Appointment of Specific Actions Can Be Defined

The Principal may decide to limit the Agent form performing certain acts with Principal Authority. If so, then he or she will need to tend to the “Grant of Specific Authority (Optional)” section. If this section is not attended to, it will be assumed the Agent may undertake all these actions with Principal Authority once this form is signed. Any of these statements that are not initialed by the Principal will not be included in the Agent’s Principal Authority thus, preventing the Agent from engaging in such activities.

If the Principal would like to grant the Agent the Principal Power to “Create, Amend, Revoke, Or Terminate An Inter Vivos Trust” on behalf of the Principal, the first statement will need to be initialed by the Principal.

The Principal will need to initial the second statement if the Agent should have the Principal Power to engage in Gift Making as defined by the Nebraska Uniform Power of Attorney Act.

If the Agent should have the Principal Authority to Create or Change the Principal’s Rights of Survivorship, the Principal will need to initial the blank space just before the words “Create Or Change Rights Of Survivorship.”

The Principal can grant the Agent the Principal Authority to “Create Or Change A Beneficiary Designation” by initialing the fourth Subject Matter.

The fifth Action Statement should be initialed by the Principal, if he or she wishes the Agent to have the Principal Power to “Delegate To Another Person To Exercise The Authority Granted Under This Power Of Attorney.”

The sixth statement must be initialed by the Principal if he or she has determined the Agent should be able to “Waive the Principal’s Right To Be A Beneficiary” to all types of Joint and Survivor Annuity.The seventh statement should be initialed by the Principal if he or she wishes to grant the Agent the Principal Power to “Exercise Fiduciary Powers That The Principal Has Authority To Delegate” If the Principal would like the Agent to have the Authority to “Renounce Or Disclaim An Interest In Property, Including A Power Of Appointment,” then he or she should initial the last Subject Matter.

6 – Additional Principal Instructions Should Be Presented

This document has been catered to apply to most cases, however, the Principal may have Personal Preferences as to the Authority being granted to the Agent. This can include limitations, circumstances, or even extensions that should be applied to the Principal Powers granted to the Agent. Such Principal Preferences must be included in the “Special Instructions (Optional)” section. If such statements require an attachment, make sure the attachment is present by the time the Principal signs this paperwork. Keep in mind that any Co-Agents or Preferences regarding the Effective Term of Principal Powers should be made here.

7 – The Principal Can Designate A Conservator And/Or Guardian

In some cases, the Principal would like to Nominate a Conservator of his or her Estate and/or a Guardian of his or her Person should the courts need to appoint one in the future. Such a Nomination may be made in this document. This is optional.

If Naming a Conservator then, use the three blank spaces labeled “Name of Nominee [Conservator Or Guardian] Of My Estate,” “Nominee’s Address,” and “Nominee’s Telephone Number” to document the Principal’s Nominee’s Name, Address, and current Telephone Number. If the Principal has a Nomination for both a Conservator and a Guardian then, enter the Conservator’s information here and the Guardian’s in the next section. If only one party has been determined then, only fill out this area.

If a Conservator and a Guardian have been named, then enter the Full Name, Address, and Telephone Number of the Guardian on the blank lines labeled “Name Of Nominee For [Guardian] Of My Person,” “Nominee’s Address,” and “Nominee’s Telephone Number” (respectively).

8 – A Principal Acknowledgment Is Provided By The Principal Signing

The section labeled “Signature And Acknowledgement” will solidify the intent of the Principal to execute this document and set its terms active.

The Principal should sign his or her Name on the blank line labeled “Your Signature.”

The Principal will also need to report the Date he or she provides the Signature above on the blank line labeled “Date.”

The Principal must Print his or her Name, then supply his or her Telephone Number, as well as his or her Address on the blank lines labeled “Your Name Printed,” “Your Telephone Number,” and “Your Address.”

The area below the words “State Of Nebraska” is reserved for the Notarization process the Notary Public will conduct.

9 – Agent Acknowledgement Is A Required Item

The next area will provide a statement the Agent gaining principal Powers should read and become familiar with. There will be an optional signature area the Agent may sign to acknowledge the Duties And Liabilities of the Agent. He or she should sign and date the area labeled “Optional Signature Of Agent.” Once again, this is not a required signature, but it should be considered in everyone’s best interest for this area to be satisfied.

The next section, “Agent’s Certification As To The Validity Of Power Of Attorney And Agent’s Authority” will require a Notarized Signature of the Agent. This will act as verification of the Agent’s understanding and intent.

The first blank line will require the Name of the County where this paperwork is being signed and executed.

Enter the Agent’s Name on the blank space just before the “Name Of Agent” label.

This should be followed by the Principal’s Name recorded on the blank space preceding the label “Name of Principal.”
Finally, the Date of the Principal’s Signing should be reported on the last blank space of this introductory statement.

If the Agent has any additional statements to make regarding this paperwork, it should be provided on the blank lines in item 4. 

The Agent must Sign and Date his or her Name on the empty lines just above the words “Agent’s Signature” and “Date” (respectively).

The Agent’s Printed Name, Address, and Phone Number should be supplied on the blank spaces below the Agent’s Signature.

The last page will complete this paperwork by the act of Notarization. Only the Notary Public present for the Agent Signing may fulfill these items.


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