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West Virginia Power of Attorney Forms

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West Virginia Power of Attorney Forms allows an individual to appoint a proxy to act for them in certain specified situations. A wide range of such appointments can be defined depending upon your needs and circumstances. Some allow you to legally appoint another to act on your behalf in financial matters, others are for more narrow purposes such as vehicle transfer or tax help. In all cases, it is important to consider who you will be appointed as your agent. Considering factors such as trustworthiness, responsibility, expertise, and reliability will assist you in choosing the best person.

Laws – Chapter 39B (Uniform Power of Attorney Act)

Types

Durable (Financial) Power of Attorney – A durable form is sometimes used as a long-term planning solution when you want to make sure you have someone in place to handle your financial affairs in the event you are no longer able to act for yourself.

General (Financial) Power of Attorney – A general form is similar to the durable form, because it allows you to appoint someone to handle your financial matters, however, it becomes void at the point you are no longer able to act for yourself.

Limited (Springing) Power of Attorney – For use when you have a specific transaction or matter for which you need an agent to act for you. Such an agency would end when the transaction is complete.

Medical Power of Attorney – This type allows you to designate a loved on to make medical decisions on your behalf in the event that you cannot make the decisions yourself.

Minor Child Power of Attorney – Allow another individual to handle a child’s healthcare and education decisions.

  • Download: Adobe PDF, Microsoft Word (.docx), Open Document Text (.odt)
  • Signing Requirement (§ 49-8-4): Caregiver and Notary Public

Real Estate Power of Attorney – Allows for the management, purchase, selling, or any other responsibilities to be given to someone else for a single property in accordance with § 39B-2-104.

Revocation of Power of Attorney – Use this form if you want to revoke a POA that you previously entered into. Make sure you inform everyone that has a copy of your old form that you have revoked it – especially your agents.

Tax Power of Attorney (Form WV 2848) – This form can be used to designate a tax professional to handle your tax filings, or deal with issues with the tax department.

  • Download: Adobe PDF
  • Signing Requirement: One (1) Witnesses or a Notary Public

Vehicle Power of Attorney (Form DMV-9-TR) – This form can be used to appoint another to handle registration and title claims with the Motor Vehicle Division of Motor Vehicles.

  • Download: Adobe PDF
  • Signing Requirement: Notary Public

How to Write

1 – Obtain A Copy Of The Attorney-in-Fact Designation Paperwork

The template supplied to this page can be accessed using the PDF, ODT, and Word buttons presented with the caption of the preview image. You may download this form in any of the file types displayed as desired

2 – Name The Agent(s) Serving As The Principal’s Attorney-in-Fact

The introduction to this template will disclose some valuable information, so before supplying any information, make sure the Principal issuing this document is fully abreast of its contents.

The first area that will require direct input will be the “Designation Of Agent” section. You may supply this information directly onscreen if you have a compatible editing program or you may print this form and fill it out manually. Start by recording the First, Middle, and Last Name of the Principal on the blank line before the parentheses label “Name Of Principal.” 

This statement will lead directly to an area containing three blank lines (“Name Of Agent,” “Agent’s Address,” and “Agent’s Telephone Number”). Use these lines to record the Full Name of the Attorney-in-Fact accepting Principal Authority, the Residential Address of this individual, and the current Telephone Number. It is recommended to list all the telephone lines the Attorney-in-Fact maintains (i.e. Work Phone, Home Phone, Cell Phone). This template will allow for the designation of a Successor Agent. That is, an Attorney-in-Fact who will be the default recipient of Principal Powers should the designated Agent fail to uphold the Principal’s Directive or is unable to act as the Attorney-in-Fact. The Name, Address, and Phone Number of the Successor Agent should be recorded on the “Successor Agent’s Name,” “Successor Agent’s Address,” and “Successor Agent’s Telephone Number.” In addition to the Successor Agent, this template can set the Principal Powers to automatically be delivered to a Second Successor Agent if neither the designated Agent nor the Successor Agent will wield Principal Power (for whatever reason). The final area in this section provides three empty lines: “Name Of Second Successor Agent, “Second Successor Agent’s Address,” and “Second Successor Agent’s Telephone Number.” Document the Name, Residential Address and current Telephone Number on these lines.

3 – A Declaration Of Authority Must Be Approved By The Principal

The section titled “Grant Of General Authority” is a list of the Principal Powers that can be assigned to the Principal’s Agent. It should be kept in mind that each item on this list will give the Attorney-in-Fact the right to behave as if he or she were the Principal in the listed subject matter. The Principal must initial each blank line that is attached to the subject he or she wishes to grant the Agent. Any subject not initialed by the Principal will be an area where the Agent may not act as the Principal. As a matter of convenience, the last item on this list is “All Preceding Subjects.” The Principal may issue all these Powers to the Attorney-in-Fact in one fell swoop by initialing this item. This item may not be initialed if any of the subjects in this list has already been initialed. That is the Principal has the option to choose which Powers to grant the Agent by initialing each allowable Power or the Principal may initial the last item to assign all Powers here to the Agent. The next area will also deal with determining how the Agent may act with Principal Authority. The “Grant Of Specific Authority (Optional)” section will serve as a method to narrow down what actions the Agent may or may not do. To grant the Agent the Principal Authority to perform an action in this list on behalf of the Principal requires the Principal locate that statement description on this list, then initial the blank space attached to it.

The first statement will give the Attorney-in-Fact the Principal Authority to handle the Principal’s Inter Vivos Trusts by Creating, Amending, or Revoking them on behalf of the Principal. The Principal Authority to perform these actions can be granted when the Principal initials this Power Statement The Principal can specifically appoint the Principal Power to perform Gifting Actions using the Principal’ Name by initialing the second statement in this list. If the Agent should be able to be able to “Create Or Change Rights Of Survivorship” on behalf of the Principal and with Principal Authority, then the Principal should initial the third action description Similarly, the Principal can initial the third statement if he or she wishes to appoint the Agent with the Principal Power to “Create Or Change A Beneficiary Designation.” If the Agent’s Principal Powers should include the Power to Delegate Principal Authority to a third party, then he or she should initial the fifth statement. The Agent can be designated with the Principal Authority to “Waive the Principal’s Right To Be A Beneficiary” in terms of a joint or survivor annuity inside and outside of Retirement Plans. If the Principal has Fiduciary Powers, these Fiduciary Powers (and responsibilities) can be granted to the Agent when he or she initials the seventh statement. The Power to “Disclaim Or Refuse An Interest In Property” on behalf of the Principal can be included in the Agent’s Principal Powers when he or she initials the last action statement. The “Special Instructions” section will conclude the description of Principal Authority that shall be delivered to the Agent through this document. Here, several blank lines have been presented so that any Principal Adjustments can be applied. This can include Principal Preferences regarding when the Authority here goes into effect or terminates, limitations the Principal expects the Agent to observe, restrictions on Power the Agent may not engage in, or special instructions the Principal may wish delivered and applied. If there are not enough blank lines to report this fully, you may continue on an attachment.

5 – A Guardian And/Or Conservator Can Be Nominated Through This Paperwork

The Principal using this paperwork can also submit a nomination for a Guardian of his or her person and/or Conservator of his or her estate should the courts ever find it necessary to appoint one. This nomination would not automatically determine such a Guardian or Conservator’s appointment but the Principal’s Nomination for these roles would be taken seriously. The Principal can nominate a party for one or both of these roles or may choose to leave it up to the courts altogether.

If the Principal intends to nominate a Conservator of his or her Estate, this entity’s Name and Contact Information must be recorded on the blank lines labeled “Name Of Nominee (Conservator Or Guardian) Of My Estate,” “Nominee’s Address,” and “Nominee’s Telephone Number.” If the Principal has a specific person in mind to serve as his or her Guardian should the courts decide this is necessary, then the intended Guardian’s Name, Address, and Telephone Number must be recorded on the blank lines labeled “Name Of Nominee For [Guardian] Of My Person,” “Nominee’s Address,” and “Nominee’s Telephone Number.”

4 – An Executing Signature Is Mandatory To Set This Document In Motion

The Principal will have to sign this paperwork to make it official. Otherwise, it will not be taken seriously as proof of the Principal’s Intentions or Approval. The “Signature And Acknowledgment” has been constructed with the areas that executing this document will require. First, the Principal must sign his or her Name on the blank line labeled “Your Signature”  The Date the Principal signed the “Your Signature” line must be reported on the blank line labeled “Date”

Next, the Principal should print his or her Name, record the Address where he or she resides, an enter his or her Telephone Number on the blank lines bearing the labels “Your Name Printed,” “Your Address,” and “Your Telephone Number.” The serious nature and possible consequence of issuing this Authority will necessitate some form of verification that it was indeed signed by the Principal. Such authentication shall be provided via the process of Notarization. The Principal will have to release this paperwork to the Notary Public he or she signed it before so that this entity may satisfy the requirements of the Notary section below the Principal’s Signature.

The “Agent’s Duties” section will have to be reviewed by the Agent receiving this Authority. Item 3 on the first page will provide an opportunity to practice how Principal Documents will likely have to be signed. The first blank line should have the Agent’s printing of the Principal Name while the second blank line requires the Agent’s Signature. The attached document, “Agent’s Certification As To The Validity Of Power Of Attorney And Agent’s Authority,” will require the Agent’s Attention. The top of the page will contain a heading which must have the State and County where the Powers have been assigned to the Agent supplied on the appropriate blank lines. The body of this page will also request information be supplied before the Agent Signature is furnished. The blank space preceding the label “(Name Of Agent)” must have the Full Name of the Agent printed precisely as it appears in the Power Document’s introduction The Name of the Principal should be transcribed from the first page to the second blank line (labeled “Name Of Principal”) on this page Finally, report the Execution Date of the Power Document onto the empty line following the words “…In A Power Of Attorney Date” The next portion will contain three numbered testimonial statements. If the Signature Agent is a Successor Agent, he or she should document why the Power Of Attorney is being assumed by him or her on the blank lines provided.     The Agent must Sign his or her Name and enter the Date of Signature on the blank line labeled “Agent’s Signature & Date”  The “Agent’s Name Printed” line requires the Agent to print his or her Name on it. 

The “Agent’s Address” and “Agent’s Telephone Number” should be recorded by the Agent on the next two blank lines. The Notary Public serving this execution will use the remainder of this page to notarize the Agent Signature.


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