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West Virginia Durable (Financial) Power of Attorney Form

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Durable Power of Attorney in West Virginia may be the document to use in the event that you seek to appoint a loved one to be the agent for your general financial matters if you get sick and unable to continue to act for yourself. Having someone in place to care of things can provide peace of mind that your affairs will be handled as if you were still able to do it yourself.

LawsChapter 39B, Article 3 (Uniform Power of Attorney Act)

Medical Power of Attorney – Identifies the attorney-in-fact responsible for caring for the Principal’s healthcare decisions.

How to Write

1 – Open The West Virginia Document You Will Need To Appoint An Attorney-in-Fact

The Documentation for a Principal’s declaration of Authority can be saved by clicking on any of the buttons (Adobe PDF, Microsoft Word (.docx), or Open Document Text (.odt)) accompanying the preview picture on this page. Save a copy to your machine then open it with the appropriate program or print it to fill it out.

2 – The “Designation Of Agent” Section Calls For Some Preparation

The first area of this paperwork that shall require some attention will be under the heading “Designation Of Agent.” The first blank space presented here requires the Name of the Principal in this document. This sentence will state that the Principal named here will approve an Attorney-in-Fact’s use of his or her Authority or Principal Powers.

The next three lines, labeled as “Name Of Agent,” “Agent’s Address,” and “Agent’s Telephone Number.” Utilize these lines to record the Full Name (First, Middle, and Last), Complete Address (Street Address, City, State, Zip Code), and current Telephone Numbers (Home Number, Work Number, Cell Number) of the Attorney-in-Fact. Because of this statement, the Attorney-in-Fact will be able to wield the Principal Powers that are approved in this document. Oftentimes, the Principal would like some assurance that his or her directives will be carried out when necessary, regardless of whether the Attorney-in-Fact is available or eligible to wield Principal Authority. Therefore, a section has been included where a Successor Agent who will be held in reserve and be assigned Principal Power only when the Attorney-in-Fact is “Unable Or Unwilling To Act” on behalf of the Principal. The three spaces following the words “…I Name As My Successor Agent,” will request the “Name Of Successor Agent,” “Successor Agent’s Address,” and “Successor Agent’s Telephone Number.”  In the next area there will be an opportunity to name a Second Successor Agent. This entity will be an Agent who will be appointed with the approved Principal Powers in this document if the Attorney-in-Fact and Successor Agent are both unable or otherwise ineligible to use Principal Authority. Naturally, we will have to identify this entity clearly. This will be handled using the blank spaces labeled “Name Of Second Successor Agent,” “Second Successor Agent’s Address,” and “Second Successor Agent’s Telephone Number.”

3 – The “Grant Of General Authority” Can Only Be Satisfied Through Principal Attention

The Principal will need to participate directly in the preparation of this appointment. He or she will have to locate the check list under the heading “Grant Of Authority” then initial each Principal Matter listed where the Attorney-in-Fact will have the Principal Authority to represent the Principal in. Any Principal Matter not initialed by the Principal will be withheld from the Principal Authority approved for the Attorney-in-Fact’s use. If the Principal wishes to approve the Attorney-in-Fact’s use of Authority in all the Principal Matters listed, he or she can simply initial the last blank line (corresponding to the label “All Preceding Subjects”). 

4 – A “Grant Of Specific Authority” May Be Included At The Principal’s Discretion

Next a list of actions the Attorney-in-Fact may take with the Principal Authority to do so is presented in the “Grant Of Specific Authority” section. Here, the Principal will have to read through the actions this section describes, decide which ones the Attorney-in-Fact may take in his or her name, then initial the blank space that precedes each action he or she will approve of the Attorney-in-Fact. If the Principal leaves a specific description un-initialed, it will indicate the Attorney-in-Fact has not received Principal Approval to carry out the action it defines.

5 – Any “Special Instructions” Regarding This Delegation Of Authority Should Be Documented

The Principal may have additional provisions to the Principal Powers delivered here. If so, they should be discussed in the “Special Instructions (Optional)” section. Thus, any additional Powers, Specific Powers, Limitations and/or Restrictions the Principal wishes applied directly to the Attorney-in-Fact’s use of Principal Authority must be included on the blank lines provided here before this paperwork is executed. For instance, if the Principal wishes the Authority described in this document is only available for the Attorney-in-Fact’s use during a predetermined Time Frame, then he or she may list the First Calendar Date and the Last Calendar Date when the Attorney-in-Fact may wield Principal Authority in this section.

6 – A Nomination Of A Principal Conservator Or Guardian May Be Made Through This Document

This appointment form can also act as documentation for a Principal Nomination of a Conservator or Guardian. This can be handy if the courts decide at some point in the future that one should be formally appointed, and the Principal has one or more people in mind for these positions. In the next section, the “Name Of Nominee For (Conservator Or Guardian) Of My Estate” will accept the Name of the individual who the Principal wishes to safeguard his or her estate should he or she become incapacitated and the courts wish to appoint a Conservator. Below the Nominee’s Name, his or her location and contact Phone Number should be reported. These may be supplied to the blank spaces labeled “Nominee’s Address” and “Nominee’s Telephone Number.” The next series of blank lines will focus on the Principal’s Nomination for a Guardian of his or her person. The Nominee’s Name, location, and Phone Numbers should be produced on the blank lines labeled “Name Of Nominee For (Guardian) Of My Person,” “Nominee’s Address,” and “Nominee’s Telephone Number.”

7 – The Signature Execution Is Delivered By The Principal

The final Principal Requirement of this paperwork will be its execution. To place the terms of this appointment in Effect, the Principal must offer a valid Signature. He or she must locate the “Signature of Acknowledgement” section then sign the line above the label “Your Signature” then, enter the Calendar Date of Signature on the blank line labeled “Date.” After signing this document, the Principal must print his or her Name, Address, and Phone Number on the lines labeled “Your Name Printed,” “Your Address,” and “Your Telephone Number.” The area immediately following the Principal’s items has been included and reserved strictly for the Notarization Process. Only the attending Notary Public can fill out this section.

8 – The Attorney-in-Fact Should Review And Sign This Template

The “Important Information For Agent” section of this paperwork is geared to disclose information to the Attorney-in-Fact as well as supply a practice area for him or her.  The “Agent’s Certification As To The Validity Of Powers Of Attorney And Agent’s Authority” section requires the State and County where this documented is executed on the first two blank lines. 

The Name of the Attorney-in-Fact should be presented on the line labeled as “Name Of Agent.” The Full Name of the Principal is required on the “Name Of Principal” line. The Date the Principal’s Signature was recorded should be transcribed to the blank space after the words “…Power Of Attorney Dated.”  The Attorney-in-Fact must Sign and Date the blank line “Agent’s Signature And Date” line and print his or her Name on the “Agent’s Name Printed” line in the “Signature ANd Acknowledgment” area of his or her testimonial.  Finally, the Agent must present his or her Address and Telephone Number on the next two blank lines. The next four spaces (“Date,” “Name Of Principal,” and “Signature Of Notary With Seal, If Any,” and “My Commission Expires”) may only be satisfied by a Notary Public. Any information relevant to a Successor Agent’s access and use of Principal Powers should be recorded in item number “(3).” The Name of the individual who prepared this paperwork should be recorded on the last blank space.