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Wyoming Durable Power of Attorney Form

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Wyoming Durable Power of Attorney Form is often used to ensure that your financial responsibilities are upheld by an agent, of your choosing, even if or when you are unavailable or incapacitated for an extended period of time. This document will enable you to define how your agent can and cannot act on your behalf as well as solidify your approval of the agent’s actions. After all, it would almost be inconceivable for a financial institution to allow someone to make decisions regarding another person’s accounts without a reliable representation of the principal’s directives. This document will answer such a requirement once it is filled out, reviewed, and properly executed by the principal. You, as the principal, will need to clearly define what authority is being given and for how long before filling out and executing this paperwork.

Laws§ 3-9-104


Medical Power of Attorney – Select an agent who can serve as your healthcare representative should you become too incapacitated to communicate effectively.

How to Write

Download: Adobe PDF, Microsoft Word (.docx) or Open Document Text (.odt)

1 – Download This Template To Issue A Durable Power Of Attorney In Wyoming

The template you can download from this page by clicking on the PDF, Word, or ODT buttons will enable a Principal to officially designate an Agent with the authority to act in his or her name. You will need a clear idea of the types of authority being granted, when and how it should be delivered and terminated, and information detailing the identity and contact information for every party involved. Select the file type you will work with then click on the appropriately labeled button under the preview image. Save this file to your machine for future use, then open it with the most compatible software on your machine.

2 – A Formal Designation Of All Agents Must Be Made

The first section in this document requiring attention, “Designation Of Agent,” requires some basic information supplied to supplement the language in its declaration statement. Begin providing this information by entering the full name of the individual appointing another person with his or her authority on the blank line just before the label “(Name Of Principal).” The next three pieces of information requested in this section will all concern the person who will accept the role of Agent and represent the Principal. This section only allows for one Agent to be named, however, if the Principal wishes to name Co-Agents, he or she may do so using the “Special Instructions” section. For the moment, report the full “Name Of Agent” to the first blank line in the column below the declaration statement. The complete address reported on the Agent’s identification papers must be presented on the blank line labeled “Agent’s Address.” Finally, record the phone number where the Agent is reachable on the blank space labeled “Agent’s Telephone Number.” You may supply more than one number for the Agent, but make sure each one is up-to-date and labeled. The next area, titled “Designation Of Successor Agent(s) (Optional),” will only need attention if the Principal wishes to appoint a back-up Agent to take over for the Agent(s) listed in the first section should they not be able or willing to fulfill their roles. Keep in mind that the first Successor Agent named will only be authorized to use the principal’s power if (and only if) the Agent and any Co-Agents named are no longer eligible or able to represent the Principal. If a Successor Agent will be named, then report his or her full name, complete address, and telephone number on the blank lines labeled “Name Of Successor Agent,” “Successor Agent’s Address,” and “Successor Agent’s Telephone Number.” In some cases, the Principal may wish the added security of having a Second Successor Agent in place to represent him or her in case all the Agents above him or her are unavailable or unwilling to wield the principal’s authority. If there is such an entity, then record his or her full name, address, and telephone number on the blank lines “Name Of Second Successor Agent,” “Second Successor Agent’s Address,” and “Second Successor Agent’s Telephone Number.”

3 – The Principal Must Supply This Document With Definitions Of Power

The next areas in this document will seek a definition as to what the Principal is authorizing the Agent to do when representing him or her. Any power given to another person can have long-lasting effects on an individual’s life, thus, the Principal will need to provide proof of his or her intention to authorize each type of authority that may legally be delegated to an Agent. The first section seeking such proof is “Grant Of General Authority.” The Principal must review this list of subject matters then initial the blank space corresponding to each subject he or she wishes the Agent to have authority to represent him or her in. Thus, if the Principal wishes the Agent to buy and sell property using the Principal’s name and handle the all related financial matters, the Principal may wish to initial the subjects “Real Property,” “Tangible Personal Property,” “Banks And Other Financial Institutions,” and “Taxes.” See the example below. If should be noted that if the Principal wishes to grant authority over all these matters to the Agent, then he or she may do so by simply initialing “All Preceding Subjects.” This should only be done if the Principal has complete confidence in the Agent’s reliability and competence when acting on his or her behalf. If the Principal initials this statement, then all other statements must be left unaltered.

Once the Principal has determined and reported the types of general authority he or she wishes to appoint to the Agent, he or she has the option of granting more specific types of powers that are not on this list. The next section “Grant Of Specific Authority (Optional)” will contain the language required to deliver certain types of principal powers to an Agent. Naturally, each action on this list the Principal wishes the Agent to perform in his or her name must bear the Principal’s initials.

If the Agent must be able to create, manage, or terminate an inter vivo trust on behalf of the Principal, then the Principal should initial the first item in this list. To restrict the Agent from being able to affect an inter vivos trust in this manner then this option should be left blank. If the Principal wishes the Agent to make gifts on his or her behalf, then he or she should initial the second statement. The behavior of the Agent will be restricted by the Uniform Power Of Attorney Act, W.S. 3-9-217 and any provisions stated in any of the Principal’s directives included with this paperwork at the time of signing. The third statement will require the Principal’s initials if he or she intends the Agent to be able to “Create Or Change Rights Of Survivorship.” If the Principal wants to grant the Agent the power to “Create Or Change A Beneficiary Designation,” then the fourth statement must be initialed by the Principal. The Agent will be given the power to authorize another individual to act on the Principal’s behalf with the exact types of authority granted to him or her by the Principal if the Principal initials the fifth statement. If the Principal does not initial this option, then the Agent will not have the right to delegate any of the principal authority named here to another individual. The Agent can be granted the authority to “Waive The Principal’s Right To Be A Beneficiary Of A Joint And Survivor Annuity, Including A Survivor Benefit Under A Retirement Plan” if the Principal initials the sixth statement. If the Agent should be able to use principal power to use the same fiduciary powers the Principal has at his or her disposal, then the Principal should initial the seventh statement. The last statement should be initialed by the Principal if the Agent should have the authority to “Disclaim Or Refuse An Interest In Property, Including A Power Of Appointment” on his or her behalf.

4 – Specific Principal Instructions And Provisions May Be Included

The next three sections (“Limitations On Agent’s Authority,” “Special Instructions (Optional),” and “Effective Date”) will complete the definition of the principal authority being delivered to the Agent. Some default conditions will be explained in these sections. For instance, unless indicated in the “Special Instructions” section, the “Effective Date” when the Agent can first begin using principal authority will be the same date as the signature date. Thus, if the Principal has any provisions that should be specified, it should be reported in the “Special Instructions” section. If there is not enough room and you are filling this out by hand you may list the name of the attachment with this information, then make sure that attachment is present at the time of signing.

5 – An Option To Nominate A Conservator Or Guardian Is Available

Another option available to the Principal through this document will be to nominate a Guardian or Conservator in case a court-appointed Guardian or Conservator is required in the future. Making such a nomination will not guarantee this person will be appointed by the courts however, a nomination made by the Principal is oftentimes strongly considered during the decision-making process.

If the Principal wishes to nominate an individual to act as a court-appointed Conservator of his or her estate, then the full name, complete address, and current telephone number of this nomination should be reported on the blank spaces labeled “Name Of Nominee For Conservator Of My Estate,” “Nominee’s Address,” and “Nominee’s Telephone Number” (respectively). In addition to nominating an individual to act as a Conservator, the Principal can also nominate a court-appointed Guardian of his or her body by recording the name, address, and phone number on the blank lines “Name Of Nominee For Guardian Of My Person,” “Nominee’s Address,” and “Nominee’s Telephone Number.”

6 – A Notarized Signature From The Principal And Agent Are Mandatory

The Principal must sign this document before a notary public so that it may be executed properly. He or she will need to sign and date the blank line labeled “Your Signature And Date.” Note: The date presented here must be the current calendar date when he or she signs this document. 

The next blank space will require the Principal to print his or her name just after the words “Your Name Printed.” Finally, the Principal must fill in his or her address and telephone number on the lines labeled “Your Address” and “Your Telephone Number.” Once these actions have been completed, the Principal must release possession of this paperwork to the notary public present. The Notary Public who has observed this signing is the only party that can satisfy the next area. This area will only be completed upon the seal of the notary handling this document. Each Agent and Co-Agent appointed with principal power must read the section labeled “Important Information For Agent.” Once completed the “Signature And Acknowledgement” area of this part of the document will require the “Agent’s Signature,” “Date” (of the Agent’s signature), the “Agent’s Name Printed,” the “Agent’s Address,” and the “Agent’s Telephone Number” provided by the Agent in front of a Notary Public. The remainder of this area will be satisfied by the Notary Public who is notarizing the Agent’s act of signing.


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