Fillable Printable Limited Power of Attorney Sample Form

Limited Power of Attorney Sample Form

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[https://LegalArrow.com/FREE‐Power‐of‐Attorney‐Form.shtml].Youareusingthisformatyourownrisk.

Furthermore,theuseofthisformissubjecttothedisclaimerspostedathttp://LegalArrow.com

.

RECORDING REQUESTED BY

___________________________

MAIL TO ADDRESS

____________________________

Limited Power of Attorney

I, _______________________ (AKA ________________________ ) of ______________ (city),

_________________ (state), appoint _____________________ of ______________(city),

_________________ (state), as my attorney-in-fact to act on my behalf for the purpose(s) of:

____________________________________________________________

This power of attorney starts to be effective on ______________, and shall continue until

_______________.

I grant my attorney-in-fact full authority to act in any reasonable and necessary manner for the

purpose of exercising the above powers. I ratify all lawfully performed acts by my attorney-in-

fact in exercising those powers.

I agree that any third party who is given a copy of this power of attorney may act relying on it. I

agree that revocation of this power of attorney is effective as to a third party only upon receipt of

actual notice by the third party. If because of reliance on this power of attorney, a third party

suffers any loss, I agree to indemnify the third party for the loss.

Signed this _______ day of _______________________ , _________ .

State of ________________________

____________________________________________

Signature of _______________________ , Principal

Page2of2–SampleLimitedPowerofAttorneyFormprintedfromtheLegalArrow®website.

[https://LegalArrow.com/FREE‐Power‐of‐Attorney‐Form.shtml].Youareusingthisformatyourownrisk.

Furthermore,theuseofthisformissubjecttothedisclaimerspostedathttp://LegalArrow.com

.

Signature of Attorney-in-Fact

By accepting this appointment and acting under it, the attorney-in-fact (agent) assumes the legal

responsibilities of an agent.

______________________________________________

Signature of _______________________ , Attorney-in-Fact

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