Fillable Printable Military Power of Attorney Form - Louisiana
Fillable Printable Military Power of Attorney Form - Louisiana
Military Power of Attorney Form - Louisiana
LOUISIANA'S MILITARY POWER OF ATTORNEY
STATE OF LOUISIANA
PARISH OF _______________________
This is a MILITARY POWER OF ATTORNEYprepared pursuant to Title 10, United
States Code, Section 1044b and executed bya person authorized to receive legal assistance
from the military services. Federallawexempts this power ofattorney from anyrequirement of
form, substance, formality, or recording that is prescribedfor powers of attorneyunderthe laws
ofa state,the District of Columbia, or a territory, commonwealth, or possession ofthe United
States. Federal law specifies that this power ofattorney shall be giventhe same legal effect as
a power of attorneyprepared and executed in accordance with the laws of the jurisdiction where
it is presented.
Additionally, this formis specificallydesigned for use under Louisianalaw, including
transactions involving immovable property. It is suggested for use by any person authorized to
receive legal assistance from the military service in accordance with federal or state law, who by
these presents represents and warrants that he is so eligible. Anyperson to whom this form is
presentedmay conclusively rely on the authority purportedly granted hereunder.
BE ITKNOWNTHAT on this _______ day of _________________,20___, before me,
NotaryPublic in and for said parish and state, duly commissionedand qualified as such,
personally came and appeared _________________________________, who declared that
he/she is amember of the __________________________, abranchof the military designated
in R.S. 9:3861, or is otherwise included thereunder, and did execute and sign the following
Military Power of Attorney.
I,___________________________________________________________________________
(YOUR NAMEAND ADDRESS)
appoint______________________________________________________________________
(NAME AND ADDRESSOF THE PERSON APPOINTED,OR OF EACH PERSON
APPOINTED IF YOU WANT TO DESIGNATE MORE THAN ONE)
as my agent (attorney-in-fact) to act for me in anylawful way with respect to the following
initialed subjects:
I. GENERAL POWERS
TO GRANT OR WITHHOLD ANY OF THE FOLLOWING POWERS, INITIAL THE LINE IN
FRONT OF ITIN THE APPROPRIATE COLUMN ("YES" OR "NO"). (THE GRANTINGOF
POWERS AFFECTING IMMOVABLE PROPERTY IS PROVIDED IN A SEPARATE SECTION.)
YES____ NO ____ (A) Tangible personal property transactions.
YES____ NO ____ (B) Stock and bond transactions.
YES____ NO ____ (C) Commodity and option transactions.
YES____ NO ____ (D) Banking and other financial institution transactions.
YES____ NO ____ (E) Business operatingtransactions.
YES____ NO ____ (F) Insurance and annuity transactions.
YES____ NO ____ (G) Estate, trust, and other beneficiary transactions.
YES____ NO ____ (H) Claims andlitigation.
YES____ NO ____ (I) Personal and family maintenance.
YES____ NO ____ (J) Care, custody, and control of a minor child.
YES____ NO ____ (K) Benefits from social security, Medicare, Medicaid, or other
governmental programs, or civil or military service.
YES____ NO ____ (L) Retirement plan transactions.
YES____ NO ____ (M) Tax matters.
YES____ NO ____ (N) ALL OF THE POWERS LISTED ABOVE.
YOU NEED NOTINITIAL ANY OTHER LINES IF YOU INITIALIN THE APPROPRIATE
COLUMN ("YES" OR "NO") OF LINE (N).
II. POWERSAFFECTING IMMOVABLE PROPERTY
TO GRANT THE POWER TO AFFECT IMMOVABLEOR REAL PROPERTY WHICH YOU
OWN,SUCH AS SELL, LEASE, OR MORTGAGE REAL ESTATE, INITIAL IN THE
APPROPRIATE COLUMN ("YES" OR "NO") OF LINE(P) AND PROVIDE LOCATION OF
PROPERTY.
YES ____ NO____ (P) Real property transactions affectingthe following property:
____________________________________________________________________________
____________________________________________________________________________
III. SPECIAL INSTRUCTIONS
ON THE FOLLOWINGLINES YOUMAY GIVE SPECIAL INSTRUCTIONS LIMITING OR
EXTENDING THE POWERS GRANTED TO YOUR AGENT.
____________________________________________________________________________
____________________________________________________________________________
UNLESS YOU DIRECT OTHERWISE ABOVE, THIS POWEROF ATTORNEY IS EFFECTIVE
IMMEDIATELY AND WILL CONTINUE UNTIL IT IS REVOKED.
This power of attorney will:
________ Continue to be effective even though I become incapacita ted.
________ Terminate when I become incapacitated.
EXERCISE OF POWER OF ATTORNEY WHERE MORE THAN ONE AGENT DESIGNATED
If I have designated more than one agent, the agents are to act:
____ separately or ____ jointly.
I agree that any third party who receives a copy of this document may act under it. I agree that
anytransaction enteredinto by any thirdparty in reliance onthis document shall be binding
upon me and I hereby waive all rights I mayhave to challenge the authority of the named agent,
except to recover against him. Revocation ofthe power ofattorneyis not effective as to a third
party until the third party has actual knowledge of the revocation.
__________________________________________
Name:_____________________________________
SSN:(optional)______________________________
Done and passed atthe Parish of ________________, Louisiana, on the day and date
firstabove written, in the presence of the undersigned competent witnesses, (two witnesses
preferred, but onlyrequired if line (P) is initialed) who sign with appearerand me, officer, after
due reading of the whole.
WITNESSES:
_______________________________________________
Name:__________________________________________
_______________________________________________
Name:__________________________________________
________________________________________
NotaryPublic:_____________________________
NotaryNumber:___________________________
My commission expires:____________________
