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 ATTORNEY prepared pursuant to Title 10, United

States Code, Section 1044b and executed by a person authorized to receive legal assistance

from the military services. Federal law exempts this power of attorney from any requirement of

form, substance, formality, or recording that is prescribed for powers of attorney under the laws

of a state, the District of Columbia, or a territory, commonwealth, or possession of the United

States. Federal law specifies that this power of attorney shall be given the same legal effect as

a power of attorney prepared and executed in accordance with the laws of the jurisdiction where

it is presented.

Additionally, this form is specifically designed for use under Louisiana law, 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. Any person to whom this form is

presented may conclusively rely on the authority purportedly granted hereunder.

BE IT KNOWN THAT on this _______ day of _________________, 20___, before me,

Notary Public in and for said parish and state, duly commissioned and qualified as such,

personally came and appeared _________________________________, who declared that

he/she is a member of the __________________________, a branch of 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 NAME AND ADDRESS)

appoint______________________________________________________________________

(NAME AND ADDRESS OF 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 any lawful 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 IT IN THE APPROPRIATE COLUMN ("YES" OR "NO"). (THE GRANTING OF

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 operating transactions.

YES ____ NO ____ (F) Insurance and annuity transactions.

YES ____ NO ____ (G) Estate, trust, and other beneficiary transactions.

YES ____ NO ____ (H) Claims and litigation.

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 NOT INITIAL ANY OTHER LINES IF YOU INITIAL IN THE APPROPRIATE

COLUMN ("YES" OR "NO") OF LINE (N).

II. POWERS AFFECTING IMMOVABLE PROPERTY

TO GRANT THE POWER TO AFFECT IMMOVABLE OR 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 affecting the following property:

____________________________________________________________________________

III. SPECIAL INSTRUCTIONS

ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS LIMITING OR

EXTENDING THE POWERS GRANTED TO YOUR AGENT.

____________________________________________________________________________

UNLESS YOU DIRECT OTHERWISE ABOVE, THIS POWER OF 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

any transaction entered into by any third party in reliance on this document shall be binding

upon me and I hereby waive all rights I may have to challenge the authority of the named agent,

except to recover against him. Revocation of the power of attorney is not effective as to a third

party until the third party has actual knowledge of the revocation.

__________________________________________

Name:_____________________________________

SSN:(optional)______________________________

Done and passed at the Parish of ________________, Louisiana, on the day and date

first above written, in the presence of the undersigned competent witnesses, (two witnesses

preferred, but only required if line (P) is initialed) who sign with appearer and me, officer, after

due reading of the whole.

WITNESSES:

_______________________________________________

Name:__________________________________________

_______________________________________________

Name:__________________________________________

________________________________________

Notary Public:_____________________________

Notary Number:___________________________

My commission expires:____________________