Fillable Printable Sample Statutory Power of Attorney Short Form

Sample Statutory Power of Attorney Short Form

Statutory Short Form Power of Attorney Uniform Conveyancing

STATUTORY POWER OF ATTORNEY

SHORT FORM

IMPORTANT NOTICE: The powers granted by this

document are broad and sweeping. They are defined

in recorded individual State Statutes. If you have

any questions about these powers, obtain competent

advice. This power of attorney may be revoked by

you if you wish to do so. This Power of Attorney is

automatically terminated if it is to your spouse and

proceedings are commenced for dissolution, legal

separation or annulment of your marriage. This

power of attorney authorizes, but does not require,

the aftorney-in-fact to act for you.

(reserved for recording data)

PRINCIPAL (Name and address of person granting

the power)

SUCCESSOR ATTORNEY(S)-IN-FACT (Optional)

To act if any named attorney-in-fact resigns, dies or is

otherwise unable to serve

(Name and Address)

ATTORNEY(S)-IN-FACT

(Name and Address)

First Successor

Second Successor

EXPIRATION DATE (Optional)

NOTICE: If more than one attorney-in-fact is desig-

nated, make a check or "x" on the line m front of one

of the following statements:

Year Only

Day

Use Specific Month

Each attorney-in-fact may independently exer-

cise the powers granted.

All attorneys-in-fact must jointly exercise the

powers granted.

I (the above named Principal), appoint the above named Attomey(s)-in-Fact to act as my attorney(s)-in-fact:

FIRST: To act for me in any way I myself could act with respect to the following matters, as each of them is

defined in State recorded Statutes:

(To grant to the attorney-in-fact any of the following powers, make a check or "x" on the line in front of each

power being granted. You may, but need not, cross out each power not granted. Failure to make a check or "x" on

the line in front of the power will have the effect of deleting the power unless the line in front of the power of (N)

is checked or x-ed.)

Check or "X"

(A) real property transactions;

County,

I choose to limit this power to real property in

State of described as follows: (Use legal description. Do not use street address.)

(If more space is needed, continue on the back or on an attachment)

(I) fiduciary transactions;

(J) claims and litigation;

(B) tangible personal property transactions;

(K) family maintenance;

(D) banking transactions;

(L) benefits from military service;

(E) business operating transactions;

(F) insurance transactions;

(G) beneficiary transactions:

(H) gift transactions;

(M) records, reports, and statements;

(N) all of the powers listed in (A) through (M)

above and all other matters.

SECOND: (You must indicate below whether or not this power of attorney will be effective if you become

incapacitated or incompetent. Make a check or "x" on the line in front of the statement that expresses your intent.)

This power of attorney shall continue to be effective if I become incapacitated or incompetent.

This power of attorney shall not be effective if I become incapacitated or incompetent.

THIRD: (You must indicate below whether or not this power of attorney authorizes the attorney-in-fact to

transfer your property to the attorney-in-fact. Make a check or "x" on the line in front of the statement that

expresses your intent.)

This power of attorney authorizes the attorney-in-fact to transfer my property to the attorney-in-fact.

This power of attorney does not authorize the attorney-in-fact to transfer my property to the attorney-in-fact.

FOURTH: (You may indicate below whether or not the attorney-in-fact is required to make an accounting.

Make a check or "x" on the line in front of the statement that expresses your intent.) (optional)

My attorney-in-fact need not render an accounting unless I request it or the accounting is otherwise required

by Individual State Statutes

accountings to me or

My attorney-in-fact must render

(Monthly, Quarterly, Annual)

(Name and Address)

during my lifetime, and a final accounting to the personal representative of my estate, if any is appointed after

my death.

day of

In Witness Whereof I have hereunto signed my name this

(Year)

(Signature of Principal)

ACKNOWLEDGMENT OF PRINCIPAL

}

STATE OF:

COUNTY OF

The foregoing instrument was acknowledged before me this

(Insert Name of Principal)

NOTARIAL STAMP OR SEAL (OR OTHER TITLE OR RANK):

SIGNATURE OF NOTARY PUBLIC OR OTHER OFFICIAL

Specimen Signature of Attorney(s)-in-Fact

(Notarization not required)

THIS INSTRUMENT WAS DRAFTED BY (NAME AND ADDRESS):

day of

(Year)