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Fillable Printable Special Military Power of Attorney Form

Fillable Printable Special Military Power of Attorney Form

Special Military Power of Attorney Form

Special Military Power of Attorney Form

SPECIAL POWER OF ATTORNEY
SPOA SPECIAL 3-18-11 Page 1 of 4
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Initials
PREAMBLE: This is a MILITARY POWER OF ATTORNEY prepar ed pursuant to Title 10 , United States Co de, §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 by 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.
KNOW ALL PERSONS BY THESE PRESENTS: That I, ____________________________________________________,
of __________________________________________________________________________, (city/state) do hereby appoint
__________________________________________________________, of ___________________________________, (city/state)
as my agent (attorney-in-fact) to act for me in any lawful way with respect to the following matters that have been signed by me:
To GRANT ONE OR MORE of the foll owi ng p owers,
SIGN THE LINE IN FRONT of each power you are granting.
TO WITHH OLD a power, DO NOT SIGN THE LINE in front of it.
Please cross out EACH power withheld.
A. TO TAKE POSSESSION OF MY HOUSEHOLD GOODS AND SHIP THEM TO A DIFFERENT LOCATION: To take
possession and order the removal and shipment of my household goods, personal baggage, or other personal property and
cause it to be shipped to any warehouse, depot, dock, or other place of storage or safekeeping, government or private, directed
by orders of appropriate U.S. Government transportation officials, and to execute and deliver all necessary forms, papers,
certificates and receipt s to carry out the foregoing.
B. TO ACCEPT DELIVERY OF MY HOUSEHOLD GOODS: To accept delivery of, receipt for, and/or clear through customs,
my household goods and/or unaccompanied baggage, and to sign any and all documents, release, voucher, receipt, shipping
ticket or ot her inst rument necessary or convenient for such purpose.
C. TO ACCEPT MILITARY QUARTERS ON MY BEHALF: To accept military quarters assigned to me or my family
members at any military installation; to sign for me and take possession of such quarters in my name; and sign for and take
possession of any furniture, appliances, and equipment that may be authorized for use in or with such quarters as I may be
assigned; to execute all necessary document s, instruments or papers and perform all acts necessary to carry out the foregoing.
D. TO TERMINATE MILITARY QUARTERS ON MY BEHALF: To effect the termination of U.S. Government quarters
assigned to me or my family members, to procure or return any and all U.S. government property used in or for such quarters;
and to sign any and all documents and do all acts necessary and proper to terminate my responsibility for such quarters.
E. TO PREPARE AND FILE MY FEDERAL AND STATE INCOME TAXES: To prepare, execute, sign and file my Federal
and State tax returns for the State(s) of _____________ ___________________ for the tax year 20_____.
F. TO PERFORM BANKING TRANSACTIONS ON MY BEHALF: To draft checks and other negotiable instruments in my
name and to otherwise withdraw from and/or deposit into my account number(s) __________________________________ with
________________________________________________________________________ (name of bank or financial institution);
to endorse, cash and receive the proceeds of any check or other negot iable instrument, which is, made payable to me.
G. TO HANDLE ANY LAWSUIT OR OTHER LEGAL ACTION THAT I MAY HAVE AN INTEREST IN: To institute and
prosecute, or to appear and defend, any claims or litigation involving me or my interest; to demand, act to recover, and receive
all sums of money and all other things which are now or will become owing or belonging to me as a result of such claims; and to
institute accounts on my behalf, and to deposit, draw upon or expend such funds of mine as are necessary in furtherance of
powers granted herein.
H. TO SELL MY REAL ESTATE ON MY BEHALF: To bargain, sell, assign, and convey, using the standard of a reasonable
seller under no compulsion to sell and engaging in an arms-length bargaining tr ansaction, to any person of my attorney’ choice,
all my right, title and interest in my property at ________________________ ________________ _________________________
__________________________________________________________________________________ (address of property),
and to convey by deed or general warranty with the customary covenants; to receive on my behalf payment of the purchase
money for the real property described above in any manner that my attorney shall deem wise; to transmit these moneys to me,
and to sign, seal, execute and deliver any and all deeds, cont racts, or other documents necessary to carry out the foregoing.
SPECIAL POWER OF ATTORNEY
SPOA SPECIAL 3-18-11 Page 2 of 4
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Initials
I. TO PURCHASE REAL ESTATE IN MY NAME: To purchase in my name and for my use any real property in the City of
___________________________ ______, County of _________ _________________ ____, State of _______________ __________,
and for that purpose to make, endorse, accept, receive, sign, seal, execute, acknowledge, and deliver any application forms,
documents, ins truments , or paper nece ssary o r convenient to enter into bo th a contrac t and mortgage or deed of trust upon said real
estate for such price, at such rate of interest, and upon such terms as my agent shall deem best.
J. TO USE, OPERATE, AND REGISTER MY MOTOR VEHICLE(S): To use, operate, insure, title, license, and register, in
my name, with any state or governmental agency any and all vehicles of which I am or may become the registered or legal
owner.
K. TO SELL MY MOTOR VEHICLE: To sell my motor vehicle upon such terms, considerations and conditions as my agent
shall think proper. Further, to execute and deliver to the proper persons and authority all documents, instruments, and papers
necessary to affect the sale and transfer of registration and license of the said vehicle. To take possession of, operate, and
maintain this automobile and to execute and deliver all necessary forms, papers, statements of ownership, and receipt to carry
out the foregoing.
L. TO PURCHASE MOTOR VEHICLES IN MY NAME: To purchase motor vehicles in my name and upon such terms,
considerations and condit ions as my agent shall think proper. Further, to execute and deliver to the proper persons and authority
all documents, instruments, and papers necessary to register and license such motor vehicles. To further execute any
documents necessary to have repairs my agent deems necessary made on this automobile before I am able to take possession
of the automobile. To take possession of, operate, and maintain this automobile and to execute and deliver all necessary forms,
papers, statements of ownership, and receipt to carry out the foregoing.
M. TO SHIP MY VEHICLE: To take possession of my vehicle, for the purpose of its removal and shipment from wherever it
may be located, and to execute any release, voucher, receipt or any other instrument necessary or convenient for such purpose
and to execute and deliver to the proper persons and authority, any and all documents, instruments and papers necessary to
effect proper registration, insurance and license, in my name, of such aut omobile.
N. TO TAKE POSSESSION OF MY VEHICLE AFTER SHIPMENT: To take possession of my vehicle, after shipment and
delivery to any port, warehouse, depot, dock, or other place of storage or safekeeping, government or private; to execute and
deliver any release, voucher, receipt, shipping ticket, certificate or other instrument necessary or convenient for such purpose
and to execute and deliver to the proper persons and authority, any and all documents, instruments and papers necessary to
register, insure and license, such vehicle in my name, and to transport the vehicle to me or any locati on which I direct in writing.
O. TO TERMINATE MY RESIDENTIAL LEASE: To execute any and all documents and do all other things necessary or
convenient to t erminate any and all leases or rental agreements in my name.
P. TO LEASE MY HOUSE/APARTMENT TO OTHERS AND ACT AS MY LANDLORD/PROPERTY MANAGER: To
manage, control, lease, sublease, and otherwise act concerning my interest in my residential property; to collect and receive
rents or income therefrom; pay taxes, charges and assessments on the same; repair, maintain, protect, preserve, alter and
improve the same; commit my resources and contract on my behalf regarding the same; and to do all things necessary or
expedient to be done in my agent’s judgment in connection with the propert y.
Q. TO ENROLL MY LAWFUL DEPENDENTS IN MILITARY BENEFITS PROGRAMS: To enroll my lawful dependents in
DEERS, TRICARE, SMILECARE, or any other benefits program to which I am or my dependents are entitled by virtue of my
military affiliation. To do all things necessary, and to execute and deliver to the proper persons and authority, any and all
documents, instruments, and papers necessary and expedient to carry out the foregoing.
R. FOR MY SPOUSE TO RECEIVE NMCRS ASSISTANCE: If my spouse is my attorney-in-fact and I am deployed, I
authorize my spouse,________________________________________________ (name of spouse) to receive necessary
financial assistance from the Navy-Marine Corps Relief Society (NMCRS) without my specific approval in the amount of
$________________ (not to exceed $3,000). I also authorize my spouse and NMCRS to initiate an allotment in my name for
repayment of the loan. I understand that assistance will be provided depending on the merits of the situation and the policies of
NMCRS.
S. MISCELLANEOUS: To do the following on my behalf:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
SPECIAL POWER OF ATTORNEY
SPOA SPECIAL 3-18-11 Page 3 of 4
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Initials
I hereby give and grant unto my attorney-in-fact full power and authority to do and perform each and every act
and matter concerning the subject of this document as fully and effectually to all intents and purposes as I could do
legally if I w ere present.
I hereby authorize my attorney-in-fact to indemnify and hold harmless any third party who accepts and acts
under or in accordan ce with this power of attorney.
I hereby ratify all that my attorney-in-fact shall lawfully do or cause to be done by this document.
I intend for this to be a DURABLE Power of Attorney. This Power of Attorney will continue to be effective if I
become disabled, incapacitated, or incompetent. All acts done by my attorney-in-fact hereunder shall have the same
effect and in ure to the benef it of and bind m yself and my h eir s a s if I were compete nt, and not dis abled, inca pacitate d, or
incom pet ent.
I shall be considered disabled or incapacitated for purposes of this Power of Attorney if a physician, based on
that physician's examination, certifies in writing at a date subsequent to the date which this Power of Attorney is
executed, that I am disabled from or incapable of exercising control over my person, property, personal affairs, or
financia l affairs. I autho rize the physici an who so certifi es, to di sclose my physical or mental co ndition t o another person
for purposes of this Power of Attorney. A third party who accepts this Power of Attorney, endorsed by proper physician
certification of my disability or incapacity, is held harmless and fully protected from any action taken under this Power of
Attorney.
This power of attorney shall remain in full force and effect until the _______ day of
_________________________, 20____, unless sooner revoked by me.
Notwithstanding my inclusion of a specific expiration date herein, if on the above-specified expiration date, or
during the sixty (60) day period preceding that specified expiration date, I should be or have been determined by the
Unite d States Governm ent to be in a mi litary status of "m issin g," "m issing in act ion," or " prisoner of w ar," or if I sho uld be
or have been properly certified, in writing, by a physician to be disabled from or incapable of exercising control over my
person, pr op ert y, per so nal affairs, or fina ncia l affa irs, then t his Po wer of Attorney sha ll remain vali d and in full effect until
sixty (60) days after I have returned to United States military control following termination of such status or sixty (60)
days after I have recovered from such disability unless sooner revoked or terminated by me.
All business transacted hereunder for me or for my account shall be transacted in my name, and all
endorsements and instruments executed by my attorney for the purpose of carrying out the foregoing powers shall
contain my name, followe d by that of my attorney and the design ation “attorn ey-i n-fact.”
IN WITNESS WHEREOF, I have hereunto set my hand and seal on this _________ day of
_____________________________, 20____.
_____________________________________________________
Signature
_____________________________________________________
Print name
SPECIAL POWER OF ATTORNEY
SPOA SPECIAL 3-18-11 Page 4 of 4
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Initials
MILITARY ACKNOWLEDGMENT
With the United States Armed Forces
On this the _______ day of _____________________________, 20____, before the undersigned
officer, personally appeared _____________________________________________________________,
satisfactorily proven to be (a) serving in or retired from the Armed Forces of the United States, or (b) a
lawful dependent of a person serving in or retired from the Armed Forces of the United States, or (c) a person
serving with, employed by, or accompanying the Armed Forces of the United States outside the United
States and outside the Canal Zone, Puerto Rico, Guam, and the Virgin Islands, and to be the person whose
name is subscribed to the within instrument and acknowledged that he or she executed the same. And the
undersigned does further certify that he or she is at the date of this certificate an officer of the Armed Forces
of the United States having the general powers of a notary public under the provisions of Section 936 or
1044a of Title 10 of the United States Code (Public Law 90-632 and 101-510).
AUTHORIZED TO ACT AS A NOTARY
PUBLIC UNDER THE PROV ISIONS OF
_____________________________________________
SECTION 1044a OF TITLE 10 OF THE Signature of Notary
UNITED STATES CODE AND SECTION Name of Officer and Position:
1183.5 OF THE CALIFORNIA CIVIL Grade and Branch of Service:
CODE. NO SEAL REQUIRED BY LAW. Command or Organization:
Either a Military or Civilian Acknowledgment is Required
CIVILIAN ACKNOWLEDGMENT
State of California )
County of San Bernardino ) ss.
Marine Corps Air Ground Combat Center )
On _______________________, before me,____________________________________________________,
personally appeared _______________________________________________________________________,
who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within
instrument and acknowledged to me that he/she executed the same in his/her authorized capacity, and that by
his/her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the
instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is
true and correct.
WITNESS my hand and official seal.
Signature _______________________________ Seal
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