Fillable Printable Statutory Short Form of General Power of Attorney - North Carolina

Statutory Short Form of General Power of Attorney - North Carolina

North Carolina Statutory Short Form of General Power of

Attorney

NOTICE

THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING.

THEY ARE DEFINED IN CHAPTER 32A OF THE NORTH CAROLINA GENERAL

STATUTES WHICH EXPRESSLY PERMITS THE USE OF ANY OTHER OR

DIFFERENT FORM OF POWER OF ATTORNEY DESIRED BY THE PARTIES

CONCERNED.

State of ______________

County of ____________

I ____________________________, appoint __________________ to be my

attorney-in-fact, to act in my name in any way which I could act for myself, with respect

to the following matters as each of them is defined in Chapter 32A of the North Carolina

General Statutes. (DIRECTIONS: Initial the line opposite any one or more of the

subdivisions as to which the principal desires to give the attorney-in-fact authority.)

______ (1) Real property transactions

______ (2) Personal property transactions

______ (3) Bond, share, stock, securities and commodity transactions

______ (4) Banking transactions

______ (5) Safe deposits

______ (6) Business operating transactions

______ (7) Insurance transactions

______ (8) Estate transactions

______ (9) Personal relationships and affairs

______ (10) Social security and unemployment

______ (11) Benefits from military service

______ (12) Tax matters

______ (13) Employment of agents

______ (14) Gifts to charities, and to individuals other than the attorney-in-fact

______ (15) Gifts to the named attorney-in-fact

(If power of substitution and revocation is to be given, add: 'I also give to such person

full power to appoint another to act as my attorney-in-fact and full power to revoke such

appointment.')

(If period of power of attorney is to be limited, add: 'This power

terminates______________, ________')

(If power of attorney is to be a durable power of attorney under the provision of Article 2

of Chapter 32A and is to continue in effect after the incapacity or mental incompetence of

the principal, add: 'This power of attorney shall not be affected by my subsequent

incapacity or mental incompetence.')

(If power of attorney is to take effect only after the incapacity or mental incompetence of

the principal, add: 'This power of attorney shall become effective after I become

incapacitated or mentally incompetent.')

(If power of attorney is to be effective to terminate or direct the administration of a

custodial trust created under the Uniform Custodial Trust Act, add: 'In the event of my

subsequent incapacity or mental incompetence, the attorney-in-fact of this power of

attorney shall have the power to terminate or to direct the administration of any custodial

trust of which I am the beneficiary.')

(If power of attorney is to be effective to determine whether a beneficiary under the

Uniform Custodial Trust Act is incapacitated or ceases to be incapacitated, add: 'The

attorney-in-fact of this power of attorney shall have the power to determine whether I am

incapacitated or whether my incapacity has ceased for the purposes of any custodial trust

of which I am the beneficiary.')

Dated___________, _______.

(Seal)

Signature __________________

STATE OF ____________________ COUNTY OF _______________

On this ______ day of___________, ______, personally appeared before me, the said

named ______________________________ to me known and known to me to be the

person described in and who executed the foregoing instrument and he (or she)

acknowledged that he (or she) executed the same and being duly sworn by me, made oath

that the statements in the foregoing instrument are true.

My Commission Expires ______________________.

__________________________ (Signature of Notary Public)

Notary Public (Official Seal)