Fillable Printable Statutory Short Form Power of Attorney - North Carolina

Statutory Short Form Power of Attorney - North Carolina

G.S. 32A-1 Page 1

Chapter 32A.

Powers of Attorney.

Article 1.

Statutory Short Form Power of Attorney.

§ 32A-1. Statutory Short Form of General Power of Attorney.

The use of the following form in the creation of a power of attorney is lawful, and, when

used, it shall be construed in accordance with the provisions of this Chapter.

"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 ..................................................... _________

(16) Renunciation of an interest in or power over property to

benefit persons other than the attorney-in-fact.................................... _________

(17) Renunciation of an interest in or power over property

to benefit persons including the 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.')

G.S. 32A-1 Page 2

(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)"

(1983, c. 626, s. 1; 1985, c. 162, s. 1; c. 618, s. 1; 1995, c. 331, s. 1; c. 486, s. 2; 2009-48, s.

11.)