Legal & Compliance
Limited Power of Attorney
Grants limited authority to an agent to act on your behalf for specific financial or legal matters.
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# Limited Power of Attorney **Date:** ___________ ## Principal **Name:** ___________ **Address:** ___________ ## Agent (Attorney-in-Fact) **Name:** ___________ **Address:** ___________ **Phone:** ___________ ## Grant of Authority I, ___________ ("Principal"), hereby appoint ___________ ("Agent") as my attorney-in-fact to act on my behalf with respect to the following specific matters: ___________ ## Limitations This Power of Attorney is LIMITED to the specific matters described above. Agent shall NOT have authority to: - Execute any document or take any action beyond the scope described above - Make gifts of Principal's property - Change beneficiary designations - Create or modify any trust ## Duration This Limited Power of Attorney shall be effective from the date of execution and shall terminate on ___________, or upon written revocation by Principal, whichever occurs first. ## Non-Durability This Power of Attorney is NOT durable. It shall automatically terminate upon the incapacity or incompetence of the Principal, as determined by a court of competent jurisdiction or by a licensed physician. If the Principal desires a durable power of attorney that survives incapacity, a separate instrument must be executed in compliance with applicable state law.
Fields (13)
effective date
date · required
principal name
text · required
principal address
text · required
agent name
text · required
agent address
text · required
agent phone
text
principal name
text · required
agent name
text · required
granted powers
textarea · required
expiration date
date · required
governing state
select · required
principal signer name
text · required
agent signer name
text · required
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