Product Patient Assistance Limited Power of Attorney
PRODUCT PATIENT ASSISTANCE LIMITED POWER OF ATTORNEY
Appointment of Attorney-in-Fact
I, [Your Name], residing at [Your Company Address], hereby appoint [Agent's Full Name], residing at [Agent's Address], as my attorney-in-fact (hereinafter referred to as "Attorney-in-Fact"), to act on my behalf in all matters relating to financial transactions, including but not limited to banking, investment, and real estate transactions, as well as legal proceedings, signing of documents, and any other affairs requiring representation or decision-making authority.
Duration
This Power of Attorney shall become effective immediately upon signing and shall remain in effect until December 31, 2055, unless earlier revoked in writing by the Principal.
Powers and Limitations
The Attorney-in-Fact shall have the authority to:
Manage financial affairs, including but not limited to banking transactions, investment decisions, and real estate transactions.
-
Make healthcare decisions, including medical treatment choices, access to medical records, and consenting to or refusing medical procedures.
-
Enter into contracts on behalf of the Principal, including legal agreements, leases, and service contracts.
-
Access and manage digital assets, including online accounts, social media profiles, and digital files.
-
Represent the Principal in legal proceedings, including litigation, arbitration, and negotiations.
However, the Attorney-in-Fact shall not have the authority to:
-
Make gifts of the Principal's assets unless specifically authorized in writing by the Principal.
-
Change the beneficiaries of the Principal's life insurance policies, retirement accounts, or other similar accounts.
-
Create or amend the Principal's will or trust documents.
-
Make decisions regarding the Principal's personal relationships or living arrangements unless expressly authorized by the Principal.
-
Exercise powers or authority not explicitly granted in this Power of Attorney document.
Revocation
I hereby declare that this Power of Attorney, which I have granted, has the inherent condition that allows me to revoke it anytime I deem necessary or appropriate. However, it is integral for me to provide a written notice to notify the party who has been appointed as the Attorney-in-Fact about this revocation for it to be enacted properly. It is also noteworthy to mention that this Power of Attorney holds an automatic termination clause, that is, it will cease to have effect the moment I pass away. Thus, the authority vested under this Power of Attorney would become invalid and void in the event of my death.
Successor Attorney-in-Fact
Suppose the Attorney-in-Fact is unable or unwilling to serve. In that case, I at this moment appoint [Agent's Full Name], residing at [Agent's Address], as my successor attorney-in-fact, with the same powers and authority granted herein to the original Attorney-in-Fact.
In witness whereof, the Patient has executed this Product Patient Assistance Limited Power of Attorney on [Date].
[Your Name] (Principal)
[Agent's Full Name] (Attorney-in-fact)
WITNESS ACKNOWLEDGEMENT
I, [Witness's Name], affirm that I witnessed the signing of this Product Patient Assistance Limited Power of Attorney by the Patient and Agent, who appeared to be of sound mind and voluntarily executed the same in my presence on [Date].
[Witness's Name]
NOTARY ACKNOWLEDGEMENT
On this [Date], before me, a Notary Public in and for the State and County aforesaid, personally appeared [Your Name] and [Agent's Full Name], known to me to be the persons described in and who executed the foregoing instrument, and acknowledged that they executed the same as their free and voluntary act and deed.
[Notary Public's Name]
My Commission Expires:
