Free Power of Attorney For Incapacitated Family Member Template
Power of Attorney For Incapacitated Family Member
I, [YOUR NAME], residing at [YOUR COMPANY ADDRESS], being of sound mind and body, do hereby appoint [TRUSTED AGENT'S NAME], residing at [TRUSTED AGENT'S ADDRESS], as my lawful attorney-in-fact, to act on my behalf in all matters specified herein, in the event of my incapacity, hereby granting unto said agent full power and authority to act and make decisions as set forth below:
I. Medical Decisions
I authorize my agent to make any decisions regarding my medical treatment, including but not limited to, the consent to or refusal of medical treatment, surgery, hospitalization, medication, and other medical procedures. My agent shall have access to my medical records, consult with healthcare providers, and make decisions that they deem necessary for my health and well-being.
II. Financial Decisions
I grant my agent the authority to manage all of my financial affairs, including but not limited to, paying bills, accessing bank accounts, managing investments, filing taxes, and engaging in any financial transactions on my behalf. This includes the authority to sign checks, withdraw funds, and enter into contracts necessary to manage my financial affairs.
III. Legal Decisions
I authorize my agent to act on my behalf in all legal matters, including but not limited to, signing legal documents, initiating or defending lawsuits, representing me in court proceedings, and engaging legal counsel as necessary. My agent shall have the authority to make legal decisions in my best interests and to protect my rights.
IV. Property Management
I empower my agent to manage and maintain any real or personal property owned by me, including but not limited to, buying, selling, leasing, or mortgaging property, making repairs or improvements, and handling insurance matters related to such property.
V. Personal Affairs
My agent is authorized to handle any other matters related to my personal affairs that may arise during my incapacity, including but not limited to, managing household expenses, arranging for care and support services, and making decisions regarding my welfare and comfort.
I understand that this Power of Attorney is effective immediately upon my incapacity and shall remain in effect until revoked by me or upon my death.
[YOUR NAME]
[DATE]
[TRUSTED AGENT'S NAME]
[DATE]
Witness Acknowledgement
I, the undersigned witness, hereby attest that the above-named Incapacitated Family Member signed this Power of Attorney in my presence and appeared to be of sound mind and under no duress at the time of signing.
Witness 1:
[WITNESS 1'S NAME]
[DATE]
Witness 2:
[WITNESS 2'S NAME]
[DATE]
Notary Acknowledgement
State of [STATE], County of [County],
On this [DATE], before me, a Notary Public in and for said County and State, personally appeared [YOUR NAME], known to me (or proved to me based on satisfactory evidence) to be the person whose name is subscribed to the within the 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.
Witness my hand and official seal.
[NOTARY PUBLIC'S NAME]
My Commission Expires: [EXPIRATION DATE OF COMMISSION]
