Limited Power of Attorney Form

Limited Power of Attorney Form

Introduction

This Limited Power of Attorney dated Month Day, Year, grants the Agent temporary authority to act on behalf of the Principal for specific matters. The authority is limited to the terms and time period specified and can be revoked by the Principal at any time.

Principal Information

Name

    Address

      Agent Information

      Name

        Address

          Powers Granted

          I hereby appoint the above-named Agent to act on my behalf in the following matters:

          • Manage bank accounts

          • Sign legal documents

          • Handle real estate transactions

          • Make medical decisions

          • Other (pls. specify):

          Duration of Authority

          This Limited Power of Attorney shall be effective:

          • From Month Day, Year to Month Day, Year

          • Or until the following event occurs:

          Special Instructions or Limitations

          Specify any limitations or special instructions related to the powers granted:

            Revocation

            This Limited Power of Attorney may be revoked at any time by the Principal by providing written notice to the Agent.

            Signature

            By signing below, I, the Principal, authorize the Agent to act on my behalf in the matters outlined, limited to the specified terms and time period.

            Principal

            Name:

            Date:

            Agent

            Name:

            Date:

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