Free Guardianship Power of Attorney Form Template
Guardianship Power of Attorney Form
Please fill out this form completely to grant guardianship powers to another individual.
Principal's Information
Name
Address
Phone number
Agent's Information
Name
Address
Phone number
Guardianship Powers Granted
Please specify the powers you wish to grant to the agent
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Medical Decisions
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Financial Decisions
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Legal Representation
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Childcare and Education (if applicable)
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Property and Assets Management
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Duration of Guardianship
This guardianship shall be in effect from
End Date (if applicable)
Revocation Clause
You have the right to revoke this power of attorney at any time. Please mark if you wish to revoke the power under certain conditions
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Agent’s incapacity
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Disagreement over decisions
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Agent no longer willing or able to act
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Principal regains the ability to make decisions
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Acknowledgment
By signing below, I acknowledge that I am granting the agent the powers described above and that I understand the implications of this decision.
Principal
Name:
Date:
Agent
Name:
Date:
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