Free Agent Power of Attorney Form Template
Agent Power of Attorney Form
Please complete this form to designate an agent to act on your behalf.
Principal Information
Name
Address
Phone Number
Agent Information
Name
Address
Phone Number
Authority Granted
Specify the authority granted to the agent:
Effective Date
Duration
Special Instructions
Signatures
I hereby grant the Agent named above the authority specified in this form. I understand the responsibilities and consequences of granting this Power of Attorney and do so voluntarily.
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Principal
Name: Date: |
Agent
Name: Date: |
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