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Durable Power of Attorney
The following template to create durable power of attorney forms allows you to assign powers of authority for specific duties that can be carried out on your behalf. All local and state requirements should be included along with your intentions to make sure that the general actions defined may legally be taken.

Free Sample Template
Format: Word PDF
# of Pages: 2
Printable: Yes


Durable Power of Attorney TemplateForm 4162
Format: Word PDF
Category: Legal, Power of Attorney
Type: POA Agreement

Durable Power of Attorney

Effective Date: ___/___/_____

I:

Name: ________________________________________________________________________________________

Address: ______________________________________________________________________________________

City: ____________________________________ State: __________ Zip Code: _____________________________

Do hereby declare:

Name: ________________________________________________________________________________________

Address: ______________________________________________________________________________________

City: ____________________________________ State: __________ Zip Code: _____________________________

As my attorney in fact (“Agent”) with the following powers to be exercised in my name and for my benefit:

To do anything that I may have a right or duty to do, now or in the future. To maintain, manage or transfer any of my real and personal property. This includes entry into safety deposit boxes and the authority to sign checks on all of my banking accounts and to transfer money this may also include any certificates of deposit. To apply for a certificate of title for any automobile or other motor vehicle and to represent a transfer that the title to the listed motor vehicle is free and clear from all liens except those that may be set forth in transfer of assignments. As it relates to business, to collect money, to transact business for me and to conduct business in which I may be engaged in and to fully carry out or amend any business agreement that I may be a party to.

This document is to be interpreted under the law of _____________ as a general power of attorney. Any statements of specific powers do not restrict the general powers as granted to my above listed Agent.

This Durable Power of Attorney will not be affected by my disability, however, may be terminated by my written revocation or by my death.

I hereby revoke any and all prior Durable Power of Attorney that I have executed.

Signature: ___________________________________________________________________ Date: ___/___/_____

Witnessed by:

Signature: ___________________________________________________________________ Date: ___/___/_____

Signature: ___________________________________________________________________ Date: ___/___/_____




Notary Public Acknowledgement:

SEAL

This affidavit was subscribed, sworn to and acknowledged before me this, the _____________ day of the month of

___________________________________, 2______.

Signature of Notary Public: _______________________________________________________________________

My Commission Expires: ___/___/_____