Power of Attorney Questionnaire

Please fill out the following form for your power of attorney

A power of attorney authorizes another person (your agent) to make decisions concerning your property for you (the principal). Your agent will be able to make decisions and act with respect to your property (including your money) whether or not you are able to act for yourself. If you wish, you may name a successor agent.

This power of attorney does not authorize the agent to make health care decisions for you.

You should select someone you trust to serve as your agent. Unless you specify otherwise in the Special Instructions, generally the agent’s authority will continue until you die or revoke the power of attorney, or the agent resigns or is unable to act for you.

Your agent shall be entitled to reimbursement of reasonable expenses incurred in performing the acts required by you in your power of attorney.

If your agent is unable or unwilling to act for you, your power of attorney will end unless you have named a successor agent.

This power of attorney shall be durable unless you state otherwise in the Special Instructions.

This power of attorney becomes effective immediately unless you state otherwise in the Special Instructions.

Please give me the following information so that I can complete your Power of Attorney.

Questions?

If you have any questions about the Power of Attorney Questionnaire, please contact us for further information.

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