The powers granted from the principal to the agent or agents in the following document are very broad. They may include the power to dispose, sell, convey, and encumber your real and personal property. Accordingly, the following document should only be used after careful consideration.
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, 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 is entitled to reasonable compensation unless you state otherwise in the Special Instructions. If your agent is unable or unwilling to act for you, your power of attorney will end unless you have named a successor agent. You may also name a second successor agent.
This power of attorney becomes effective immediately unless you state otherwise in the Special Instructions.
If you have questions about the power of attorney or the authority you are granting to your agent, you should seek legal advice before signing this form.
Section 1
DESIGNATION OF AGENT
Pursuant to A.S.13.26.600, 13.26.625- 13.26.640, and 13.26.655 - 13.26.695.
I, _________, with permanent residence address at _________, telephone number _________, and email address _________, hereby designate the following person as my agent to act as I have indicated below in any way which I myself could do, if I were personally present, with respect to the following matters, as each of them is defined in AS 13.26.665, to the full extent that I am permitted by law to act through an agent:
Name of Agent: _________
Agent's Address: _________
Agent's Telephone Number: _________
Agent's Email Address: _________
DURABLE POWER OF ATTORNEY
Section 2
GRANT OF GENERAL AUTHORITY
MARK THE LINES TO INDICATE THE POWERS YOU WANT TO GIVE YOUR AGENT(S). MARK "YES" IN THE LINES THAT ARE OPPOSITE A CATEGORY TO GIVE YOUR AGENT(S) THE POWER IN THAT AUTHORITY. IF YOU MARK "NO" IN THE LINE OPPOSITE A CATEGORY, YOUR AGENT(S) WILL NOT HAVE THE POWER TO ACT UNDER THAT AUTHORITY.
________ - (A) Real estate transactions
________ - (B) Transactions involving tangible personal property, chattels, and goods
________ - (C) Bonds, shares, and commodities transactions
________ - (D) Banking transactions
________ - (E) Business operating transactions
________ - (F) Insurance transactions
________ - (G) Estates transactions
________ - (H) Retirement plans
________ - (I) Claims and litigation
________ - (J) Personal relationships and affairs
________ - (K) Benefits from government programs and civil or military service
________ - (L) Records, reports, and statements
________ - (M) Voter registration and absentee ballot requests
________ - (N) All other matters
________ - (O) Only these powers specified below: ________________________________
__________________________________________________________________________
__________________________________________________________________________ LIMITATION ON AGENT'S AUTHORITY
An agent that is not my ancestor, spouse, or descendant MAY NOT use my property to benefit the agent or a person to whom the agent owes an obligation of support unless I have included that authority in the Special Instructions.
My Agent is entitled to reasonable compensation for services rendered as my Agent.
My Agent will be entitled to reimbursement for reasonable expenses incurred in acting under this Power of Attorney.
To indicate when this document shall become effective, mark the line opposite the option chosen:
________ (Mark here if this is your choice) - This power of attorney shall be effective immediately and will continue to be effective until my death, even if I became incapacitated, except as may be provided otherwise by an applicable state statute.
This Power of Attorney may be revoked or terminated by me at any time by providing written notice to my Agent.
Section 4
Notice of revocation of the powers granted in this document
You may revoke all of the powers granted in this document, or just specific powers. Unless otherwise provided in this document, you may revoke all the powers granted in this power of attorney by completing a subsequent power of attorney. Or, you may revoke a specific power granted in this power of attorney by completing a special power of attorney that includes the specific power in this document that you want to revoke.
Section 5
Notice to Third Parties
A third party who relies on the reasonable representations of an agent as to a matter relating to a power granted by a properly executed statutory form power of attorney does not incur any liability to the principal or to the principal's heirs, assigns, estate as a result of permitting the agent to exercise the authority granted by the power of attorney.
A third party who fails to honor a properly executed statutory form power of attorney may be liable to the principal, the agent, the principal's heirs, assigns, or estate for civil penalty, plus damages, costs, and fees associated with the failure to comply with the statutory form power of attorney. If the power of attorney is one which becomes effective upon the incapacity of the principal, the incapacity of the principal is established by an affidavit, as required by law.
Section 6
If you have given an agent authority regarding health care services, complete the following:
________ - I have executed a separate declaration under AS 13.52 known as an "Alaska Advance Health Care Directive".
________ - I have not executed an "Alaska Advance Health Care Directive".
RELIANCE ON THIS POWER OF ATTORNEY
Any person, including my agent, may rely upon the validity of this power of attorney or a copy of it unless that person knows it has terminated or is invalid.
Dated ____________________, _____, at _________, Alaska.
| |
___________________________________ | _______________ |
_________ | Date |
| |
Address: _________
Telephone Number: _________
Email Address: _________
___________________________________ | _______________ |
_________ | Date |
State of Alaska
_________ County
This document was acknowledged before me on | _______________. |
| (date) |
by ___________________________________
_________
___________________________________
(Seal, if any)
Signature of Notary: __________________________________
My commission expires: _______________________________