STATUTORY FORM POWER OF ATTORNEY
This 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. The meaning of authority over subjects listed on this form is explained in the Uniform Power of Attorney Act.
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.
This form provides for designation of one agent. If you wish to name more than one agent, you may name a co-agent in the Special Instructions. Co-agents are not required to act together unless you include that requirement 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.
DESIGNATION OF AGENT
I, _________, with permanent residence address at _________, telephone number _________, and email address _________, name the following person as my agent:
Name of Agent: _________
Agent's Address: _________
Agent's Telephone Number: _________
Agent's Email Address: _________
DURABLE POWER OF ATTORNEY
GRANT OF GENERAL AUTHORITY
I grant my agent and any successor agent general authority to act for me with respect to the following subjects as defined in the Uniform Power of Attorney Act:
- Real property
- Tangible personal property
- Stocks and bonds
- Commodities and options
- Banks and other financial institutions
- Operation of entity or business
- Insurance and annuities
- Estates, Trusts, and Other Beneficial Interests
- Claims and Litigation
- Personal and Family Maintenance
- Benefits from governmental programs or civil or military service
- Retirement plans
- Taxes
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 is entitled to reimbursement for reasonable expenses incurred in acting under this Power of Attorney.
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.
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.
SIGNATURE AND ACKNOWLEDGMENT
Dated ____________________, _____, at _________, Massachusetts.
| |
___________________________________ | _______________ |
_________ | Date |
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Address: _________
Telephone Number: _________
Email Address: _________
___________________________________ | _______________ |
_________ | Date |
Commonwealth of Massachusetts
_________ County
This document was acknowledged before me on | _______________. |
| (date) |
by ___________________________________
_________
___________________________________
(Seal, if any)
Signature of Notary: __________________________________
My commission expires: _______________________________
IMPORTANT INFORMATION FOR AGENT
Agent's Duties
When you accept the authority granted under this power of attorney, a special legal relationship is created between you and the principal. This relationship imposes upon you legal duties that continue until you resign or the power of attorney is terminated or revoked. You must:
(1) Act in accordance with the principal's reasonable expectations to the extent actually known by the agent and, otherwise, in the principal's best interest;
(2) Act in good faith;
(3) Act only within the scope of authority granted in the power of attorney.
Unless the Special Instructions in this power of attorney state otherwise, you must also:
(1) Act loyally for the principal's benefit;
(2) Act so as not to create a conflict of interest that impairs the agent's ability to act impartially in the principal's best interest;
(3) Act with the care, competence, and diligence ordinarily exercised by agents in similar circumstances;
(4) Keep a record of all receipts, disbursements, and transactions made on behalf of the principal;
(5) Cooperate with any person that has authority to make health-care decisions for the principal to do what you know the principal reasonably expects or, if you do not know the principal's expectations, to act in the principal's best interest; and
(6) Attempt to preserve the principal's estate plan if you know the plan and preserving the plan is consistent with the principal's best interest based on all relevant factors, including:
(a) The value and nature of the principal's property;
(b) The Principal's foreseeable obligations and need for maintenance;
(c) Minimization of taxes, including income, estate, inheritance, generation skipping transfer, and gift taxes; and
(d) Eligibility for a benefit, program, or assistance under a statute or regulation.
Termination of Agent's Authority
You must stop acting on behalf of the principal if you learn of any event that terminates this power of attorney or your authority under this power of attorney. Events that terminate a power of attorney or your authority to act under a power of attorney include:
(1) The death of the principal;
(2) The principal becomes incapacitated, if the power of attorney is not durable;
(3) The principal's revocation of the power of attorney;
(4) The occurrence of a termination event stated in the power of attorney;
(5) The purpose of the power of attorney is fully accomplished; or
(6) The principal revokes the agent's authority or the agent dies, becomes incapacitated, or resigns, and the power of attorney does not provide for another agent to act under the power of attorney.
The meaning of the authority granted to you is defined in the Uniform Power of Attorney Act. If you violate the Uniform Power of Attorney Act or act outside the authority granted, you may be liable for any damages caused by your violation.
An agent that acts with care, competence, and diligence for the best interest of the principal is not liable solely because the agent also benefits from the act or has an individual or conflicting interest in relation to the property or affairs of the principal.
If there is anything about this document or your duties that you do not understand, you should seek legal advice.