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 Title 14 - Decedents' Estates and Fiduciary Relations Chapter 123 - Powers of Attorney.
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:
- 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 will be 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.
By signing as a witness, I acknowledge that the principal signed the Power of Attorney in my presence, or that the principal acknowledged to me that the principal's signature was affixed by him or her or at his or her direction. I also acknowledge that the principal appears to be of sound mind and free from duress and has stated that this Power of Attorney reflects his or her wishes and that he or she has signed it voluntarily. I am not named herein as an agent or as a permissible recipient of gifts.
In Witness Whereof I have hereunto signed my name on the _____ day of ___________, 20__, at _________, _________.
WITNESS signs here:
_______________________________
_________
Dated ____________________, _____, at _________, Vermont.
| |
___________________________________ | _______________ |
_________ | Date |
| |
Address: _________
Telephone Number: _________
Email Address: _________
___________________________________ | _______________ |
_________ | Date |
State of Vermont
_________ 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 good faith and in the interest of the principal;
(2) Refrain from self-dealing, except as provided in the power of attorney pursuant to subsection 3504(d) or (f);
(3) Avoid conflicts of interest which would impair the ability of the agent to act in the interest of the principal;
(4) Not commingle the funds of the principal with his or her own funds or the funds of third parties, except in an attorney-client trust account in accordance with the rules governing such accounts;
(5) Exercise the degree of care that would be observed by a prudent person dealing with the property and affairs of another person;
(6) iI selected as agent with the expectation he or she has special skills or expertise, use those skills on behalf of the principal, provided the terms of the power of attorney specify that the agent is expected to use special skills and expertise, and provided, further, the agent acknowledges in signing the power of attorney that he or she has been so selected;
(7) Take no action beyond the scope of authority granted by the terms of the power of attorney;
(8) Take no action which violates any provision of Title 14 - Decedents' Estates and Fiduciary Relations Chapter 123 - Powers of Attorney;
(9) Keep records of all transactions taken under the power of attorney;
(10) Provide accounting upon request of the principal or at such times or in such manner as is specified by the terms of the power of attorney;
(11) Follow the directions of the principal specifically forbidding an action, notwithstanding any provision of the power of attorney giving the agent authority to take such action; provided, however, no third party who acts in reliance on the apparent authority of the agent under the power of attorney shall be bound or limited by the directions of the principal to the agent not set forth in the power of attorney unless such third party has actual notice of the instructions; and
(12) Comply with any lawful termination of the power of attorney as provided in section 3507 of this title.
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 revocation by the principal;
(2) The divorce of the principal and spouse, where the spouse is the agent;
(3) The death of the principal;
(4) The disability or incapacity of the principal, except as provided in section 3508 of this title;
(5) The resignation or death of the agent, unless an alternate agent is named in the power of attorney or by the agent;
(6) A termination date specified in the power of attorney, if any;
(7) The occurrence of a termination event explicitly specified in the power of attorney; or
(8) The order of a court of competent jurisdiction.