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Legal Questions
Who should get my money and property when I'm gone? Is there enough money to provide for my family? Who
should be guardian of minors or handicapped beneficiaries? A good estate plan includes planning for your possible
disability. You may become sick due to illness, accident or age. Planning can insure that your wishes are carried
out and can ease the burden on your loved ones. There are four important legal documents that you should
consider having: the Durable General Power of Attorney, the Health Care Power of Attorney, the "Living Will"
and a regular Will. The Will, Living Will, and General Powers of Attorney must be signed while you are mentally
capable. Death automatically cancels powers of attorney, so you still need a Will.
The Durable General Power of Attorney
The Durable General Power of Attorney and Living Trusts are legal documents where you (the principle) allow
another person (the agent, attorney-in-fact or trustee) the powers necessary to manage your assets, property and
personal affairs. "Durable" means the document can operate if you become physically or mentally unable to decide
personally. The Living Trust is a way of managing your property and using income and principal to pay your bills
during your lifetime then pass it on to your beneficiaries at death without probate.
If you want or need to have someone else manage your property and pay your bills in case of illness, the
Living
Trust is by far the best. Because a trust is not filed in court, it is private, unlike a Will, which must be filed in court
at death. However, copies of the trust may be required by persons dealing with the trustee such as, for example,
banks, stock brokers, etc. Examples of Powers of Attorney are the deputy cards that you can sign to authorize
someone to write checks on your bank account or to authorize access to your safe deposit box. In a long illness, a
General Power of Attorney doesn't work as smoothly as a Living Trust. For this reason, many lawyers
recommend Living Trusts for clients who are ill or elderly, and use the Power of Attorney for clients who are
younger and healthy.
The Health Care Power of Attorney/Proxy
This is a legal document where you can give legal control to someone to make medical decisions for you
if you
become unable to. Some states call a healthcare power of attorney a "healthcare proxy" or "proxy directive." The
person named to make decisions is called an agent, surrogate, patient advocate, representative, proxy, or attorney
in fact. Your state may have a law that allows certain people to make healthcare decisions for you if you become
disabled even if you have not made a healthcare planning document, but these laws do not tell the person your
wishes.
The health care agent you choose is given the power to hire and fire doctors and to consent to your admission
and
discharge from hospitals and other institutions. The agent may be given the authority to make all medical
decisions for you, including decisions about life-supports.
The Living Will
The Living Will is a legal document where you express that there are certain life-prolonging procedures
you do not
wish for yourself in the event you become terminally ill and are unable to speak for yourself. In this document you
state that you do not wish to be kept alive through various means such as tube feeding, hydration, artificial
breathing devices, chemotherapy, and other certain conditions. The form allows you to withdraw life-sustaining
treatment when you are in either of two conditions "terminal and incurable" or "persistent vegetative state." For
each condition you may direct the withholding of "extraordinary means" of keeping you alive, such as a respirator,
or the withholding of both extraordinary means and "artificial nutrition and hydration."
You can get a copy of the Living Will, in the form approved by your state, from Concern for Dying (CFD),
250
West 57th Street, New York, NY 10017, (212) 246-6962. According to CFD, signing a Living Will, wont affect
any life insurance policy.
Important Differences Between the Documents
Both the Living Will and the Health Care Power of Attorney can provide for the withholding of life-sustaining
procedures. In a Living Will you decide in advance, but in a Health Care Power of Attorney you may place the
burden to make the decision on your health care agent. A Living Will, also called a directive or declaration,
expresses your wishes directly to providers, but they have conditions about when they can be obeyed and the kinds
of choices providers can accept. If you have only a living will, a physician who wants to respect your choices may
not be able to if a family member or another provider objects. A Power of Attorney authorizes an agent to speak for
you with your providers, and usually allows your agent to make every kind of decision for you that you could make
yourself if you were able to.
Any mentally sound adult can make these documents, and occasionally, certain minors. In most states the
legal
age of adults is eighteen. If you are physically unable to complete a document, check to see if someone else can
do that for you at your direction. In no state can another person make a healthcare power of attorney for you except
at your request. Minors who live on their own, are married, or are mature and have strong religious or other
personal beliefs about life-sustaining medical treatments such as blood transfusions, might be able to make legal
healthcare planning documents in certain states.
Anyone who wants to avoid life-sustaining medical treatment in some circumstances should have healthcare
planning documents, because anyone can experience an illness or injury for which life-sustaining treatment might
be used. Attorney involvement is normally not necessary, but recommended. When you are ready to make
healthcare planning documents you should check the laws in your state. One way to do that is through an attorney,
but you can get the most current information, at minimal cost, from Choice in Dying, 200 Varick Street, New
York, NY 10014, telephone (212) 366-5540. You should consult a lawyer if you have a question about your rights,
your providers' obligations, the rights of others (family, agents, healthcare providers, etc.) who you expect will
want to be involved in decisions about your health care or who disagree with your intentions about life-sustaining
treatment, you are a minor, your physician will not accept your choices, you think your mental ability might be
questioned when you sign your documents, you believe that someone might claim you did not understand the
documents when you made them, you are physically unable to complete documents personally and your state law
does not authorize someone else to do that for you at your direction, or if you want someone else to make your
healthcare decisions for you while you still are able to make decisions for yourself.
Generally, documents that are legal in one state are legal in other states. Certain conditions, however,
might not
be accepted by providers, or be legally carried out, if the law of the state where implementation is requested does
not allow them or if it forbids them. You should not expect healthcare planning documents made in the United
States to be honored in other countries, although they might be.
State Law Summaries (as of 1992)
Legal Requirements for Health Care Durable Powers of Attorney
| Alabama: No health care power of attorney law. |
| Alaska: You must sign and date your document. Your document, including
any pages you add to any form,
must be notarized, but not witnessed. |
| Arizona: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. Either witnessing or notarization is required; the choice is yours. Only one witness is
required. You can't use anyone who is related to you by blood, adoption, or marriage as a witness. You may not
use as a witness anyone entitled to any of your property when you die. Your attending physician or any
employee of his/hers can't be a witness. An operator, employee, or physician of a healthcare facility where you
receive care also can't be witnesses. Also excluded from witnessing is any person directly involved in providing
health care to you (for example, a friend providing home care) when your document is witnessed. The person
you chose as an agent can't be a witness. This exclusion applies as well to a notary, who also cannot be your
agent. |
| Arkansas: No health care power of attorney law. |
| California: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. You must name an agent. You can name an alternate. You can't choose your
healthcare provider or any of your provider's employees. Also, excluded from being your agent is a non relative
employee of your healthcare provider; an operator of a community care facility or a residential care facility for
the elderly; a non relative employee of such a facility. If you have a conservator, she cannot be your agent
unless certain legal requirements are met, which require consulting a lawyer. Either witnessing or notarization
is required; the choice is yours. You can't use anyone who is related to you by blood, adoption, or marriage as a
witness. You may not use as a witness anyone entitled to any of your property when you die. An operator,
employee, or physician of a healthcare facility, even if you don't receive care there, also can't be witnesses. Also
excluded from witnessing is any healthcare provider and provider's employees, including any operator or
employee of a community care facility or residential care facility for the elderly. The person you chose as an
agent can't be a witness. If you reside in a skilled nursing facility when you sign your durable power of
attorney, a patient advocate or ombudsman authorized by the State Department of Aging must be one of the
witnesses. That person must sign on one of the witness lines, and sign an additional statement that appears at
the end of the state form. This state requires that a certain notice explaining the nature of healthcare powers of
attorney accompanies the form. You must also use the specific power of attorney form for your state. |
| Colorado: The law does not state any requirements for document validity.
|
| Connecticut: You must sign and date your document. You must name an
agent. You can name an alternate.
You can't choose your healthcare providers. Also excluded from being your agent are operators and employees
of a hospital, "home for the aged, rest home with nursing supervision, or chronic or convalescent nursing home"
if you are a patient or resident when you sign your document, or if you have applied for admission. If you reside
in such a facility, an administrator or employee of a government agency that is financially responsible for your
medical care cannot be your agent unless related to you. Your document, including any pages you add to any
form, must be witnessed, but not notarized. Witnesses for someone who resides in a facility operated or licensed
by the state department of mental health must include at least one person who is a physician or clinical
psychologist with specialized training in treating mental illness. Witnesses for a person who resides in a facility
operated or licensed by the department of mental retardation must include a least one witness who is a physician
or clinical psychologist with specialized training in developmental disability. The person you chose as an agent
can't be a witness. |
| Delaware: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. Your document, including any pages you add to any form, must be witnessed, but not
notarized. You can't use anyone who is related to you by blood or marriage as a witness. You can't use as a
witness anyone entitled to any of your property when you die and anyone who might be owed money by your
estate. An operator, employee, or physician of a healthcare facility where you receive care also can't be
witnesses. Anyone financially responsible for you medical care can't be a witness. If you reside in any kind of
nursing home when your power of attorney is signed, one of the two witnesses must be "a person designated as a
patient advocate or ombudsman by either the Division of Aging or the Public Guardian." Neither of these people
can have any of the characteristics that would exclude other witnesses. |
| D.C.: Your document can be signed and dated by someone else for you,
at your direction, if you are physically
unable to do so. Your document, including any pages you add to any form, must be witnessed, but not notarized.
You can't use anyone who is related to you by blood, adoption, or marriage as a witness. You can't use as
a
witness anyone entitled to any of your property when you die. Your attending physician or any employee of
his/hers can't be a witness. An operator, employee, or physician of a healthcare facility where you receive
care
also can't be witnesses. |
| Florida: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. Your document, including any pages you add to any form, must be witnessed, but
not
notarized. You can't use anyone who is related to you by blood or marriage as a witness. The person you chose
as an agent can't be a witness. |
| Georgia: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. You must name an agent. You can name an alternate. You can't choose your
healthcare providers. You may not name any of the following people as an agent: an operator, administrator, or
employee of any healthcare facility where you are a patient or resident including a physician if he is a facility
employee. Your document, including any pages you add to any form, must be witnessed, but not notarized.
If you are a patient in a hospital or skilled nursing facility when your power of attorney is signed, your
attending
physician must witness it in addition to the other two witnesses. |
| Hawaii: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. You must name an agent. You can name an alternate. You can't choose your
healthcare providers. Both witnessing and notarization are required. You can't use anyone who is related
to you
by blood, adoption, or marriage as a witness. Your attending physician or any employee of his/hers can't
be a
witness. An operator, employee, or physician of a facility where you receive care also can't be witnesses. |
| Idaho: You must sign and date your document. You must name an agent.
You can name an alternate. You
can't choose your healthcare providers. Also excluded from being your agent is an operator of a community care
facility, a nonnegative employee of such a facility, or a nonnegative employee of any of your healthcare
providers. Either witnessing or notarization is required; the choice is yours. You can't use anyone who is related
to you by blood or marriage as a witness. Also excluded from witnessing are a community care facility operator,
and employees of such a facility and of your healthcare providers even if they are your relatives. |
| Illinois: You must sign and date your document. You must name an agent.
You can name an alternate. You
can't choose your healthcare providers. You may not name any of the following people as an agent: an operator,
administrator, or employee of any healthcare facility where you are a patient or resident including a physician if
he is a facility employee. Neither witnessing nor notarization is required. The form in the statute, which is
optional, includes a space for one witness. For that reason, witnessing by at least one witness is strongly advised. See
Table 2 for restrictions. |
| Indiana: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. The law contains conflicting verification requirements. Both witnessing and
notarization are required. Notarization and witnessing by at least one witness are strongly advised. This
state
requires that a certain notice explaining the nature of healthcare powers of attorney accompanies the form. |
| Iowa: Your document can be signed and dated by someone else for you,
at your direction, if you are physically
unable to do so. You must name an agent. You can name an alternate. You can't choose your healthcare
provider or any of your provider's employees. Either witnessing or notarization is required; the choice is yours.
You can't use anyone who is related to you by blood, adoption, or marriage as a witness. Your attending
physician or any employee of his/hers can't be a witness. Your healthcare providers' employees can be witnesses
if they are your relatives. An operator, employee, or physician of a healthcare facility where you receive care
also can't be witnesses. The person you chose as an agent can't be a witness. |
| Kansas: You must sign and date your document. You must name an agent.
You can name an alternate. You
can't choose your healthcare provider or any of your provider's employees. A provider or his employee can be
your agent if related to you, or if you and the agent are "members of the same community of persons who are
bound by vows to a religious life and who conduct or assist in the conduct of religious service and regularly
engage in religious, benevolent, charitable or educational ministrations or the performance of healthcare
services." You may not name any of the following people as an agent: an operator, administrator, or employee
of any healthcare facility where you are a patient or resident including a physician if he is a facility employee.
Either witnessing or notarization is required; the choice is yours. You can't use anyone who is related to you by
blood, adoption, or marriage as a witness. You can't use as a witness anyone entitled to any of your property
when you die. Anyone financially responsible for you medical care can't be a witness. The person you chose as
an agent can't be a witness. You must also use the specific power of attorney form for your state. |
| Kentucky: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. Either witnessing or notarization is required; the choice is yours. Neither your agent,
your witnesses, nor your notary public can be an owner, director, officer, or employee of a healthcare facility
where you are a patient or resident, unless related to you. An operator, employee, or physician of a healthcare
facility where you receive care also can't be witnesses. |
| Louisiana: No health care power of attorney law. |
| Maine: You must sign and date your document. Applicable laws contain
conflicting verification requirements.
Either witnessing or notarization is required; the choice is yours. Notarization and witnessing are strongly
advised. |
| Maryland: No health care power of attorney law. |
| Massachusetts: Your document can be signed and dated by someone
else for you, at your direction, if you are
physically unable to do so. Also excluded from being your agent is an operator, administrator, or employee of a
healthcare facility where you are a patient or resident or have applied for admission. Your document, including
any pages you add to any form, must be witnessed, but not notarized. |
| Michigan: You must sign and date your document. Before acting for you,
your agent must sign the Michigan
acceptance form. Your document, including any pages you add to any form, must be witnessed, but not
notarized. You can't use anyone who is related to you by blood, adoption, or marriage as a witness. Relatives
excluded from witnessing are your spouse, parents, children, grandchildren, and siblings. You can't use as a
witness anyone entitled to any of your property when you die. Also excluded from witnessing are employees of
a life or health insurance company that insures you. Your attending physician or any employee of his/hers can't
be a witness. Employees of your physician are not excluded if they are not also employees of a facility where you
are a patient or resident. An operator, employee, or physician of a healthcare facility where you receive care also
can't be witnesses. The person you chose as an agent can't be a witness. |
| Minnesota: No health care power of attorney law. |
| Mississippi: You must sign and date your document. You
must name an agent. You can name an alternate.
You can't choose your healthcare provider or any of your provider's employees. Either witnessing or
notarization is required; the choice is yours. You can't use as a witness anyone entitled to any of your
property
when you die. Your attending physician or any employee of his/hers can't be a witness. An operator, employee,
or physician of a healthcare facility, even if you don't receive care there, also can't be witnesses. The
person you
chose as an agent can't be a witness. This state requires that a certain notice explaining the nature of healthcare
powers of attorney accompanies the form. |
| Missouri: You must sign and date your document. You must name an agent.
You can name an alternate.
You can't choose your healthcare provider or any of your provider's employees. A provider or his employee can
be your agent if related to you, or if you and the agent are "members of the same community of persons who are
bound by vows to a religious life and who conduct or assist in the conduct of religious service and regularly
engage in religious, benevolent, charitable or educational ministrations or the performance of healthcare
services." You may not name any of the following people as an agent: an operator, administrator, or employee
of any healthcare facility where you are a patient or resident including a physician if he is a facility employee.
Your document, including any pages you add to any form, must be notarized, but not witnessed. |
| Montana: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. Your document, including any pages you add to any form, must be witnessed, but
not
notarized. |
| Nebraska: You must sign and date your document. You must name an agent.
You can name an alternate.
You can't choose your healthcare provider or any of your provider's employees. An employee of your physician,
or the owner, operator, or employee of a facility in which you are a patient or resident, can be your agent if
related to you. A person who is already the agent for at least ten people is excluded. You may not name any of
the following people as an agent: an operator, administrator, or employee of any healthcare facility where you
are a patient or resident including a physician if he is a facility employee. Your document, including any pages
you add to any form, must be witnessed, but not notarized. Witnesses must be at least nineteen years old. You
can't use anyone who is related to you by blood, adoption, or marriage as a witness. You can't use as a witness
anyone entitled to any of your property when you die. Your attending physician or any employee of his/hers
can't be a witness. The person you chose as an agent can't be a witness. Regarding witness exclusions, see the
comments in the Michigan note. Also, only one witness may be an administrator or employee of your
healthcare providers. You must also use the specific power of attorney form for your state. |
| Nevada: You must sign and date your document. You must name an agent.
You can name an alternate. You
can't choose your healthcare provider or any of your provider's employees. All physicians and their employees
are excluded even if not involved in your care. You may not name any of the following people as an agent: an
operator, administrator, or employee of any healthcare facility where you are a patient or resident including a
physician if he is a facility employee. Either witnessing or notarization is required; the choice is yours. You
can't use anyone who is related to you by blood, adoption, or marriage as a witness. You can't use as a witness
anyone entitled to any of your property when you die. Your attending physician or any employee of his/hers
can't be a witness. An operator, employee, or physician of a healthcare facility, even if you don't receive care
there, also can't be witnesses. The person you chose as an agent can't be a witness. This state requires that a
certain notice explaining the nature of healthcare powers of attorney accompanies the form. You must also use
the specific power of attorney form for your state. |
| New Hampshire: Your document can be signed and dated by someone
else for you, at your direction, if you are
physically unable to do so. You must name an agent. You can name an alternate. You can't choose your
healthcare providers. You may not name any of the following people as an agent: an operator, administrator, or
employee of any healthcare facility where you are a patient or resident including a physician if he is a facility
employee. Your residential care provider cannot be your agent. Your providers' employees are not excluded if
related to you. Both witnessing and notarization are required. You can't use anyone who is related to you by
blood or marriage as a witness. Your spouse is the only relative excluded from witnessing. You can't use as a
witness anyone entitled to any of your property when you die. An operator, employee, or physician of a
healthcare facility where you receive care also can't be witnesses. The person you chose as an agent can't be a
witness. One witness can be your health or residential care provider or provider's employee. This state requires
that a certain notice explaining the nature of healthcare powers of attorney accompanies the form. You must
also use the specific power of attorney form for your state. |
| New Jersey: Your document can be signed and dated by someone else
for you, at your direction, if you are
physically unable to do so. You may not name any of the following people as an agent: an operator,
administrator, or employee of any healthcare facility where you are a patient or resident including a physician if
he is a facility employee. This exclusion does not apply to a physician who is not involved in your care while
acting as your agent. Also, any of these people can be your agent if related to you. Either witnessing or
notarization is required; the choice is yours. The person you chose as an agent can't be a witness. |
| New Mexico: Your document can be signed and dated by someone else
for you, at your direction, if you are
physically unable to do so. Your document, including any pages you add to any form, must be witnessed, but not
notarized. |
| New York: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. You must name an agent. You can name an alternate. You can't choose your
healthcare providers. Unless related to you, a physician, or an operator, administrator, or employee of a hospital
is excluded from being your agent not only if you are a patient or resident, but also if you have applied for
admission. Also, a doctor cannot act as your attending physician and agent at the same time. A person who,
when your document is signed, is already the named agent for at least ten people, cannot be your agent unless he
is your spouse, child, parent, sibling, or grandparent, or is married to one of those relatives. Your document,
including any pages you add to any form, must be witnessed, but not notarized. Witnesses to a healthcare power
of attorney for a person who resides in a facility operated or licensed by the state office of mental health must
include at least one person not affiliated with the facility, and at least one physician certified by the American
Board of Psychiatry and Neurology. The person you chose as an agent can't be a witness. Witnesses to a
healthcare power of attorney for a person who resides in a facility operated or licensed by the office of mental
retardation and developmental disability must include at least one person not affiliated with the facility, and at
least one witness must be a physician or clinical psychologist who (1) is employed by a school for the retarded
or disabled, (2) has been employed a minimum of two years to render care and service in a facility operated by
the office of mental retardation and developmental disabilities, or (3) has been approved by the commissioner of
mental retardation and developmental disabilities. A superior court clerk or assistant clerk can certify your
document instead of a notary public. |
| North Carolina: You must sign and date your document. You must name
an agent. You can name an
alternate. You may not name any of the following people as an agent: an operator, administrator, or employee
of any healthcare facility where you are a patient or resident including a physician if he is a facility employee.
You can't choose your healthcare providers. Also, excluded are relatives of your spouse. Both witnessing
and
notarization are required. You can't use anyone who is related to you by blood, adoption, or marriage as
a
witness. You can't use as a witness anyone entitled to any of your property when you die and anyone who
might
be owed money by your estate. Your attending physician or any employee of his/hers can't be a witness.
An
operator, employee, or physician of a healthcare facility where you receive care also can't be witnesses. |
| North Dakota: You must sign and date your document. You must name
an agent. You can name an alternate.
You can't choose your healthcare provider or any of your provider's employees. You may not name any of the
following people as an agent: an operator, administrator, or employee of any healthcare facility where you are a
patient or resident including a physician if he is a facility employee. Agent exclusions do not apply to employees
who are your relatives. Your document, including any pages you add to any form, must be witnessed, but not
notarized. You can't use anyone who is related to you by blood or adoption as a witness. Witnesses can include
relatives by marriage. You can't use as a witness anyone entitled to any of your property when you die and
anyone who might be owed money by your estate. Your attending physician or any employee of his/hers can't be
a witness. An operator, employee, or physician of a healthcare facility where you receive care also can't be
witnesses. The person you chose as an agent can't be a witness. This state requires that a certain notice
explaining the nature of healthcare powers of attorney accompanies the form. You must also use the specific
power of attorney form for your state. |
| Ohio: You must sign and date your document. You must name an agent.
You can name an alternate. You
can't choose your healthcare provider or any of your provider's employees. You may not name any of the
following people as an agent: an operator, administrator, or employee of any healthcare facility where you are a
patient or resident including a physician if he is a facility employee. These agent exclusions do not apply to
relatives or to fellow members of a religious order. Either witnessing or notarization is required; the choice is
yours. You can't use anyone who is related to you by blood, adoption, or marriage as a witness. Your attending
physician can't be a witness. Witnesses can include employees of your physician. An administrator of a nursing
home where you receive care cannot be a witness. The person you chose as an agent can't be a witness. This
state requires that a certain notice explaining the nature of healthcare powers of attorney accompanies the form. |
| Oklahoma: No health care power of attorney law. |
| Oregon: You must sign and date your document. You must name an agent.
You can name an alternate. You
can't choose your healthcare provider or any of your provider's employees. You may not name any of the
following people as an agent: an operator, administrator, or employee of any healthcare facility where you are a
patient or resident including a physician if he is a facility employee. These People are not excluded from being
your agent if related to you. Your document, including any pages you add to any form, must be witnessed, but
not notarized. You can't use anyone who is related to you by blood, adoption, or marriage as a witness. You
can't use as a witness anyone entitled to any of your property when you die. Your attending physician can't be a
witness. Your physician's employees can be witnesses. The person you chose as an agent can't be a witness.
This state requires that a certain notice explaining the nature of healthcare powers of attorney accompanies
the
form. You must also use the specific power of attorney form for your state. |
| Pennsylvania: The law does not state any requirements for document
validity. |
| Rhode Island: Your document can be signed and dated by someone else
for you, at your direction, if you are
physically unable to do so. You must name an agent. You can name an alternate. You can't choose your
healthcare provider or any of your provider's employees. Also, excluded from being your agent is an operator of
a community care facility, and its employees not related to you. Non relative employees of your physician can
be your agent. Your document, including any pages you add to any form, must be witnessed, but not notarized.
You can't use anyone who is related to you by blood, adoption, or marriage as a witness. You can't use as a
witness anyone entitled to any of your property when you die. Your attending physician or any employee of
his/hers can't be a witness. An operator, employee, or physician of a healthcare facility, even if you don't
receive care there, also can't be witnesses. All healthcare providers, operators of community care facilities, and
their employees, are excluded from witnessing, even if related to you. The person you chose as an agent can't be
a witness. This state requires that a certain notice explaining the nature of healthcare powers of attorney
accompanies the form. You must also use the specific power of attorney form for your state. |
| South Carolina: Your document can be signed and dated by someone else
for you, at your direction, if you are
physically unable to do so. You must name an agent. You can name an alternate. You can't choose your
healthcare provider or any of your provider's employees. Also excluded from being your agent, unless related to
you, is an employee of a nursing care facility in which you reside, and a spouse of any of your healthcare
providers or their employees. Both witnessing and notarization are required. You can't use anyone who is
related to you by blood, adoption, or marriage as a witness. You can't use as a witness anyone entitled to any of
your property when you die and anyone who might be owed money by your estate. Your attending physician or
any employee of his/hers can't be a witness. An operator, employee, or physician of a healthcare facility where
you receive care also can't be witnesses. Also excluded from witnessing are beneficiaries of any life insurance
you may have. Anyone financially responsible for you medical care can't be a witness. The person you chose
as
an agent can't be a witness. This state requires that a certain notice explaining the nature of healthcare
powers
of attorney accompanies the form. You must also use the specific power of attorney form for your state. |
| South Dakota: The law does not state any requirements for document
validity. |
| Tennessee: You must sign and date your document. You must name an agent.
You can name an alternate.
You can't choose your healthcare provider or any of your provider's employees. You may not name any of the
following people as an agent: an operator, administrator, or employee of any healthcare facility where you are a
patient or resident including a physician if he is a facility employee. Your agent can be an employee of your
provider or of a healthcare institution, if related to you. If you have a conservator whom you want to be your
agent, you need to consult an attorney. Both witnessing and notarization are required. You can't use anyone
who is related to you by blood, adoption, or marriage as a witness. You can't use as a witness anyone entitled to
any of your property when you die and anyone who might be owed money by your estate. Your attending
physician or any employee of his/hers can't be a witness. Excluded from witnessing are all healthcare providers
and their employees, even if not involved in your care. An operator, employee, or physician of a healthcare
facility, even if you don't receive care there, also can't be witnesses. The person you chose as an agent can't be
a witness. This state requires that a certain notice explaining the nature of healthcare powers of attorney
accompanies the form. |
| Texas: Your document can be signed and dated by someone else for you,
at your direction, if you are
physically unable to do so. You must name an agent. You can name an alternate. You can't choose your
healthcare providers. You may not name any of the following people as an agent: an operator, administrator, or
employee of any healthcare facility where you are a patient or resident including a physician if he is a facility
employee. An employee is not excluded from being your agent if related to you. Your document, including any
pages you add to any form, must be witnessed, but not notarized. You can't use anyone who is related to you by
or marriage as a witness. You can't use as a witness anyone entitled to any of your property when you die and
anyone who might be owed money by your estate. The only relative automatically excluded from witnessing is a
spouse. Your attending physician or any employee of his/hers can't be a witness. An operator, employee, or
physician of a healthcare facility where you receive care also can't be witnesses. The person you chose as an
agent can't be a witness. This state requires that a certain notice explaining the nature of healthcare powers of
attorney accompanies the form. Be sure to sign your name on the line at the end of the disclosure statement in
the state form. You must also use the specific power of attorney form for your state. |
| Utah: You must sign and date your document. Utah law authorizes only
a "special power of attorney," in
which you can designate a person you choose to make a living will for you. Your document, including any pages
you add to any form, must be notarized, but not witnessed. You must also use the specific power of attorney
form for your state. |
| Vermont: See the Texas note. Your document can be signed and dated
by someone else for you, at your
direction, if you are physically unable to do so. You must name an agent. You can name an alternate. You
can't choose your healthcare providers. You may not name any of the following people as an agent: an operator,
administrator, or employee of any healthcare facility where you are a patient or resident including a physician if
he is a facility employee. Also, if you are being admitted to or are a resident of a nursing or residential care
home when you make your document, "an ombudsman, a recognized member of the clergy, an attorney licensed
to practice in this state, or other person as may be designated by the probate court for the county in which the
facility is located" must "sign a statement affirming that he or she has explained the nature and effect of the
durable power of attorney for health care to [you]." If you are a patient or being admitted to a hospital when
your healthcare power of attorney is signed, "a person designated by the hospital" must "sign a statement that he
or she has explained the nature and effect of the durable power of attorney for health care to [you]." A statement
for either of those is included in the state form. Be sure to sign the acknowledgment after the disclosure
statement in the state form. Your document, including any pages you add to any form, must be witnessed, but
not notarized. You can't use anyone who is related to you by blood or marriage as a witness. You can't use as a
witness anyone entitled to any of your property when you die and anyone who might be owed money by your
estate. Your attending physician or any employee of his/hers can't be a witness. An operator, employee, or
physician of a healthcare facility where you receive care also can't be witnesses. The person you chose as an
agent can't be a witness. This state requires that a certain notice explaining the nature of healthcare powers of
attorney accompanies the form. You must also use the specific power of attorney form for your state. |
| Virginia: You must sign and date your document. Your document, including
any pages you add to any form,
must be witnessed, but not notarized. You can't use anyone who is related to you by blood or marriage as
a
witness. |
| Washington: You must sign and date your document. You must name an
agent. You can name an alternate.
You can't choose your healthcare providers. You may not name any of the following people as an agent: an
operator, administrator, or employee of any healthcare facility where you are a patient or resident including a
physician if he is a facility employee. Any of these people can be your agents if he/she is your spouse, adult
child, or sibling. The law is unclear about verification requirements, so both witnessing and notarization are
recommended. You can't use anyone who is related to you by blood or marriage as a witness. You can't use as
a witness anyone entitled to any of your property when you die and anyone who might be owed money by your
estate. Your attending physician or any employee of his/hers can't be a witness. An operator, employee, or
physician of a healthcare facility where you receive care also can't be witnesses. |
| West Virginia: Your document can be signed and dated by someone else
for you, at your direction, if you are
physically unable to do so. You must name an agent. You can name an alternate. You can't choose your
healthcare providers. You may not name any of the following people as an agent: an operator, administrator, or
employee of any healthcare facility where you are a patient or resident including a physician if he is a facility
employee. An employee is not excluded from being your agent if related to you. Both witnessing and
notarization are required. You can't use anyone who signs and dates your documents for you as a witness. Your
attending physician's employees can be witnesses. You can't use anyone who is related to you by blood or
marriage as a witness. You can't use as a witness anyone entitled to any of your property when you die. Your
attending physician or any employee of his/hers can't be a witness. Anyone financially responsible for you
medical care can't be a witness. The person you chose as an agent can't be a witness. You must also use the
specific power of attorney form for your state. |
| Wisconsin: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. You must name an agent. You can name an alternate. You can't choose your
healthcare providers. You may not name any of the following people as an agent: an operator, administrator, or
employee of any healthcare facility where you are a patient or resident including a physician if he is a facility
employee. Also, excluded from being your agent is the spouse of any of those people. Employees and spouses
are not excluded if related to you. Your document, including any pages you add to any form, must be witnessed,
but not notarized. You can't use anyone who is related to you by blood, adoption, or marriage as a witness. You
can't use as a witness anyone entitled to any of your property when you die and anyone who might be owed
money by your estate. Your healthcare providers and their employees when your document is made-except a
chaplain or social worker-cannot be witnesses. An operator, employee, or physician of a healthcare facility, even
if you don't receive care there, also can't be witnesses. Anyone financially responsible for you medical care
can't be a witness. The person you chose as an agent can't be a witness. This state requires that a certain notice
explaining the nature of healthcare powers of attorney accompanies the form. You must also use the specific
power of attorney form for your state. |
| Wyoming: Your document can be signed and dated by someone else for
you, at your direction, if you are
physically unable to do so. You must name an agent. You can name an alternate. You can't choose your
healthcare providers. Either witnessing or notarization is required; the choice is yours. You can't use anyone
who is related to you by blood, adoption, or marriage as a witness. You can't use as a witness anyone entitled to
any of your property when you die. Your attending physician or any employee of his/hers can't be a witness. An
operator, employee, or physician of a healthcare facility, even if you don't receive care there, also can't be
witnesses. The agent and witness exclusions apply to operators and employees of community care and
residential care facilities, but not other types of facilities. The person you chose as an agent can't be
a witness. |
Legal Requirements for Declarations and Directives, Including the Supplement (as of December 31,
1992)
Alabama: Your document can be signed and dated by someone else for you, at your direction,
if you are
physically unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone who signs and
dates your document for you, anyone related to you by blood or marriage, anyone entitled to your property when
you die, and anyone financially responsible for your medical care.
Alaska: Your document can be signed and dated
by someone else for you, at your direction, if you are physically
unable to do so. Witnessing or notarization is required, but the choice is yours. Witnesses can't be anyone related
to you by blood or marriage.
Arizona: Your document can be signed and dated
by someone else for you, at your direction, if you are physically
unable to do so. Witnessing or notarization is required, but the choice is yours. Witnesses can't be: anyone related
to you by blood, adoption, or marriage, anyone entitled to your property when you die, your attending physician or
any employee of his/hers, an operator or an employee of a healthcare facility where you receive care, or anyone you
named as an agent or alternative. The law includes permanent unconsciousness in the definition of terminal
condition.
Arkansas: Your document can be signed and dated
by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. The law includes permanent
unconsciousness in the definition of terminal condition.
California: Your document can be signed and
dated by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone entitled to
your property when you die, your attending physician or any employee of his/hers, or an operator of a healthcare
facility where you receive care or an employee of the facility. The law includes permanent unconsciousness in the
definition of terminal condition.
Colorado: You must sign and date your document.
Witnessing is required, but not notarization. Witnesses can't
be: anyone entitled to your property when you die, anyone who might be owed money by your estate, your
attending physician or any employee of his/hers, or an operator of a healthcare facility where you receive care or an
employee of the facility.
Connecticut: You must sign and date your document.
Witnessing is required, but not notarization. The law
includes permanent unconsciousness in the definition of terminal condition.
Delaware: Your document can be signed and dated
by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone related to you
by blood or marriage, anyone entitled to your property when you die, anyone who might be owed money by your
estate, an operator of a healthcare facility where you receive care or an employee of the facility, or anyone
financially responsible for your medical care.
D.C.: Your document can be signed and dated
by someone else for you, at your direction, if you are physically
unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone who signs and dates your
document for you, anyone related to you by blood or marriage, anyone entitled to your property when you die, your
attending physician or any employee of his/hers, an operator of a healthcare facility where you receive care or an
employee of the facility, or anyone financially responsible for your medical care.
Florida: Your document can be signed and dated
by someone else for you, at your direction, if you are physically
unable to do so. Witnessing is required, but not notarization. Witnesses can't be anyone related to you by blood or
marriage. The law includes permanent unconsciousness in the definition of terminal condition.
Georgia: You must sign and date your document.
Witnessing is required, but not notarization. Witnesses can't
be: anyone related to you by blood or marriage, anyone entitled to your property when you die, anyone who might
be owed money by your estate, your attending physician or any employee of his/hers, an operator of a healthcare
facility where you receive care or an employee of the facility, or anyone financially responsible for your medical
care. The law includes permanent unconsciousness in the definition of terminal condition.
Hawaii: Your document can be signed and dated
by someone else for you, at your direction, if you are physically
unable to do so. Both witnessing and notarization are required. Witnesses can't be: anyone related to you by
blood, adoption, or marriage, your attending physician or any employee of his/hers, or an operator of a healthcare
facility where you receive care or an employee of the facility. The law includes permanent unconsciousness in the
definition of terminal condition.
Idaho: You must sign and date your document.
Witnessing is required, but not notarization. The law includes
permanent unconsciousness in the definition of terminal condition.
Illinois: Your document can be signed and dated
by someone else for you, at your direction, if you are physically
unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone who signs and dates your
document for you, anyone entitled to your property when you die, or anyone financially responsible for your
medical care.
Indiana: Your document can be signed and dated
by someone else for you, at your direction, if you are physically
unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone who signs and dates your
document for you, anyone related to you by blood, adoption, or marriage, anyone entitled to your property when
you die, or anyone financially responsible for your medical care.
Iowa: Your document can be signed and dated
by someone else for you, at your direction, if you are physically
unable to do so. Witnessing or notarization is required, but the choice is yours. Witnesses can't be: anyone related
to you by blood, adoption, or marriage, or your attending physician or any employee of his/hers. The law includes
permanent unconsciousness in the definition of terminal condition.
Kansas: Your document can be signed and dated by someone else for you, at your direction,
if you are physically
unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone who signs and dates your
document for you, anyone related to you by blood or marriage, anyone entitled to your property when you die, or
anyone financially responsible for your medical care.
Kentucky: Your document can be signed and dated
by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone entitled to
your property when you die, your attending physician or any employee of his/hers, an operator of a healthcare
facility where you receive care or an employee of the facility, or anyone financially responsible for your medical
care.
Louisiana: You must sign and date your document.
Witnessing is required, but not notarization. The law
includes permanent unconsciousness in the definition of terminal condition.
Maine: Your document can be signed and dated
by someone else for you, at your direction, if you are physically
unable to do so. Witnessing is required, but not notarization. The law includes permanent unconsciousness in the
definition of terminal condition.
Maryland: Your document can be signed and dated
by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone who signs and
dates your document for you, anyone related to you by blood or marriage, anyone entitled to your property when
you die, anyone who might be owed money by your estate, or anyone financially responsible for your medical care.
Massachusetts: No law authorizing directives.
Michigan: No law authorizing directives.
Minnesota: You must sign and date your document.
Witnessing or notarization is required, but the choice is
yours. Witnesses can't be: anyone entitled to your property when you die.
Mississippi: You must sign and date your document.
Witnessing is required, but not notarization. Witnesses
can't be: anyone related to you by blood or marriage, anyone entitled to your property when you die, anyone who
might be owed money by your estate, or your attending physician or any employee of his/hers.
Missouri: Your document can be signed and dated
by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. Witnesses can't be anyone who signs and
dates your document for you.
Montana: Your document can be signed and dated
by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization.
Nebraska: Your document can be signed and dated
by someone else for you, at your direction, if you are
physically unable to do so. Witnessing or notarization is required, but the choice is yours. Witnesses can't be an
operator of a healthcare facility where you receive care or an employee of the facility. The law includes permanent
unconsciousness in the definition of terminal condition.
Nevada: Your document can be signed and dated
by someone else for you, at your direction, if you are physically
unable to do so. Witnessing is required, but not notarization.
New Hampshire: You must sign and date your document.
Both witnessing and notarization are required.
Witnesses can't be: anyone related to you by blood or marriage, anyone entitled to your property when you die,
anyone who might be owed money by your estate, your attending physician or any employee of his/hers, or an
operator of a healthcare facility where you receive care or an employee of the facility. The law includes permanent
unconsciousness in the definition of terminal condition.
New Jersey: Your document can be signed and
dated by someone else for you, at your direction, if you are
physically unable to do so. Witnessing or notarization is required, but the choice is yours. Witnesses can't be
anyone you named as an agent or alternative. The law includes permanent unconsciousness in the definition of
terminal condition.
New Mexico: Your document can be signed and
dated by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. The law includes permanent
unconsciousness in the definition of terminal condition.
New York: No law authorizing directives.
North Carolina: You must sign and date your
document. Both witnessing and notarization are required.
Witnesses can't be: anyone related to you by blood or marriage, anyone entitled to your property when you die,
anyone who might be owed money by your estate, your attending physician or any employee of his/hers, or an
operator of a healthcare facility where you receive care or an employee of the facility. The law includes permanent
unconsciousness in the definition of terminal condition.
North Dakota: Your document can be signed and
dated by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone related to you
by blood or marriage, anyone entitled to your property when you die, anyone who might be owed money by your
estate, your attending physician or any employee of his/hers, or anyone financially responsible for your medical
care.
Ohio: Your document can be signed and dated
by someone else for you, at your direction, if you are physically
unable to do so. Witnessing or notarization is required, but the choice is yours. Witnesses can't be: anyone related
to you by blood, adoption, or marriage, your attending physician or any employee of his/hers, or an operator of a
healthcare facility where you receive care or an employee of the facility. The law includes permanent
unconsciousness in the definition of terminal condition.
Oklahoma: You must sign and date your document.
Witnessing is required, but not notarization. Witnesses can't
be anyone entitled to your property when you die. The law includes permanent unconsciousness in the definition of
terminal condition.
Oregon: You must sign and date your document.
Witnessing is required, but not notarization. Witnesses can't be:
anyone related to you by blood or marriage, anyone entitled to your property when you die, anyone who might be
owed money by your estate, your attending physician or any employee of his/hers, or an operator of a healthcare
facility where you receive care or an employee of the facility.
Pennsylvania: Your document can be signed and
dated by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. Witnesses can't be anyone who signs and
dates your document for you. The law includes permanent unconsciousness in the definition of terminal condition.
Rhode Island: Your document can be signed and
dated by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. Witnesses can't be anyone related to you
by blood or marriage.
South Carolina: You must sign and date your document.
Both witnessing and notarization are required.
Witnesses can't be: anyone related to you by blood, adoption, or marriage, anyone entitled to your property when
you die, anyone who might be owed money by your estate, your attending physician or any employee of his/hers, an
operator of a healthcare facility where you receive care or an employee of the facility, or anyone financially
responsible for your medical care. The law includes permanent unconsciousness in the definition of terminal
condition.
South Dakota: Your document can be signed and
dated by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. The law includes permanent
unconsciousness in the definition of terminal condition.
Tennessee: You must sign and date your document.
Both witnessing and notarization are required. Witnesses
can't be: anyone related to you by blood or marriage, anyone entitled to your property when you die, anyone who
might be owed money by your estate, your attending physician or any employee of his/hers, or an operator of a
healthcare facility where you receive care or an employee of the facility. The law includes permanent
unconsciousness in the definition of terminal condition.
Texas: You must sign and date your document.
Witnessing is required, but not notarization. Witnesses can't be:
anyone related to you by blood or marriage, anyone entitled to your property when you die, anyone who might be
owed money by your estate, your attending physician or any employee of his/hers, or an operator of a healthcare
facility where you receive care or an employee of the facility.
Utah: Your document can be signed and dated by
someone else for you, at your direction, if you are physically
unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone who signs and dates your
document for you, anyone related to you by blood or marriage, anyone entitled to your property when you die, an
operator of a healthcare facility where you receive care or an employee of the facility, or anyone financially
responsible for your medical care.
Vermont: You must sign and date your document.
Witnessing is required, but not notarization. Witnesses can't
be: anyone related to you by blood or marriage, anyone entitled to your property when you die, anyone who might
be owed money by your estate, or your attending physician or any employee of his/hers.
Virginia: You must sign and date your document.
Witnessing is required, but not notarization. Witnesses can't
be anyone related to you by blood or marriage. The law includes permanent unconsciousness in the definition of
terminal condition.
Washington: You must sign and date your document.
Witnessing is required, but not notarization. Witnesses
can't be: anyone related to you by blood or marriage, anyone entitled to your property when you die, anyone who
might be owed money by your estate, your attending physician or any employee of his/hers, or an operator of a
healthcare facility where you receive care or an employee of the facility. The law includes permanent
unconsciousness in the definition of terminal condition.
West Virginia: Your document can be signed and
dated by someone else for you, at your direction, if you are
physically unable to do so. Both witnessing and notarization are required. Witnesses can't be: anyone who signs
and dates your document for you, anyone entitled to your property when you die, your attending physician or any
employee of his/hers, or anyone financially responsible for your medical care, or anyone you named as an agent or
alternative. The law includes permanent unconsciousness in the definition of terminal condition.
Wisconsin: Your document can be signed and dated
by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone related to you
by blood, adoption, or marriage, anyone entitled to your property when you die, anyone who might be owed money
by your estate, your attending physician or any employee of his/hers, an operator of a healthcare facility or an
employee of the facility even if you do not receive care there, or anyone financially responsible for your medical
care. The law includes permanent unconsciousness in the definition of terminal condition.
Wyoming: Your document can be signed and dated
by someone else for you, at your direction, if you are
physically unable to do so. Witnessing is required, but not notarization. Witnesses can't be: anyone who signs and
dates your document for you, anyone entitled to your property when you die, or anyone financially responsible for
your medical care.
Sample Durable Power of Attorney
DURABLE POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
That I, (name), of (town), (state), do hereby make, constitute and appoint (name of person), my true and
lawful
attorney for me and in my name, place and stead to act under the following provisions:
1. General Powers. To exercise or perform any act, power, duty, right or obligation whatsoever that
I now have
or may hereafter acquire relating to any person, matter, transaction or property, real or personal, tangible or
intangible, present, contingent or expectant, now possessed or hereafter acquired by me, including, but
without limitation, the specifically enumerated powers granted below. I further grant to my said attorney full
power and authority to do everything necessary in exercising any of the powers herein granted as fully as I
might or could do if personally present.
2. Powers of Collection, Payment and Enforcement. To demand, sue for, collect, compromise, recover and
receive all debts, moneys, property interests, claims and demands whatsoever, now due or that may hereafter
be or become due to me, including the right to institute any legal or equitable proceedings therefor; and to
execute and deliver on my behalf and in my name, any and all endorsements, elections, releases, receipts, or
discharges for the same.
3. Banking Powers. To make, execute, deliver and endorse notes, drafts, checks, certificates of deposit
and
orders for the payment of money or other property from or to me in order of my name; to make deposits or
withdrawals on any accounts in banks or other financial institutions on my behalf.
4. Power to Acquire, Manage, Lease and Sell. To make, execute and deliver deeds, releases, conveyances,
leases, subleases, and contracts of every nature in relation to both real and personal property, including
stocks, bonds, options, contracts of indemnity and insurance, on such terms and conditions as my
attorney shall deem proper; to manage or to become involved in the management of any such property
including the operation of any business in which I have a substantial interest, and to carry out any act of
management which may be appropriate to such involvement.
5. Powers with Respect to Life Insurance Contracts. To have full authority to deal with any policies
of
insurance on my life, or policies on the life or lives of others in which I may have any interest, including,
but not limited to, the right to make irrevocable assignments thereof, to surrender, borrow against, or
convert any such policies and to change the beneficiaries thereof, or to take any other action with
respect to such policies as my said attorney shall deem proper.
6. Powers over Safe Deposit Boxes. To have access to all my safe deposit boxes, whether in my name
alone or
held jointly with others.
7. Powers as to Securities. To purchase, sell, transfer or otherwise deal in any way with all forms
of securities;
to act as my proxy with power of substitution; to vote all stocks or other securities in my name in relation to
any individual or corporate action; to deposit any stocks or other securities in connection with any plans of
protective or reorganizational committees; to purchase, accept or exercise rights to subscribe for securities and
to sell same; to endorse securities or any agreements relating thereto, on my behalf; to create, utilize,
terminate and otherwise deal with accounts (including margin accounts) with securities brokers.
8. Powers as to Rents. To receive and give receipt for all rents and income to which I am or may become
entitled, pay therefrom all necessary expenses for the maintenance, upkeep, care, improvement and
protection of my property; to pay the net income therefrom from time to time to me or in such manner as I
shall direct, or in the absence of such payment to me or such direction, to invest the same in her best
judgment.
9. Use of Funds for My Care. In the event of my illness, incapacity or other emergency, to incur, pay
and
satisfy such expenses and obligations for my comfort, benefit and care, and obligations of a nature
customarily incurred by me, as in her judgment she may consider necessary or desirable or consistent with
my wishes.
10. Powers as to Taxes. To prepare, execute and file federal or state income, gift, or other tax returns
and other
real and personal property tax returns or statements and to pay or compromise any or all such taxes or apply
for and collect any refunds due; to make any tax elections on my behalf of which I am entitled to make.
11. Power to Create Entities or Forms of Ownership and Related Transfers. To create, amend or terminate
one or more trusts, partnerships, corporations, co-tenancies or any other form of ownership for the
purpose of dealing with any property or property interest of any nature that I may have or hereafter
acquire, under such terms and with such provisions as my attorney deems in the best interests of
myself and my family. In this regard, the fact that my said attorney may be a remainderman, partner,
shareholder or a beneficiary of any such entity in connection with any such transfer hereunder shall not
affect the validity thereof, nor, by itself, constitute a breach of her fiduciary duty hereunder; to transfer
any or all property, tangible, intangible or real, in which I may have any interest, into a trust or
trusts, whether created by me or by my said attorney on my behalf, and whether or not such trusts were
created before or after the execution of this durable power of attorney, or to any other form of entity or
ownership, including any form of co-tenancy.
12. Power to Make Gifts. To make outright or in trust gifts of my property to or for the benefit
of such persons
as, in the opinion of my said attorney, would be the donees I might choose, having in mind the resources,
both public and private, available for my care after the making of such gifts, and having in mind the
objective of preserving the largest amount of my property for my family as a whole. Notwithstanding the
foregoing, any gifts that are made to my attorney hereunder pursuant to the foregoing power, or to my
attorney's creditors, my attorney's estate, or the creditor's of my attorney's estate, shall not exceed the
greater of $5,000.00 or five percent of all assets subject to this power in a given calendar year, on a non-
cumulative basis.
13. Power to Employ Agents. To employ, compensate and discharge such agents as my attorney deems
appropriate to carry out any acts authorized or contemplated hereunder.
14. Powers with respect to Retirement Plans. To establish and contribute to any form of so-called
retirement
plan for my benefit, including but not limited to Individual Retirement Accounts, Keogh plans, and any
other form of pension or employee benefit plan; to change beneficiaries of my account in any such plan,
designating such beneficiaries as my attorney determines to be consistent with my wishes; to borrow
against or withdraw from my plan accounts on such terms as my attorney deems appropriate; to select
any form of payment option or to modify options I may have selected; to accept any benefits or lump sum
payments on my behalf and to "roll-over" any such benefits on my behalf.
15. Third Party Reliance. Any party dealing with my said attorney hereunder, may rely absolutely
on the
authority granted herein and need not look to the application of any proceeds nor the authority of my
said attorney as to any action taken hereunder. In this regard, no person who may in good faith act in
reliance upon the representations of my attorney or the authority granted hereunder shall incur any
liability to me or my estate as a result of such act.
16. Guardianship. In the event a petition is filed in any court for the appointment of a guardian
or a conservator
to care for me or my estate, then I nominate (name of person) as such appointee. In the event she is not able
to serve, then I nominate (name of person) in her stead. Nothing in this part shall be construed as a direction
that such a petition be filed or such appointment be made, and it is my express wish that such action be taken
only when and if absolutely necessary.
17. Successor Attorneys in Fact. In the event that the said (name of person) for any reason ceases
or is unable
to serve under this power, then I grant the same aforesaid powers in every respect to (name of person).
A written statement by the said (name of person) as to the cessation or inability of (name of person) to
serve shall be conclusive evidence of such fact, and any third party may rely upon the same in dealing
with him under this power.
18. Reliance on Copies of this Power. A photostatic copy of this power, as executed, may be treated
as an original
power by any third party dealing with my attorney in fact.
19. Disability or Incompetence. This Power of Attorney in the said (name of person), or in the
said (name of
person) as the case may be, shall not be affected by my subsequent disability or incapacity.
20. Ratification of Attorney's Acts. I hereby ratify and confirm whatever my said attorney shall
lawfully do under
these presents.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of (month) , (year).
___________________________________ _____________________________________________
Witness (Your name)
COMMONWEALTH OF (YOUR STATE)
(YOUR COUNTY), SS.
I hereby certify that on this the day of (month), (year), personally appeared the said (YOUR NAME)
and acknowledged the foregoing instrument to be her free act and deed, before me,
____________________________________________
Notary Public
My Commission Expires:
Signature of Attorney in Fact:
____________________________________ ___________________________________________
Witness
Sample Proxy
This next section should give you some ideas of things to include when preparing your legal documents.
After
completing your documents distribute them. Providers cannot honor documents they don't know exist, or haven't
seen. |
