Limited Power of Attorney Form

A limited power of attorney does not grant the broad powers of a general power of attorney and can restrict your Agent to handle only specified matters on your behalf.

The financial power of attorney form on this page deals specifically with banking and money transactions. (Banks or financial institutions will most often also have an additional form which must be completed to conduct banking transactions on behalf of someone else).

Please refer to our Power of Attorney main page for other specific power of attorney forms and guidelines for their use.

Note: This is not a durable power of attorney (which would remain in effect should you become mentally incapacitated) and will expire on the date stipulated on the form.

Limited Power of Attorney

I, the undersigned

(Full legal name) ______________________________

(Identity / Social Security number) ______________________________ residing at

(Address) ____________________________________

____________________________________

appoint

(Full legal name) ________________________________

(Identity / Social Security number) ______________________________ residing at

(Address) ____________________________________

____________________________________

as my Attorney-in-Fact (Agent) with the power of delegation and substitution.

If my Agent is unable or unwilling to serve for any reason, I designate

(Full legal name) ________________________________

(Identity / Social Security number) ______________________________ residing at

(Address) ____________________________________

____________________________________

as substitute Agent.

This document shall be construed and interpreted as a limited power of attorney and my Agent shall have full authority to act on my behalf only in relation to the matters specified below:

1. Conduct any business with any banking or financial institution with which I hold an account, including but not limited to, making deposits and withdrawals, obtaining bank statements, drafts or money orders, and to draw, sign, endorse and negotiate checks and to sign my name and execute on my behalf all contracts with such a banking or financial institution.

2. Settle accounts, claims and disputes between me and any other party and to demand, sue for, collect, adjust, settle or write-off any debts owed to me in any manner as he / she may deem fit.

3. Open, maintain or close any accounts with a brokerage, banking or financial institution and to overdraw such accounts.

4. Have access to the contents of any safety deposit box registered in my name.

5. Collect any social security, medical insurance, disability grants, unemployment benefits, pension payments or any other government benefits.

6. Invest any money and to vary or alter any such investment as may be expedient from time to time.

7. Prepare, sign and file income and other tax returns and settle all payments with relevant governmental bodies.

8. Obtain documents and information from any relevant governmental agency.

I indemnify and hold harmless my Agent from any loss that results from an error made in good faith save for willful misconduct or the willful failure to act in good faith.

I indemnify any third party from any claims which may arise against the third party because of reliance on this power of attorney.

My Agent shall provide accurate records of all transactions completed on my behalf and shall provide accounting records if I so request.

If I am unable to review the records and accounting, they must be submitted to:

(Full legal name) ________________________________

(Identity / Social Security number) ______________________________ residing at

(Address) ____________________________________

____________________________________

My Agent shall be entitled to compensation for his / her services at a rate as set out by law and for reimbursement of all reasonable expenses in his / her duties as my Agent.

This limited power of attorney shall become effective on the _____ day of ________________________20____ and shall expire on the ____ day of ______________________20____ or at an earlier date if revoked by me in writing.

Executed this ______ day of __________________20 ____

at ______________________________________

Signature: ________________________________

in the presence of the undersigned witnesses:

Witness 1.

Name: ______________________

Address: _____________________________________________

Signature: ________________________

Witness 2.

Name: ______________________

Address: _____________________________________________

Signature: ________________________

Acknowledgement

This document was acknowledged before me on this ______day of ____________________20__ by ________________________(Principal's Full legal name)

Signature of Notary Public ______________________

Full legal Name ______________________________

My commission expires ________________________

State of ________________________

County of ______________________

This free limited power of attorney can be copied into your word program where you can add / delete provisions to suit your requirements. However, all our Free Legal Forms are provided for informational purposes only and are not intended as a replacement for suitable legal counsel.

Let's hear your verdict about what you've read here!