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.

toy safe with shadow

Note: This is not a durable power of attorney (which would remain in effect should you become mentally incapacitated), so it will expire on the date stipulated on the form or should you become mentally incapacitated prior to that stipulated date.

If you want this document to be a durable financial power of attorney then you need to stipulate that in your document with the following sample wording:

This is a Durable Limited Power of Attorney which shall become effective on the _____ day of ______________________20____ and it shall remain effective until my death even if I should become disabled or incompetent.
This Power of Attorney may be revoked by me at any time by providing written notice to my Agents and interested third parties.

It's important to note though that as long as you have mental capacity, your agent must act on your behalf according to your wishes.

We supply a selection of free power of attorney templates such as:

  • General and a separate Durable Power of Attorney;
  • POA for Real Estate;
  • POA to empower your Agent to sell a variety of goods on your behalf;
  • Medical Power of Attorney;
  • Revocation form, etc.
For additional legal guidelines and links to the above free legal forms, please visit our main Power of Attorney page.

The printable financial power of attorney template can be used as is or you can copy and paste it into a word program for easy editing. If you do not want to nominate an alternate / substitute agent then delete that section and delete or add any functions to suit your requirements.

Copyright Notice

Limited Power of Attorney

I, the undersigned

(Full legal name) ______________________________

(Identity / Social Security number) ______________________________ residing at


hereby 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


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 or should I become incapacitated and unable to make decisions as determined by a qualified physician.

Executed this ______ day of __________________20 ____


Signature: ________________________________

in the presence of the undersigned witnesses who hereby declare that to the best of their knowledge the Principal is of legal age and sound mind and not under duress or undue influence to execute this document:

Witness 1.


Address: _____________________________________________

Signature: ________________________

Witness 2.

Name: ______________________


Signature: ________________________


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 ______________________

Acceptance by Agent

The Agent hereby executes and so acknowledges and affirms his appointment as agent with full understanding of his duties as described herein and the governing laws thereto.

Full legal name: _____________________ Signature _________________________


You can also download the free Limited Power of Attorney as a PDF or Word document by following the links below:

PDF Download Text Document Download

You can have a number of Limited Power of Attorney documents in place to empower the best person in every instance to look after your affairs.

money, house and signature

For example, you could have:

  • A financial POA as per the sample form above where you appoint your accountant as your Agent;
  • A real estate POA where a management agency looks after your properties;
  • A general power of attorney where your adult children handle your day-to-day affairs but you exclude finances and real estate;
  • A durable POA which will continue even if you become incapacitated.

Review the information on our site and consult with your attorney/accountant to establish the best options for you.

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