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LEGALDOCS - Special Power of Attorney Questionnaire

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This is an example of a completed Special Power of Attorney.

THERE IS A CHARGE OF $7.95 TO OBTAIN AND PRINT THIS DOCUMENT. You can proceed with the Questionnaire, and obtain a Special Power of Attorney free of charge, but to obtain the final, completed document, ready for viewing and instant printing (or Save-to-File), you will be asked to submit credit card information and will be billed $7.95. However, please feel free to complete or review this Questionnaire and the Summary which will be produced. It is educational and will provide some insight regarding which areas, minimally, should be covered, and will let you see if the subject matters important to you are covered in the Special Power of Attorney

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Skip this explanation and go directly to Questionnaire below:

What is a Special Power of Attorney?

A Special Power of Attorney is an instrument authorizing one person to do a specific act or acts on the behalf of another. A Power of Attorney may be appointed to act on your behalf in the event you became ill or disabled, if you need to travel and matters need to be completed at home, or other instances when you are unable to personally complete the task at hand.

The person granting the authorization is called the principal. The person authorized to act on the principal's behalf is called the attorney-in-fact or agent. The term attorney-in-fact should not be confused with an attorney-at-law. One need not be a lawyer to serve as an attorney-in-fact under a Power of Attorney.

With a Special Power of Attorney, your Attorney-in-Fact is authorized to undertake specific acts you can do. For example, legal, business and financial matters, opening checking accounts, withdrawing funds from accounts, signing documents to sell your home, etc.

Certain acts cannot be delegated using a Power of Attorney. For example, a Special Power of Attorney does not have the authority to:

-1. Delegate rights or duties which are personal in nature. For example, a judge could not delegate his or her judicial function.

- 2. Make or revoke wills or living wills.

- 3. Enter into marriage contracts or initiate divorce.

- 4. NOTE: Although technically legal, most title companies will not recognized a general POA to transfer or sell property - use a Special POA instead.

If you want to grant a general power of attorney, which is a power of attorney not limited to the specific acts set forth in a Special Power of Attorney, do not use this form, but use the general power of attorney General Power of Attorney.

To create a Special Power of Attorney, complete the Questionnaire below.


Please enter the following information about the person who is granting the Power of Attorney and the person who will act as the Attorney-in-Fact.

Enter the name and address of the person who is granting the Power of Attorney (the "Principal").

Street Address:

Enter the name and address of the person who is being given the Power of Attorney (the "Agent").

Street Address:


Check the appropriate box next to the powers you want to grant your Agent.


    NO YES Collect Debts on my behalf
    NO YES Manage my Real Estate
    NO YES Sell my Real Estate described in Exhibit "A" attached to this Power of Attorney (attach an Exhibit showing the legal description of the real estate):
    NO YES Represent my interests with the Social Security Administration and other governmental agencies conveying federal and state benefits
    NO YES Have access to my Safe Deposit Box
    NO YES Represent my interests before the Internal Revenue Service
    NO YES Make investments, change investments, to liquidate investments on my behalf
    NO YES Continue and manage any business I am currently operating
    NO YES Open bank accounts, make deposits, make withdrawals and close bank accounts
    NO YES (I want to specify my own specific powers language). Finish the following sentence - do not capitalize the first word, and do not use a period at the end of the sentence.
    I grant my Agent the following authority and powers:

    For example: "to purchase a 1989 Cadillac, VIN # 1234ABCD5678 on my behalf", or "to enter into a Settlement and Release Agreement in form attached hereto as Exhibit "A".


Many banks, other financial institutions, title insurance companies, etc., will not honor the Power of Attorney unless they are certain of the genuineness of your signature. Any Power of Attorney which deals with the transfer of real estate also must be notarized because the Power of Attorney needs to be recorded along with the transfer documents. Therefore, it is recommended that this document be notarized - otherwise your Power of Attorney may not be honored when you need it most; i.e., when you are unavailable. It does not have to be recorded now, only notarized so it can be recorded later if needed.

    Enter the County the Special Power of Attorney is signed.


    Enter the State the Special Power of Attorney is signed.


This completes the information input for your Special Power of Attorney. When you Send this Form, this program will prepare a Summary of the Special Power of Attorney for your review. Make sure that all facts stated in the Summary are correct in all respects.


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