Lasting Power of Attorney Forms


Lasting power of attorney forms are important legal documents enabling individuals who have capacity and are over 18 to choose another person (Attorney(s)) to make decisions on their behalf. The decisions are of either property and financial affairs or health and welfare.  Below is a sample of how lasting power of attorney forms look like.

Sample Lasting Power of Attorney Forms


Part A-Donors Statement Details

Full names___________________________ Date of birth__________________

Email address___________________ Postal contact_________________

Details of the attorney(s) your are appointing

I appoint the following attorney(s in) accordance with the mental capacity act.

Full name_____________________

Telephone contacts__________________ Mobile phone___________________

Email address____________________ Postal address__________________

Company_______________________

I wish to give my attorney authority(s) to give or refuse content to life sustaining treatment on my behalf.    Yes ______________     No___________

I wish to place restrictions or conditions on my attorney(s) in relation to my welfare.

Yes __   No___

I confirm that I have fully read the prescribed information.

Signature____________ Date_____________

Name of Witness_______________ Signature__________ Date_________


Category: Power of Attorney forms

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