Limited Power of Attorney Form


A limited power of attorney form is used to help illustrate how a person can represent another as their attorney for a certain period. Limited power of attorney is all about how someone can represent another person on their behalf in legal or business affairs for a specific duration.

Below is a sample limited power of attorney form.

Sample Limited Power of Attorney Form

Name of client: ___________________________

Address: ______________________

State: ________________________

Location: _______________________________ Country: ______________________

Tel no: _________________________________

Name of agent: _______________________________

Address: ______________________

State: ________________________

Location: _______________________________ Country: ______________________

Tel no: _________________________________

This is a confirmation that both parties are in full agreement that the agent will have authority to act under the power of attorney. The power of attorney shall expire within 20 days from the date signed by both parties as below.

Dated: _______________________________

Signed in the presence of witness: ______________________

Signed (client): _______________________________

Signed (agent): _______________________________


Category: Power of Attorney forms

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