Standard Power of Attorney Form
This document gives the attorney power to act on the principal’s behalf, often on financial affairs. This form can restrict the attorney to only a single transaction. It usually terminates at a specified time or when the principal becomes incapacitated. Below is a sample of standard power of attorney form.
Sample Standard Power of Attorney Form
I, ___________, resident of _________ (city) ___________ (county) residing at
_____________ (address) do hereby appoint __________residing at
__________ (address) as my attorney in fact for me and in my name, place
and stead to transact limited matters set forth herein, specifically:
To consent to medical treatment for __________ minor child, of whom am
the biological parent/ legal guardian. Medical treatment is limited to
medical chiropractic, optometric, dental examination, but not limited to
hospitalization, disease control and blood testing except that “medical
treatment” shall not include tests for sexually transmitted diseases or any
other testing for which a separate court order or informed consent is
required under the law.
So acknowledged this ___________ day of__________, 20_________
Parent/guardian Name ____________
Signature ____________
Sworn before me on ___________20_____________Notary public
Commission expires on 20___________
Category: Power of Attorney forms
