General and Statutory
Power of Attorney
ocstoc Legal Agreements
This General and Statutory Power of Attorney is intended to be used
by an individual to grant an agent powers, with respect to his property
and financial matters. This document will enable agent to make
decisions and act with respect to the individual property (including
money) on behalf of person executing this document. Note: Do not
use this document if you wish to grant power of attorney for child
care. This document does not authorize anyone to make medical and
other health-care decisions for you. You may revoke this power of
attorney if you later wish to do so.
ALL INFORMATION AND FORMS ARE PROVIDED “AS IS” WITHOUT ANY EXPRESS OR IMPLIED
WARRANTY, INCLUDING AS TO LEGAL EFFECT OR COMPLETENESS. They are for guidance and should be
®
modified by you or your attorney to meet your specific needs and the laws of your state. Use at your own
risk. Docstoc, its employees or contractors who wrote or modified any form, are NOT providing legal or any other
kind of advice and are not creating or entering into an Attorney-Client relationship. The information and forms
are not a substitute for the advice of your own attorney. Subject to our Terms of Service
(http://www.docstoc.com/popterm.aspx?page_id=15). See back cover page and read more here
(http://www.docstoc.com/popterm.aspx?page_id=114) for additional disclaimers and more. This document is
not approved, endorsed by, or affiliated with any State, or governmental or licensing entity.
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not
Entire document © Docstoc, Inc., 2010, 2011 1
Attorney Drafted
GENERAL AND STATUTORY POWER OF ATTORNEY
KNOW ALL PERSONS BY THESE PRESENTS:
I, ________________________________ [Instruction: Insert the name of principal]
hereinafter termed as the “Principal”, residing at ___________________ [Instruction: Insert
the Address of Principal], County of ______________ [Instruction: Insert the County], State
of Arizona, do hereby make, constitute and appoint ________________________________
[Instruction: Insert the name of attorney in fact/agent], hereinafter termed as “Agent”,
residing at ___________________ [Instruction: Insert the Address of attorney in fact], my
true and lawful attorney in fact for me and in my name and behalf.
My Agent shall have full power and authority to perform any act, power, duty, legal right, or
obligation whatsoever that I now have or may later acquire in connection with or relating to any
person, item, transaction, thing, business, property, real or personal, tangible, or intangible, or
matter whatsoever as I could do if personally present. I hereby ratify and confirm all acts that my
Agent, or my Agent’s substitute or substitutes, shall lawfully do or cause to be done by virtue of
this power of attorney and the rights hereby granted. My Agent’s powers and authority shall
include, but not be limited to:
(__)Real Estate property transactions;
(__)Tangible personal property transactions;
(__)Stock and bond transactions;
(__)Commodity and option transactions;
(__)Banking and other financial institution transactions;
(__)Business operating transactions;
(__)Insurance and annuity transactions;
(__)Estate, trust, and other beneficiary transactions;
(__)Claims and litigation;
(__)Personal and family maintenance;
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 2
(__)Benefits from social security, Medicare, Medicaid, or other governmental programs or civil
or military service;
(__)Retirement plan transactions;
(__)Tax matters, including any transactions with the Internal Revenue Service;
(__)Decisions regarding lifesaving and life prolonging medical treatment.
(__)Decisions relating to medical treatment, surgical treatment, nursing care, medication,
hospitalization, institutionalization in a nursing home or other facility and home health care.
(__)Transfer of property or income as a gift to the principal's spouse for the purpose of
qualifying the principal for governmental medical assistance.
[Instruction: Mark an ‘X’ next to desired powers and draw a line through those you do not
wish to include]
IF NO POWER LISTED ABOVE IS CROSSED OUT, THIS DOCUMENT MAY BE
CONSTRUED AND INTERPRETED AS A GENERAL POWER OF ATTORNEY AND MY
AGENT (Attorney-in-Fact) MAY HAVE THE POWER AND AUTHORITY TO PERFORM
OR UNDERTAKE ANY ACTION I COULD PERFORM OR UNDERTAKE IF I WERE
PERSONALLY PRESENT.
SPECIAL INSTRUCTIONS: (Optional)
I grant my Agent the power to apply my property to make gifts, except that the amount of a gift
to an individual may not exceed the amount of annual exclusions allowed from the federal gift
tax for the calendar year of the gift.
[Comment: In the following space, Principal may give special instructions limiting or
extending the powers granted to the Agent].
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 3
This power of attorney becomes effective immediately and shall remain effective until my death
or until my disability or incapacity.
As used herein, “disability” or “incapacity” shall mean a lack of capacity to receive and evaluate
information effectively, to communicate decisions, and/or to manage my financial resources and
affairs properly.
This Power of Attorney shall be construed broadly as a General Power of Attorney. The listing
of specific terms, rights, acts, or powers are not intended to restrict or limit the definition or
scope of powers granted herein in any manner. If any part of this document is held to be invalid,
illegal, or unenforceable under applicable law, then the remaining unaffected parts of the
document shall still remain in full force and effect and not be affected by any partial invalidity.
Any third party who receives the copy of this document may act under it. Revocation or
termination of the power of attorney is not effective as to a third party until the third party has
actual notice or knowledge of such revocation or termination, and I, for myself and for my heirs,
executors, legal representatives, and assigns, hereby agree to indemnify and hold harmless any
such third party from and against any and all claims that may arise against such third party by
reason of such third party having relied on the provisions of this instrument.
Successor Agent: If the Agent named by me shall die, become incompetent, resign, or refuse to
accept the office of Agent, I name the following (each to act alone and successively, in the order
named) as successor(s) to such Agent :
______________________________________________________________________________
______________________________________________________________________________
[Instructions: Insert the name(s) and address(es) of such successor(s) in the following
paragraph.) [Comment: Choose this clause if you or the Principal wish to name the
successor(s) of the Agent].
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 4
Neither the Agent nor his successor(s) shall be liable for losses resulting from judgment errors
made in good faith. However, Agent will be liable for breach of fiduciary duty, failure to act in
good faith, and/or willful misconduct, while acting under the authority of this Power of Attorney.
I may revoke this Power of Attorney at any time by providing written notice to my Agent.
Signed this ______ [Month] ____ [Date], 20___ [Year].
_______________________________________
[Instruction: Insert the signature of Principal]
___________________________________________
[Instruction: Insert the printed name of Principal]
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 5
ACKNOWLEDGMENT
STATE OF ARIZONA
COUNTY OF ______________________ [Instruction: Insert County
On the day of _____________________ [Instruction: Insert date], before me, the undersigned,
a Notary Public in and for said State, personally appeared personally known to me or proved to
me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the
individual(s), or the person upon behalf of which the individual(s) acted, executed the
instrument, and that such individual made such appearance before the undersigned in
_____________________________________________
[Instruction: Insert city/political subdivision and county
or state or other place where acknowledgment taken]
________________________________________________
(Signature and office of individual taking acknowledgment)
My commission expires: _________________________
THE ATTORNEY IN FACT OR AGENT, BY ACCEPTING OR ACTING UNDER THE
APPOINTMENT, ASSUMES THE FIDUCIARY AND OTHER LEGAL
RESPONSIBILITIES OF AN AGENT.
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 6
Note: Carefully read and follow the Instructions and Comments contained in this document for
your customization to suit your specific circumstances and requirements. You will want to
delete the Instructions and Comments from open bracket (“[“) to close bracket (“]”) after
reading and following them. You (or your attorney) may want to make additional modifications
to meet your specific needs and the laws of your state
◊Where within this document you see this symbol: ◊ or an instruction states “Insert any number you choose◊,”
or something similar, or there is a blank for the user to complete, please note that although Docstoc believes the
information or number may be any that the user chooses, and that there is no law governing what the
information or number should be, you might want to verify this, including by consulting with your own attorney
practicing in your state, and be reasonable.
INFORMATION AND FORMS ARE PROVIDED "AS IS" WITHOUT ANY EXPRESS OR IMPLIED WARRANTY
OF ANY KIND INCLUDING WARRANTIES OF MERCHANTABILITY, NONINFRINGEMENT OF
INTELLECTUAL PROPERTY, OR FITNESS FOR ANY PARTICULAR PURPOSE. IN NO EVENT SHALL
DOCSTOC, INC., OR ITS AGENTS, OFFICERS, ATTORNEYS, ETC., BE LIABLE FOR ANY DAMAGES
WHATSOEVER (INCLUDING, WITHOUT LIMITATION, DAMAGES FOR LOSS OF PROFITS, BUSINESS
INTERRUPTION, LOSS OF INFORMATION) ARISING OUT OF THE USE OF OR INABILITY TO USE THE
MATERIALS, EVEN IF DOCSTOC HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
Your use of this document is deemed to be your agreement to the foregoing, the disclaimers on the cover page,
and that you have read and agree to our Terms of Service
(http://www.docstoc.com/popterm.aspx?page_id=15), as well as our disclaimer that Legal information is not
legal advice, and the important content available here: Read More
(http://www.docstoc.com/popterm.aspx?page_id=114)
"Docstoc is unable to and does not provide legal advice, and please further note that laws change and are
regularly amended, therefore, the names and section numbers of statutes within this document may not be
100% correct as they may be partially or wholly out of date and some relevant ones may have been omitted or
misinterpreted. You may wish to consult with your own attorney practicing in your state to confirm the
accuracy of statutory references."
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 7