Free Texas Financial Durable Power of Attorney Form - PDF Form Download
Texas Financial Durable Power of Attorney Form is a legal instrument intended to grant powers to an agent/attorney-in-fact to act on your behalf as if you were present during the action.
The Durable Power of Attorney Act, Chapter XII, Texas Probate Code has directives about the governance of the power of attorney along with sweeping and broad powers of execution. Read this form carefully to understand various provisions and limitations for granting the powers. You as a signing principal are authorized to revoke the power of attorney as per your will and wish.
Be careful while allotting/granting power/s to the agent and mention the special instructions to boost and/or limit the powers of the power of attorney. Notarization of the document is necessary. You as signing principal and the agent under the appointment must sign the document before a Notary Public of Texas to legalization and execution of the instrument.
Begin by typing your name and address on the foremost line of Texas Financial Durable Power of Attorney Form. This defines your role as signing principal. Furnish name and address of attorney-in-fact/agent under the appointment.
The next section has lists of powers to be accorded. You must strike out the powers you do not need to grant. No strikeouts in this section denote the grant of all powers mentioned and in turn makes this legal instrument a general power of attorney. However, under no circumstances, the appointed agent can take any/all healthcare decisions for you using this power of attorney. You must select the powers you want to grant among 13 options described in this section carefully.
Mention your choice about gifts in the space provided by signing in front of the statement pertaining to gifts in acceptance to it. Provide special instructions in the next section to limit and/or boost aforementioned powers as well as grant new ones not listed. Use this section as a tool to protect your interests.
The succeeding portion seeks the input of your choice of the mode of execution. You can opt for immediate execution or execution upon the declaration of your incapacity and/or disability. However, you must strike out anyone from the option (a) or (b). No strikeout makes option (a) applicable.
Mention the name of a successor agent if applicable and continue by entering the date and signing in the respective spaces allocated in the power of attorney form. Continue by furnishing the name of the state and county on the succeeding lines.
Inputs by a notary officer are necessary in the last section of the power of attorney. Furnish date, name of the signing principal, signature of the notarial officer, seal if any, and printed name. Insert the date of commission expiry to complete and execute the Texas Financial Durable Power of Attorney Form unless mentioned otherwise.
Text Version of the Form
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Texas Statutory Durable Power Of Attorney
STATUTORY DURABLE POWER OF ATTORNEY
NOTICE: THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND
SWEEPING. THEY ARE EXPLAINED IN THE DURABLE POWER OF
ATTORNEY ACT, CHAPTER XII, TEXAS PROBATE CODE. IF YOU HAVE ANY
QUESTIONS ABOUT THESE POWERS, OBTAIN COMPETENT LEGAL ADVICE.
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.
I, __________ (insert your name and address), appoint __________ (insert the
name and address of the person appointed) as my agent (attorney-in-fact) to act for me in
any lawful way with respect to all of the following powers except for a power that I have
crossed out below.
TO WITHHOLD A POWER, YOU MUST CROSS OUT EACH POWER
Real 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;
Benefits from social security, Medicare, Medicaid, or other governmental programs
or civil or military service;
Retirement plan transactions;
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IF NO POWER LISTED ABOVE IS CROSSED OUT, THIS DOCUMENT
SHALL BE CONSTRUED AND INTERPRETED AS A GENERAL POWER OF
ATTORNEY AND MY AGENT (ATTORNEY IN FACT) SHALL HAVE THE
POWER AND AUTHORITY TO PERFORM OR UNDERTAKE ANY ACTION I
COULD PERFORM OR UNDERTAKE IF I WERE PERSONALLY PRESENT.
Special instructions applicable to gifts (initial in front of the following sentence to
have it apply):
I grant my agent (attorney in fact) 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.
ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS
LIMITING OR EXTENDING THE POWERS GRANTED TO YOUR AGENT.
UNLESS YOU DIRECT OTHERWISE ABOVE, THIS POWER OF
ATTORNEY IS EFFECTIVE IMMEDIATELY AND WILL CONTINUE UNTIL IT IS
CHOOSE ONE OF THE FOLLOWING ALTERNATIVES BY CROSSING
OUT THE ALTERNATIVE NOT CHOSEN:
(A) This power of attorney is not affected by my subsequent disability or incapacity.
(B) This power of attorney becomes effective upon my disability or incapacity.
YOU SHOULD CHOOSE ALTERNATIVE (A) IF THIS POWER OF
ATTORNEY IS TO BECOME EFFECTIVE ON THE DATE IT IS EXECUTED.
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IF NEITHER (A) NOR (B) IS CROSSED OUT, IT WILL BE ASSUMED THAT
YOU CHOSE ALTERNATIVE (A).
If Alternative (B) is chosen and a definition of my disability or incapacity is not
contained in this power of attorney, I shall be considered disabled or incapacitated for
purposes of this power of attorney if a physician certifies in writing at a date later than the
date this power of attorney is executed that, based on the physician’s medical examination of
me, I am mentally incapable of managing my financial affairs. I authorize the physician who
examines me for this purpose to disclose my physical or mental condition to another person
for purposes of this power of attorney. A third party who accepts this power of attorney is
fully protected from any action taken under this power of attorney that is based on the
determination made by a physician of my disability or incapacity.
I agree that any third party who receives a copy of this document may act under it.
Revocation of the durable power of attorney is not effective as to a third party until the third
party receives actual notice of the revocation. I agree to indemnify the third party for any
claims that arise against the third party because of reliance on this power of attorney.
If any agent named by me dies, becomes legally disabled, resigns, or refuses to act, I
name the following (each to act alone and successively, in the order named) as successor(s)
to that agent: __________.
Signed this ______ day of __________, 20___
__________ (your signature)
State of _______________________
County of ______________________
This document was acknowledged before me on _________________________(date)
by __________ (name of principal)
__________ (signature of notarial officer)
(Seal, if any, of notary) ___________________________________
__________ (printed name)
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.