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Power Of Attorney, Simple

Free Printable Power Of Attorney, Simple FormFree Printable Power Of Attorney, Simple Form

Power of Attorney, Simple


A power of attorney allows someone to appoint a person or an organization to handle his or her affairs while he/she is unavailable or unable to do so. He or she can appoint an “Attorney-in-Fact” or an “Agent” whoever he/she prefers.The individual determines the amount power given to the “Attorney-in-Fact” or “Agent”. Regardless of the type of power of attorney granted to the person, the attorney-in-fact is responsible for keeping accurate records of all transactions that he or she makes on behalf of the individual who gave the power of attorney.

The power an Attorney-in-Fact can make includes the following:

  • Make financial decisions
  • Make gifts of money
  • Make health care decisions, including the ability to consent to giving, withholding, or stopping medical treatments, services, or diagnostic procedures. The individual can also make a separate power of attorney with regards to health care if he/she wishes to.
  • Recommend a guardian
  • Maintaining and operating business interests
  • Employing professional assistance


The “Attorney-in-fact” can be a spouse, relative, or a trusted person by the individual because the power of attorney is not regulated or monitored by the court system that is why a misuse of power can occur.


The said power of attorney is very simple yet very powerful because it has a specific time period depending on the agreement of the individual and the “Agent”. The power of attorney is also very important because there is an automatic termination date at the end of the period but the individual has to make sure to limit the time period for protection purposes. We always have to remember that the Power of Attorney can be renewed anytime as long as the time period has ended. So, remember to appoint a power of attorney whenever you are not around.

Power of Attorney, Simple

_______________________________________________________________, the “parent”” of _____________________________________________________________, herewith appoints ______________________________ of _____________________________, as their attorney in fact, to act in the place and stead and with the same authority as Principal would have to do the following acts:

To act as the guardian of the person of my minor children:

including the right to act entirely in loco parentis; including the authority to approve or to decline medical treatment of any kind for the child and including the right to review medical records or school records of the child.

This power of attorney shall be in effect from ________________ to ___________________.
_______________________________, As Principal
STATE OF ______________________

COUNTY OF _______________________
_______________________________ personally appeared before me and acknowledged the execution of this power of attorney for the purposes set forth therein.

Dated: _______________________________
Notary Public
Commission Expires:

Power of Attorney, Simple
Review List

This review list is provided to inform you about this document in question and assist you in its preparation. This is a simple but powerful Power of Attorney for care of your children that has a specific time period. An important feature of this form is the automatic termination date at the end of the period. You can adapt this Power of Attorney to relate to many matters where you want someone to serve as your proxy.

1. Make sure to limit the time period in the document itself for your own protection. Remember, you can always renew the Power of Attorney, should you want to do so.
2. A notary is suggested to be sure the Power of Attorney is honored in a crisis. Authorities love the legal niceties; this gives it to them so your agent with the Power of Attorney can act promptly and effectively.

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