Here is a template you can copy and paste. You can add your own information and make whatever modifications you see fit.
DURABLE POWER OF ATTORNEY
I, _______________________________________
[PRINCIPAL FULL LEGAL NAME], of _______________________________________
[City], __________________ County, Missouri, appoint
[AGENT FULL LEGAL NAME], of _______________________________________
[City/State], as my Attorney-in-Fact (“Agent”) to act for me as provided below.
1. GENERAL GRANT OF AUTHORITY
My Agent may act for me in any lawful way with respect to my financial, property, business, personal, and health care affairs to the full extent I could act if personally present.
This Power of Attorney is intended to be broad and comprehensive.
2. SPECIFIC POWERS
Without limiting the general authority granted above, my Agent may:
A. Real Estate (Including Sale of Home)
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Buy, sell, convey, transfer, exchange, lease, manage, insure, maintain, repair, and otherwise deal with any real property I own or later acquire.
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List real property for sale.
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Hire and work with real estate agents or brokers.
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Negotiate and accept offers.
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Sign listing agreements, purchase agreements, counteroffers, and closing documents.
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Execute deeds (warranty deed, special warranty deed, quitclaim deed).
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Sign seller disclosures, affidavits, escrow instructions, settlement statements, and all documents required by title companies or closing agents.
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Record this Power of Attorney if required.
B. Banking and Financial Institutions
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Open, close, and manage checking, savings, brokerage, CD, and investment accounts.
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Deposit and withdraw funds.
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Endorse and negotiate checks.
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Transfer funds between accounts.
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Obtain statements and records.
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Access online banking.
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Access safe deposit boxes.
C. Bills and Household Affairs
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Pay utilities, insurance, medical bills, housing costs, taxes, and other expenses.
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Contest or negotiate debts.
D. Investments and Retirement Accounts
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Buy, sell, and manage stocks, bonds, mutual funds, ETFs, and other securities.
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Manage retirement accounts to the extent permitted by plan rules.
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Communicate with brokers and financial advisors.
E. Insurance and Government Benefits
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Apply for and manage Medicare, Medicaid, Social Security, and other benefits.
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File insurance claims.
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Communicate with government agencies.
F. Taxes
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Prepare, sign, and file federal, state, and local tax returns.
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Pay taxes and receive refunds.
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Obtain tax transcripts and records.
G. Legal Claims
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Hire attorneys.
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Initiate, defend, settle, or resolve claims or lawsuits.
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Sign releases and settlement agreements.
H. Personal Property
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Buy, sell, and manage vehicles, household goods, and personal belongings.
3. HEALTH CARE AUTHORITY
My Agent may:
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Make medical and health care decisions for me.
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Consent to, refuse, or discontinue medical treatment.
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Select doctors, hospitals, assisted living, nursing facilities, or rehabilitation centers.
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Arrange for admission or discharge.
4. HIPAA AUTHORIZATION
My Agent is authorized to access, obtain, and disclose my medical and mental health records under HIPAA and any other privacy laws for purposes of making health care decisions and managing my care.
5. GIFTS (Initial One Option)
_____ OPTION 1 (LIMITED): My Agent may not make gifts to themselves and may only make customary gifts consistent with my prior history.
_____ OPTION 2 (BROADER): My Agent may make gifts consistent with my past practices and for Medicaid or tax planning purposes but may not gift to themselves unless specifically authorized here:
6. COMPENSATION
Initial One:
_____ My Agent may receive reasonable compensation and reimbursement of expenses.
_____ My Agent shall receive reimbursement only (no compensation).
7. SUCCESSOR AGENT
If my Agent is unable or unwilling to serve, I appoint:
[SISTER’S FULL LEGAL NAME]
as Successor Agent.
8. EFFECTIVE DATE
This Power of Attorney is effective:
_____ Immediately upon signing.
_____ Upon my incapacity as certified in writing by a physician.
(For your situation, “Immediately upon signing” is typically recommended.)
9. DURABILITY
This Power of Attorney shall not be affected by my subsequent incapacity or disability. It is intended to be a Durable Power of Attorney under Missouri law.
10. REVOCATION
I may revoke this Power of Attorney at any time in writing.
11. RELIANCE
Any third party may rely on this Power of Attorney unless they have actual knowledge it has been revoked.
A photocopy or electronic copy shall have the same force as an original.
SIGNATURES
Principal Printed Name: _______________________________
Principal Signature: _________________________________
Date: _____________________________________________
Agent Printed Name: _________________________________
Agent Signature: __________________________________
Date: _____________________________________________
WITNESSES
Witness #1 Printed Name: _____________________________
Signature: _________________________________________
Date: _____________________________________________
Witness #2 Printed Name: _____________________________
Signature: _________________________________________
Date: _____________________________________________
NOTARY ACKNOWLEDGMENT (MISSOURI)
State of Missouri )
County of __________________ )
On this ____ day of ______________, 20, before me personally appeared _______________________________________, known to me (or satisfactorily proven) to be the person whose name is subscribed to this instrument, and acknowledged that they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
Notary Public: ____________________________________
My Commission Expires: ____________________________
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