Maryland Statutory Form - Limited Power Of Attorney Template Page 17
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20An agent that is not my ancestor, spouse, or descendant MAY NOT use my property to
benefit the agent or a person to whom the agent owes an obligation of support unless I
have included that authority in the Special Instructions.
SPECIAL INSTRUCTIONS (OPTIONAL)
You may give special instructions on the following lines:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
EFFECTIVE DATE
This power of attorney is effective immediately unless I have stated otherwise in the
Special Instructions.
TERMINATION DATE (OPTIONAL)
This power of attorney shall terminate on _______________________________, 20______.
(Use a specific calendar date)
NOMINATION OF GUARDIAN (OPTIONAL)
If it becomes necessary for a court to appoint a guardian of my property or guardian of
my person, I nominate the following person(s) for appointment:
Name of Nominee for guardian of my property:
______________________________________________________________________________
Nominee’s Address: ____________________________________________________________
Nominee’s Telephone Number: __________________________________________________
Name of Nominee for guardian of my person:
______________________________________________________________________________
Nominee’s Address: ____________________________________________________________
Nominee’s Telephone Number: __________________________________________________
SIGNATURE AND ACKNOWLEDGMENT
_____________________________________________ __________________________
Your Signature Date
__________________________________________________________________________
Your Name Printed
______________________________________________________________________________
______________________________________________________________________________
Your Address
______________________________________________________________________________
Your Telephone Number
– 17 –
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal