Maryland Statutory Form - Limited Power Of Attorney Template Page 2
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20of Coagents”).
I, ___________________________________________________, name the following person
(Name of Principal)
as my agent:
Name of
Agent: ________________________________________________________________________
Agent’s
Address: ______________________________________________________________________
Agent’s Telephone
Number: ______________________________________________________________________
DESIGNATION OF COAGENTS (OPTIONAL)
This section of the form provides for designation of two or more coagents. Coagents are
required to act together unanimously unless you otherwise provide in this form.
I, ____________________________________________________________________________ ,
(Name of Principal)
Name the following persons as coagents:
Name of Coagent: ______________________________________________________________
Coagent’s Address: ____________________________________________________________
Coagent’s Telephone Number:___________________________________________________
Name of Coagent: ______________________________________________________________
Coagent’s Address: _____________________________________________________________
Coagent’s Telephone Number:___________________________________________________
Special Instructions Regarding Coagents: ________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL)
If my agent is unable or unwilling to act for me, I name as my successor agent:
Name of Successor Agent:_______________________________________________________
Successor Agent’s
Address: ______________________________________________________________________
Successor Agent’s Telephone Number: ___________________________________________
If my successor agent is unable or unwilling to act for me, I name as my second successor
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