Form A Enduring A Power Of Attorney Appointing A Personal Attorney Page 3

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5. Enduring Power of Attorney
My personal attorney’s (or attorneys’) authority under this Enduring Power of Attorney shall not be terminated by my
lack of capacity that occurs after my Enduring Power of Attorney has been executed.
6. Contingent Enduring Power of Attorney
(optional)
My Enduring Power of Attorney shall come into effect on the following date or on the occurrence of the
following contingency:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Optional:
The following adult(s) may declare in writing that the contingency that I have specified has occurred:
_______________________________________________________________________________________________________
(name of adult)
_______________________________________________________________________________________________________
(street address)
(city)
(province)
(postal code)
(You may name one or more adults to make this declaration. If the contingency you have specified is your lack of capacity and you do not name anyone
to make this declaration, two health care professionals may be asked to make the declaration.)
7. Accounting
(optional)
If I lack capacity, an accounting of my personal attorney’s (attorneys’) management of my personal affairs
may be requested by ____________________________________________________________________________________
(name of person)
of _____________________________________________________________________________________________________
(street address)
(city)
(province)
(postal code)
(If this option is not checked, an accounting may be requested by one of your adult family members.)
If a fee is charged for services rendered by my personal attorney(s), my personal attorney(s) must provide an
annual accounting of my personal attorney’s (attorneys’) management of my personal affairs to
_______________________________________________________________________________________________________
(name of person)
of _____________________________________________________________________________________________________
(street address)
(city)
(province)
(postal code)
(If this option is not checked, the accounting will be provided to your most immediate and available family member and to the Public Guardian and
Trustee of Saskatchewan.)
8. Revocation
(optional)
I revoke the Enduring Power of Attorney previously given by me on ____________________________________ ,
(date)
appointing ______________________________________________________________________ as my personal attorney.
(name)
9. Signatures of grantor and witnesses
________________________________________________
__________________________________
(Signature of grantor)
(date)
________________________________________________
__________________________________
(Signature of witness)
(date)
________________________________________________
__________________________________
(Signature of second witness if first witness is not a lawyer)
(date)
(If witnessed by a lawyer, attach Form D - Legal Advice and Witness Certificate. If witnessed by two adults, attach Form E - Non-lawyer Witness
Certificate.)
or

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