Power Of Attorney New York Statutory Short Form printable pdf download

1. The use of the following form in the creation of a power of attorney is lawful, and, when

used, and executed in accordance with subdivision one of section 5-1501B of this title, it

shall be construed as a statutory short form power of attorney in accordance with the

provisions of this title: "POWER OF ATTORNEY NEW YORK STATUTORY SHORT FORM (a) CAUTION TO THE

PRINCIPAL: Your Power of Attorney is an important document. As the "principal," you give the

person whom you choose (your "agent") authority to spend your money and sell or dispose of your

property during your lifetime without telling you. You do not lose your authority to act even

though you have given your agent similar authority. When your agent exercises this authority,

he or she must act according to any instructions you have provided or, where there are no

specific instructions, in your best interest. "Important Information for the Agent" at the end

of this document describes your agent's responsibilities. Your agent can act on your behalf

only after signing the Power of Attorney before a notary public. You can request information

from your agent at any time. If you are revoking a prior Power of Attorney by executing this

Power of Attorney, you should provide written notice of the revocation to your prior agent(s)

and to the financial institutions where your accounts are located. You can revoke or terminate

your Power of Attorney at any time for any reason as long as you are of sound mind. If you are

no longer of sound mind, a court can remove an agent for acting improperly. Your agent cannot

make health care decisions for you. You may execute a "Health Care Proxy" to do this. The law

governing Powers of Attorney is contained in the New York General Obligations Law, Article 5,

Title 15. This law is available at a law library, or online through the New York State Senate

or Assembly websites, or If there is anything

about this document that you do not understand, you should ask a lawyer of your own choosing to

explain it to you. (b) DESIGNATION OF AGENT(S): I,

_______________________________________________, hereby appoint: name and address of principal

_____________________________________________________as my agent(s) name(s) and address(es) of

agent(s) If you designate more than one agent above, they must act together unless you initial

the statement below. ( ) My agents may act SEPARATELY. (c) DESIGNATION OF SUCCESSOR AGENT(S):

(OPTIONAL) If every agent designated above is unable or unwilling to serve, I appoint as my

successor agent(s): _______________________________________________________________ name(s) and

address(es) of successor agent(s) Successor agents designated above must act together unless

you initial the statement below. ( ) My successor agents may act SEPARATELY. (d) This POWER OF

ATTORNEY shall not be affected by my subsequent incapacity unless I have stated otherwise

below, under "Modifications". (e) This POWER OF ATTORNEY REVOKES any and all prior Powers of

Attorney executed by me unless I have stated otherwise below, under "Modifications." If your

are NOT revoking your prior Powers of Attorney, and if you are granting the same authority in

two or more Powers of Attorney, you must also indicate under "Modifications" whether the agents

given these powers are to act together or separately. (f) GRANT OF AUTHORITY: To grant your

agent some or all of the authority below, either (1) Initial the bracket at each authority you

grant, or (2) Write or type the letters for each authority you grant on the blank line at (P),

and initial the bracket at (P). If you initial (P), you do not need to initial the other lines.

I grant authority to my agent(s) with respect to the following subjects as defined in sections

5-1502A through 5-1502N of the New York General Obligations Law: ( ) (A) real estate

transactions; ( ) (B) chattel and goods transactions; ( ) (C) bond, share, and commodity

transactions; ( ) (D) banking transactions; ( ) (E) business operating transactions; ( ) (F)

insurance transactions; ( ) (G) estate transactions; ( ) (H) claims and litigation; ( ) (I)

personal and family maintenance; ( ) (J) benefits from governmental programs or civil or

military service; ( ) (K) health care billing and payment matters; records, reports, and

statements; ( ) (L) retirement benefit transactions; ( ) (M) tax matters; ( ) (N) all other

matters; ( ) (O) full and unqualified authority to my agent(s) to delegate any or all of the

foregoing powers to any person or persons whom my agent(s) select; ( ) (P) EACH of the matters

identified by the following letters______. You need not initial the other lines if you initial

line (P). (g) MODIFICATIONS: (OPTIONAL) In this section, you may make additional provisions,

including language to limit or supplement authority granted to your agent. However, you cannot

use this Modifications section to grant your agent authority to make major gifts or changes to

interests in your property. If you wish to grant your agent such authority, you MUST complete

the Statutory Major Gifts Rider. (h) MAJOR GIFTS AND OTHER TRANSFERS: STATUTORY MAJOR GIFTS

RIDER (OPTIONAL) In order to authorize your agent to make major gifts and other transfers of

your property, you must initial the statement below and execute a Statutory Major Gifts Rider

at the same time as this instrument. Initialing the statement below by itself does not

authorize your agent to make major gifts and other transfers. The preparation of the Statutory

Major Gifts Rider should be supervised by a lawyer. ( )(SMGR) I grant my agent authority to

make major gifts and other transfers of my property, in accordance with the terms and

conditions of the Statutory Major Gifts Rider that supplements this Power of Attorney. (i)

DESIGNATION OF MONITOR(S): (OPTIONAL) I wish to designate ______________________, whose

address(es) is (are) ____________________________________________________________, as

monitor(s). Upon the request of the monitor(s), my agent(s) must provide the monitor(s) with a

copy of the power of attorney and a record of all transactions done or made on my behalf. Third

parties holding records of such transactions shall provide the records to the monitor(s) upon

Power Of Attorney New York Statutory Short Form

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