Fillable Wisconsin Power Of Attorney printable pdf download

WISCONSIN POWER OF ATTORNEY

NOTICE: THIS IS AN IMPORTANT DOCUMENT. BEFORE SIGNING THIS DOCUMENT, YOU SHOULD KNOW THESE

IMPORTANT FACTS.

BY SIGNING THIS DOCUMENT, YOU ARE NOT GIVING UP ANY POWERS OR RIGHTS TO

CONTROL YOUR FINANCES AND PROPERTY YOURSELF. IN ADDITION TO YOUR OWN POWERS AND RIGHTS, YOU

ARE GIVING ANOTHER PERSON, YOUR “AGENT,” POWERS TO HANDLE YOUR FINANCES AND PROPERTY. THIS

DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL OR OTHER HEALTH CARE DECISIONS FOR YOU. IF

THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER TO

EXPLAIN THIS FORM TO YOU BEFORE YOU SIGN IT.

IF YOU WISH TO CHANGE YOUR WISCONSIN POWER OF ATTORNEY, YOU MUST COMPLETE A NEW DOCUMENT AND

REVOKE THIS ONE. YOU MAY REVOKE THIS DOCUMENT AT ANY TIME BY DESTROYING IT, BY DIRECTING ANOTHER

PERSON TO DESTROY IT IN YOUR PRESENCE OR BY SIGNING A WRITTEN AND DATED STATEMENT EXPRESSING

YOUR INTENT TO REVOKE THIS DOCUMENT. IF YOU REVOKE THIS DOCUMENT, YOU SHOULD NOTIFY YOUR AGENT

AND ANY OTHER PERSON TO WHOM YOU HAVE GIVEN A COPY OF THE FORM. YOU ALSO SHOULD NOTIFY ALL

PARTIES HAVING CUSTODY OF YOUR ASSETS. THESE PARTIES HAVE NO RESPONSIBILITY TO YOU UNLESS YOU

ACTUALLY NOTIFY THEM OF THE REVOCATION. IF YOUR AGENT IS YOUR SPOUSE AND YOUR MARRIAGE IS

ANNULLED, OR YOU ARE DIVORCED AFTER SIGNING THIS DOCUMENT, THIS DOCUMENT IS INVALID.

YOU SHOULD SIGN THIS FORM ONLY IF THE AGENT YOU NAME IS RELIABLE, TRUSTWORTHY AND COMPETENT TO

MANAGE YOUR AFFAIRS.

I, ______________________________________________________ [name of student] permanently residing at: ____________

_____________________________________________________________________________________________ [address],

appoint _________________________________________________________ [name of person appointed] who is my

__________________________________ [relationship to student] as my agent to act for me in any lawful way with respect to

the powers initialed below.

TO GRANT ONE OR MORE OF THE FOLLOWING POWERS, INITIAL THE LINE IN FRONT OF EACH POWER YOU ARE

GRANTING. TO WITHHOLD A POWER, DO NOT INITIAL THE LINE IN FRONT OF IT. YOU MAY, BUT NEED NOT, CROSS

OUT EACH POWER WITHHELD.

POWERS GRANTED (Initial those granted):

_____ 1. PAYMENTS OF BILLS: My agent may make payments that are necessary or appropriate in connection with the

administration of my affairs (including in connection with my educational expenses).

_____ 2. BANKING: My agent may conduct business with financial institutions, including endorsing all checks and drafts made

payable to my order (including checks and drafts in connection with financial aid for my education) and collecting the proceeds;

signing in my name checks or orders on all accounts in my name or for my benefit; withdrawing funds from accounts in my

name; opening accounts in my name; and entering into and removing articles from my safe deposit box.

_____ 3. INSURANCE: My agent may obtain insurance of all types, as considered necessary or appropriate, settle and adjust

insurance claims and borrow from insurers and third parties using insurance policies as collateral.

_____ 4. ACCOUNTS: My agent may ask for, collect and receive money, dividends, interest, legacies and property due or that

may become due and owing to me and give receipt for those payments.

This Wisconsin Power of Attorney becomes effective when I sign it BUT WILL CEASE TO BE EFFECTIVE IF I BECOME

DISABLED OR INCAPACITATED. Unless terminated or revoked earlier by me, this Wisconsin Power of Attorney will expire one

year from the date of my signature below.

I agree that any third party who receives a copy of this document may act under it. Revocation of this Wisconsin Power of

Attorney is not effective as to a third party until the third party learns of the revocation. I agree to reimburse the third party for

any loss resulting from claims that arise against the third party because of reliance on this Wisconsin Power of Attorney.

Signed this ______ day of ______________________, 20____.

____________________________________

_____________________________________________

Printed Name of Student

Signature of Student

____________________________________

Social Security Number

Wisconsin Power Of Attorney

Related Articles

Related forms

Related Categories