Pennsylvania Durable Power of Attorney
This Durable Power of Attorney is made in accordance with the laws of the Commonwealth of Pennsylvania. It allows you to appoint someone to make decisions on your behalf if you become unable to do so.
Principal: ________________________________
Date of Birth: ________________________________
Address: ______________________________________
City: _____________________ State: ______ Zip: ___________
Agent: ________________________________
Date of Birth: ________________________________
Address: ______________________________________
City: _____________________ State: ______ Zip: ___________
Alternate Agent: ________________________________
Date of Birth: ________________________________
Address: ______________________________________
City: _____________________ State: ______ Zip: ___________
In this document, I designate my Agent to make decisions on my behalf concerning:
- Financial matters
- Real estate transactions
- Legal affairs
- Healthcare decisions
- Other, please specify: ______________________
This Durable Power of Attorney will remain in effect until revoked or until my death.
By signing below, I understand the purpose and effect of this document.
___________________________
Signature of Principal
Date: ______________________
___________________________
Signature of Agent
Date: ______________________
Witnessed by:
____________________________
Name of Witness
Date: ______________________
____________________________
Name of Witness
Date: ______________________
This document can be notarized to add another layer of legality.