Contoh Power of Attorney
I. Appointment of Agent
I, [YOUR NAME], residing at [YOUR ADDRESS], appoint [AGENT'S NAME], residing at [AGENT'S ADDRESS], as my Attorney-in-Fact ("Agent") regarding the following powers, permissible and to the extent authorized by law:
II. Powers of Agent
The individual designated as my Agent is bestowed with the authority to represent me in a broad range of actions and decisions. Hence, they have the absolute power and jurisdiction to act on my behalf. They are endowed with the mandate to make decisions that are aligned with my best interests and welfare. Likewise, they are responsible for ensuring that these decisions are carried out and executed in a manner that is fully compliant to existing legal standards. Thus, they are tasked with carrying out all tasks and activities that lie within the constraints of the law.
III. Effective Date and Duration
This Power of Attorney shall be effective as of [EFFECTIVE DATE] and shall remain in effect until revoked by the Principal or terminated by operation of law.
IV. Compensation
The Agent shall be entitled to reasonable compensation for their services rendered under this Power of Attorney. The specific amount and method of payment shall be mutually agreed upon by the Principal and the Agent, and may be outlined in a separate agreement. The Agent shall maintain accurate records of their time and expenses incurred in the performance of their duties and shall provide periodic statements to the Principal upon request.
V. Revocation
The Principal retains the right to modify or cancel this Power of Attorney at any time. This action requires a written notice to be provided to both the Agent and any pertinent third parties involved.
VI. Specific Powers
The Agent is granted full power and authority to handle a spectrum of responsibilities during my absence, including but not limited to:
1. Financial Management:
The Agent shall have the authority to manage all aspects of my financial affairs, including but not limited to banking, investments, real estate transactions, tax filings, and any other financial matters deemed necessary.
The Agent is authorized to access my bank accounts, make withdrawals, deposits, and transfers, as well as to open and close accounts on my behalf.
2. Property Management:
The Agent shall oversee the management of all my real and personal property, including maintenance, rental, leasing, and sale.
The Agent is empowered to enter into agreements, sign contracts, and negotiate terms related to the acquisition, disposition, or management of any property owned by me.
3. Healthcare Decision Making:
The Agent is granted the authority to make healthcare decisions on my behalf, including consent to medical treatment, surgery, hospitalization, and medication.
The Agent may access my medical records and communicate with healthcare providers to ensure appropriate care and treatment.
4. Legal Representation:
The Agent is empowered to represent me in legal matters, including but not limited to signing legal documents, initiating or defending lawsuits, and settling disputes.
The Agent may engage legal counsel and other professionals to act on my behalf in legal proceedings, with the authority to incur reasonable expenses for such representation.
5. Governmental Affairs:
The Agent is authorized to interact with government agencies and officials on my behalf, including filing documents, responding to inquiries, and representing me in administrative proceedings.
The Agent may apply for and receive government benefits, such as social security, Medicare, or Medicaid, and handle related matters, including appeals and documentation requirements.
VII. Governing Law
This Power of Attorney and all matters arising out of or relating to it shall be governed by and construed in accordance with the laws of the [State/Country] without regard to its conflict of law principles.
VIII. Duration
Unless the Principal decides to revoke it using a written document, this Power of Attorney will continue to remain in effect without any specified end date or time limit.
IX. Signatures
IN WITNESS WHEREOF, I have executed this Insurance Power of Attorney on [DATE].
[YOUR NAME]
[AGENT'S NAME
WITNESS ACKNOWLEDGEMENT
We, the undersigned witnesses, attest that the Principal and Agent signed this Power of Attorney in our presence and that they appeared to be of sound mind and acting willingly.
[WITNESS 1 FULL NAME]
[DATE]
[WITNESS 2 FULL NAME]
[DATE]
NOTARY ACKNOWLEDGEMENT
On this day of in the year , before me, a Notary Public in and for said County and State, personally appeared [YOUR NAME], known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged that they executed the same for the purposes therein contained.
Witness my hand and official seal.
[NOTARY PUBLIC'S NAME]
My Commission Expires:
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