Indiana Durable Power of Attorney
This Durable Power of Attorney is established on this ______ day of _______________, 20______, by the undersigned, _____________________________ (hereinafter referred to as the "Principal"), currently residing at ____________________________________________, Indiana, hereby appointing ____________________________________________, residing at ____________________________________________, Indiana, as my Attorney-in-Fact ("Agent") to act in my capacity to the extent allowed by the Indiana Durable Power of Attorney Act.
In accordance with the Indiana Durable Power of Attorney Act, this document grants full authority to my Agent to make decisions on my behalf should I become unable or unwilling to do so. This authority will remain in effect despite my subsequent disability or incapacity.
Article I: Powers Granted
My Agent shall have the power to act on my behalf in all matters as allowed by law, including, but not limited to, the following areas:
- Real estate transactions
- Financial matters and transactions
- Personal and family maintenance
- Government benefits and military service benefits
- Legal claims and litigation
- Health care, including the power to make medical decisions on my behalf
- Tax matters, including the authority to file returns, claim refunds, and represent me before any taxing authority
Article II: Special Instructions
If there are specific limitations to the authority of my Agent or special instructions regarding the exercise of this power, they are listed below:
__________________________________________________________________________________________
__________________________________________________________________________________________
Article III: Durability
This Power of Attorney shall not be affected by subsequent disability or incapacity of the Principal. It is my explicit intention that this document remain in full force and effect until my death or until explicitly revoked in writing by me.
Article IV: Third Party Reliance
Any third party who receives a copy of this document may act under it. Revocation of this Power of Attorney is effective as to a third party only upon the third party's actual receipt of notice of revocation.
Article V: Governing Law
This Durable Power of Attorney shall be governed by the laws of the State of Indiana.
Article VI: Signatures
This Durable Power of Attorney must be signed and dated by the Principal in the presence of a notary public to be legally effective. The Agent’s acceptance of this appointment is also required:
Principal’s Signature: ___________________________________ Date: _______________
Principal’s Printed Name: ________________________________
Agent’s Signature: ______________________________________ Date: _______________
Agent’s Printed Name: ____________________________________
State of Indiana
County of _______________________
On this ______ day of _______________, 20____, before me, a notary public, personally appeared _____________________________, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he/she executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
Notary Public’s Signature: ________________________________
Notary’s Printed Name: ___________________________________
My commission expires: _______________