Pennsylvania Power of Attorney Template
This Power of Attorney is created in accordance with the laws of the Commonwealth of Pennsylvania.
Principal Information:
Name: ________________________________________
Address: ______________________________________
City: ________________________________________
State: ____________ Zip Code: _________________
Agent Information:
Name: ________________________________________
Address: ______________________________________
City: ________________________________________
State: ____________ Zip Code: _________________
Effective Date:
This Power of Attorney shall become effective on: ________________
Durability:
This Power of Attorney shall remain in effect even if I become incapacitated.
Powers Granted:
- To manage my financial affairs.
- To make healthcare decisions on my behalf.
- To handle real estate transactions.
- To manage bank accounts.
- To file taxes.
Revocation:
This Power of Attorney may be revoked at any time by the Principal, provided written notice is given to the Agent and any relevant institutions.
Signature of Principal:
______________________________ Date: ___________
Witness Statement:
I, the undersigned witness, affirm that I am not the Agent named in this document. I have witnessed the Principal sign this Power of Attorney.
Name of Witness: ______________________________________
Signature of Witness: ______________________________ Date: ___________
Notarization:
State of Pennsylvania
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 this instrument, and acknowledged that he/she executed the same for the purposes therein contained.
Notary Public Signature: _____________________________
My Commission Expires: __________________________