Virginia Durable Power of Attorney
This Durable Power of Attorney is established according to the Virginia Uniform Power of Attorney Act. It grants the person(s) named below the authority to act on behalf of the principal in matters specified within this document.
Principal’s Information
- Full Name: _________________________________________
- Address: ___________________________________________
- City, State, Zip: _________________________________
- Phone Number: _____________________________________
Agent’s Information
- Full Name: _________________________________________
- Address: ___________________________________________
- City, State, Zip: _________________________________
- Phone Number: _____________________________________
Alternate Agent’s Information (if applicable)
- Full Name: _________________________________________
- Address: ___________________________________________
- City, State, Zip: _________________________________
- Phone Number: _____________________________________
This Durable Power of Attorney becomes effective immediately and will continue to be effective even if the principal becomes disabled or incapacitated, unless a future date or event is specified here: _________________________.
Powers Granted to the Agent
This document authorizes the agent to act on the principal’s behalf in the following areas (initial next to each power granted):
- _____ Real property transactions
- _____ Tangible personal property transactions
- _____ Stock and bond transactions
- _____ Commodity and option transactions
- _____ Banking and financial service transactions
- _____ Business operating transactions
- _____ Insurance and annuity transactions
- _____ Estate, trust, and other beneficiary transactions
- _____ Claims and litigation
- _____ Personal and family maintenance
- _____ Benefits from Social Security, Medicare, Medicaid, or other governmental programs, or military service
- _____ Retirement plan transactions
- _____ Tax matters
Additional powers or restrictions (if any): ____________________________________________________________________________.
This Power of Attorney will be governed by the laws of the State of Virginia. It may be revoked by the principal at any time by providing written notice to the agent(s).
Signatures
This document must be signed by the principal, the agent(s), and a notary public to be considered valid.
Principal’s Signature: _____________________________________ Date: _______________
Agent’s Signature: ________________________________________ Date: _______________
Alternate Agent’s Signature (if applicable): ___________________ Date: _______________
State of Virginia, County of ____________
This document was acknowledged before me on (date) ____________ by (name of principal) _____________________.
Notary Public’s Signature: _______________________ Printed Name: ______________________
My commission expires: __________________