Pennsylvania Power of Attorney Template
This Power of Attorney is executed in accordance with Pennsylvania law, specifically under the Pennsylvania Consolidated Statutes, Title 20, Chapter 56.
Principal Information:
- Name: ____________________________
- Address: ____________________________
- City, State, Zip Code: ________________
- Date of Birth: ____________________________
Agent Information:
- Name: ____________________________
- Address: ____________________________
- City, State, Zip Code: ________________
- Relationship to Principal: ________________
Effective Date of Power of Attorney: This Power of Attorney shall become effective on: ____________________________.
Durability: This Power of Attorney will remain in effect until revoked by the Principal, or until the death of the Principal.
Powers Granted: The Principal grants the Agent the authority to act on their behalf in the following matters:
- Manage financial affairs, including banking and investments.
- Make health care decisions, if specified.
- Handle real estate transactions.
- File and manage tax returns.
- Other: ____________________________.
Signatures:
In witness whereof, the Principal has executed this Power of Attorney on the _____ day of ____________, 20__.
____________________________________
Principal Signature
____________________________________
Printed Name of Principal
Witnesses:
By signing below, the witnesses affirm that the Principal is known to them and that the Principal appears to be of sound mind and free from duress.
Witness #1:
____________________________________
Signature
____________________________________
Printed Name
Witness #2:
____________________________________
Signature
____________________________________
Printed Name
Notary Public:
State of Pennsylvania
County of ___________________________
On this _____ day of ____________, 20__, before me, the undersigned 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 they executed the same for the purposes therein contained.
____________________________________
Notary Public Signature
My Commission Expires: ____________