Power of Attorney Form Idaho

Agent’s Phone Number: _________________________

 

DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL)

 

If my agent is unable or unwilling to act for me, I name as my successor agent:

 

Name of Successor Agent: _________________________

Successor Agent’s Address: _________________________

Successor Agent’s Phone Number: _________________________

 

If my successor agent is unable or unwilling to act for me, I name as my second successor agent:

 

Name of Second Successor Agent: _________________________

Second Successor Agent’s Address: _________________________

Second Successor Agent’s Phone Number: _________________________

 

GRANT OF GENERAL AUTHORITY

 

I grant my agent and any successor agent general authority to act for me with respect to the following subjects as defined in the uniform power of attorney act, chapter 12, title 15, Idaho Code:

 

(INITIAL each subject you want to include in the agent’s general authority. If you wish to grant general authority over all of the subjects you may initial "All Preceding Subjects" instead of initialing each subject.)

 

(____) Real Property

(____) Tangible Personal Property

(____) Stocks and Bonds

(____) Commodities and Options

(____) Banks and Other Financial Institutions

(____) Operation of an Entity or Business

(____) Insurance and Annuities

(____) Estates, Trusts, and Other Beneficial Interests

(____) Claims and Litigation

(____) Personal and Family Maintenance

(____) Benefits from Governmental Programs or Civil or Military Service

(____) Retirement Plans

(____) Taxes

(____) All Preceding Subjects

 

GRANT OF SPECIFIC AUTHORITY (OPTIONAL)

 

My agent MAY NOT do any of the following specific acts for me UNLESS I have INITIALED the specific authority listed below:

 

(CAUTION: Granting any of the following will give your agent the authority to take actions that could significantly reduce your property or change how your property is distributed at your death. INITIAL ONLY the specific authority you WANT to give your agent.)

 

(____) Create, amend, revoke, or terminate an inter vivos trust

(____) Make a gift, subject to the limitations of the uniform power of attorney act, chapter 12, title 15, Idaho Code, and any special instructions in this power of attorney

(____) Make a gift without limitations except any special instructions in this power of attorney

(____) Create or change rights of survivorship

(____) Create or change a beneficiary designation

(____) Authorize another person to exercise the authority granted under this power of attorney

(____) Waive the principal’s right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan

(____) Exercise fiduciary powers that the principal has authority to delegate

 

LIMITATION ON AGENT’S AUTHORITY

 

An agent that is not my ancestor, spouse, or descendant MAY NOT use my property to benefit the agent or a person to whom the agent owes an obligation of support unless I have included that authority in the Special Instructions.

 

SPECIAL INSTRUCTIONS (OPTIONAL)

 

On the following lines you may give special instructions:

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

 

EFFECTIVE DATE

 

This power of attorney is effective immediately unless I have stated otherwise in the Special Instructions.

 

NOMINATION OF CONSERVATOR (OPTIONAL)

 

If it becomes necessary for a court to appoint a conservator of my estate, I nominate the following person(s) for appointment:

 

Name of Nominee for conservator of my estate: _________________________

Nominee’s Address: _________________________

Nominee’s Phone Number: _________________________

 

RELIANCE ON THIS POWER OF ATTORNEY

 

Any person, including my agent, may rely upon the validity of this power of attorney or a copy of it unless that person knows it is terminated or invalid.

 

SIGNATURE AND ACKNOWLEDGMENT

 

(OPTION ONE – IF YOU ARE ABLE TO SIGN ON YOUR OWN)

 

Your Signature: _________________________

Date: _________________________

Your Name Printed: _________________________

Your Address: _________________________

Your Phone Number: _________________________

 

NOTARY – REQUIRED FOR RECORDING AND FOR REAL PROPERTY

 

State of Idaho, county of _________________________, ss.

 

On this ____ day of _________________________, in the year of 20____, before me _________________________(here insert the name and quality of the officer), personally appeared _________________________, known or identified to me (or proved to me on the oath of _________________________), to be the person whose name is subscribed to the within instrument, and acknowledged to me that he (or they) executed the same.

 

Notary signature: _________________________

 

My commission expires on: _________________________

 

(OPTION TWO – IF YOU ARE UNABLE TO SIGN ON YOUR OWN AND DIRECT THE NOTARY TO SIGN FOR YOU)

 

_________________________ (official signature and seal)

 

Witness Signature: _________________________

 

Signature affixed by notary in the presence of _________________________ (names of person and witness).

 

State of Idaho )

)ss.

County of _________________________)

 

On this ____ day of _________________________, in the year 20____, before me (here insert the name and quality of the officer), personally appeared _________________________, known or identified to me (or proved to me on the oath of _________________________) to be the person whose name is subscribed to the within instrument, and acknowledged to me that he executed the same by directing the undersigned notary to affix his signature thereto.

 

_________________________ (official signature and seal)

 

My commission expires on: _________________________

 

IMPORTANT INFORMATION FOR AGENT AGENT’S DUTIES

 

When you accept the authority granted under this power of attorney, a special legal relationship is created between you and the principal. This relationship imposes upon you legal duties that continue until you resign or the power of attorney is terminated or revoked.

 

You must:

 

(1)  Do what you know the principal reasonably expects you to do with the principal’s property or, if you do not know the principal’s expectations, act in the principal’s best interest;

 

(2)  Act in good faith;

 

(3)  Do nothing beyond the authority granted in this power of attorney; and

 

(4)  Disclose your identity as an agent whenever you act for the principal by signing the name of the principal and signing your own name as "agent" in the following manner:

 

(Principal’s Name) by (Your Signature) as agent

 

Unless the Special Instructions in this power of attorney state otherwise, you must also:

 

(1)  Act loyally for the principal’s benefit;

 

(2)  Avoid conflicts that would impair your ability to act in the principal’s best interest;

 

(3)  Act with care, competence and diligence;

 

(4)  Keep a record of all receipts, disbursements, and transactions conducted for the principal;

 

(5)  Cooperate with any person that has authority to make health care decisions for the principal to do what you know the principal reasonably expects or, if you do not know the principal’s expectations, to act in the principal’s best interest; and

 

(6)  Attempt to preserve the principal’s estate plan if you know the plan and preserving the plan is consistent with the principal’s best interest.

 

TERMINATION OF AGENT’S AUTHORITY

 

You must stop acting on behalf of the principal if you learn of any event that terminates this power of attorney or your authority under this power of attorney. Events that terminate a power of attorney or your authority to act under a power of attorney include:

(1)  Death of the principal;

 

(2)  The principal’s revocation of the power of attorney or your authority;

 

(3)  The occurrence of a termination event stated in the power of attorney;

 

(4)  The purpose of the power of attorney is fully accomplished; or

 

(5)  A legal action is filed with a court to end your marriage to the principal, or for your legal separation, unless the Special Instructions in this power of attorney state that such an action will not terminate your authority.

 

LIABILITY OF AGENT

 

The meaning of the authority granted to you is defined in the act. If you violate the act or act outside the authority granted, you may be liable for any damages caused by your violation.

 

IF THERE IS ANYTHING ABOUT THIS DOCUMENT OR YOUR DUTIES THAT YOU DO NOT UNDERSTAND, YOU SHOULD SEEK LEGAL ADVICE.

 

 

AGENT’S CERTIFICATION AS TO THE VALIDITY OF POWER OF ATTORNEY AND

AGENT’S AUTHORITY

State of Idaho                       )

                                             ) ss.

County of ______________ )

 

I, _________________________ (Name of Agent), certify under penalty of perjury that _________________________ (Name of Principal) granted me authority as an agent or successor agent in a Power of Attorney dated _________________________, 20____.

 

I further certify that to my knowledge:

(1)  The Principal is alive and has not revoked the Power of Attorney or my authority to act under the Power of Attorney and that the Power of Attorney and my authority to act under the Power of Attorney have not terminated;

(2)  If the Power of Attorney was drafted to become effective upon the happening of an event or contingency, the event or contingency has occurred;

(3)  If I was named as a successor agent, that the prior agent is no longer able or willing to serve; and

(4)   (Insert other relevant statements): _______________________________________

________________________________________________________________________________________________________________________________________

 

SIGNATURE AND ACKNOWLEDGMENT

 

Agent's Signature: _______________________________________

 

Date: _______________________________________

 

Agent’s Name Printed: _______________________________________

 

Agent’s Address: _______________________________________

 

Agent’s Phone Number: _______________________________________

 

This document was acknowledged before me on _________________________, 20____

by _______________________________________ (Name of Agent)

 

Notary Public for Idaho: _______________________________________

 

Residing at: _______________________________________

 

My commission expires on: _______________________________________