Instructions for Powers of Attorney


Advance
 

Prepared by Norman Pickell, a will and power of attorney lawyer  based in Goderich, Ontario.

Please complete as much of this Form as possible by printing your answers.
Make sure that you have completed the General Information for Wills and Powers of Attorney Form.

Name: ___________________________         Date: ___________________

PROPERTY POWER of ATTORNEY

(With this document, you give authority to another person to handle your financial and property matters.)

Have you previously given such a Power of Attorney to anyone?


No _______ Yes _______

If Yes, details _______________________________________________________

___________________________________________________________________

If Yes, do you want it cancelled? Yes ______ No _________

Who do you want to give Power of Attorney to for your finances and property matters?

(You should name at least two people, unless you are naming a trust company - in which case you do not need to name anyone else. One of your Attorneys can be your spouse. At least one of them should be younger than you are. You can name up to four people. All of your Attorneys must be at least 18 years old.)

Name, address, relationship to you and telephone number for each person you name as your Attorney:

1. __________________________________________________________________

2. __________________________________________________________________

3. __________________________________________________________________

4. __________________________________________________________________

Is it alright for any one of your attorneys to be able to act by her/himself on your behalf?

Yes _____ No ______

If No, why not? _______________________________________________________

____________________________________________________________________

____________________________________________________________________

If No, how many of the above are needed to make the decisions and sign the cheques, for example? 
Any two _____ All _____ Other ______

Are your Attorneys able to make:
loans to any of your relatives                     No ______ Yes ______

loans to any of your friends                       No ______ Yes ______

gifts to any of your relatives                      No ______ Yes ______

gifts to any of your friends                        No ______ Yes ______

gifts to charities on your behalf                 No ______ Yes ______

Other comments (if any) about loans and gifts: __________________________

_________________________________________________________________

_________________________________________________________________

Are there any restrictions or special instructions that you want to include in your Property Power of Attorney?

No _______ Yes _______

If Yes, details ______________________________________________________

__________________________________________________________________

__________________________________________________________________

PERSONAL CARE POWER of ATTORNEY

(With this document, you give authority to another person to make decisions for you concerning your "personal care" if you are unable to make those decisions yourself. "Personal care" includes medical treatment, nutrition, accommodation, clothing and hygiene.)

Have you previously given such a Power of Attorney to anyone?


No _______ Yes _______

If Yes, details _______________________________________________________

___________________________________________________________________

If Yes, do you want it cancelled? Yes ______ No _________

Who do you want to be the ones to make decisions about your personal care if you are not able to decide?

(You should name at least two people. One of your Attorneys can be - and probably should be - your spouse. Do not name a trust company. At least one of the Attorneys should be younger than you are. You can name as many people as you want. All of your Attorneys must be at least 18 years old. None of your Attorneys can be your doctor, nurse, landlord, social worker or homemaker - unless they are related to you.)

Name, address, relationship to you and telephone number for each person you name as your Attorney:

1. __________________________________________________________________

2. __________________________________________________________________

3. __________________________________________________________________

4. __________________________________________________________________

5. __________________________________________________________________

6. __________________________________________________________________

Is it alright for any one of your attorneys to be able to make decisions by her/himself on your behalf?

Yes _____ No ______

If No, why not? _______________________________________________________

_____________________________________________________________________

_____________________________________________________________________

If No, how many of the above are needed to make personal care decisions on your behalf?

Any two _____ All _____ Other ______

If your Doctor believes that the only way that you can be kept alive for other than a brief period of time is to be on a life support system, do you want your Attorney(s) to consent to having you be on such a life support system? No ______ Yes _______

If Yes, details _________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Are there any restrictions or special instructions that you want to include in your Personal Care Power of Attorney? No _______ Yes _______

If Yes, details _________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Name and Address of your Doctor ____________________________________________________________________

____________________________________________________________________

This is NOT A POWER of ATTORNEY. These are INSTRUCTIONS ONLY. When you have completed this Form as much as you can, please mail this Form (together with the General Information Form) to your Lawyer, or take them to your FIRST Interview with your Lawyer.

What you have printed in these Instructions will NOT become part of your Powers of Attorney until they have been prepared by your Lawyer AND you have signed your Powers of Attorney.

Your Lawyer will review these Instructions and include in your Powers of Attorney the appropriate powers to be given to your Attorney(s).

 

_________________________________
Signature of person completing this form


 
 


 

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Norman B. Pickell  Lawyer - Mediator - Arbitrator  58 South Street, Goderich, Ontario N7A 3L5  Telephone (519) 524-8335   Fax (519) 524-1530