Arkansas Durable Power of Attorney
This Durable Power of Attorney is established in accordance with the Arkansas Financial Power of Attorney Act, allowing a person (the "Principal") to designate another person (the "Agent") to manage the Principal's financial affairs. This document remains in effect even if the Principal becomes incapacitated.
Principal Information
Full Name: _______________________________________________
Address: __________________________________________________
City, State, Zip: ___________________________________________
Phone Number: ____________________________________________
Agent Information
Full Name: _______________________________________________
Address: __________________________________________________
City, State, Zip: ___________________________________________
Phone Number: ____________________________________________
Alternate Agent Information (Optional)
To act if the first agent is unable, unwilling, or unavailable to serve.
Full Name: _______________________________________________
Address: __________________________________________________
City, State, Zip: ___________________________________________
Phone Number: ____________________________________________
Powers Granted
The Principal grants the Agent authority to act on the Principal's behalf regarding the following matters (initial next to each power granted):
- ____ Banking and other financial institution transactions
- ____ Real estate transactions
- ____ Personal property 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
- ____ Tax matters
- ____ Employment of agents
- ____ Gifts
Special Instructions (Optional)
Any specific limitations on the Agent's power or special instructions are listed here:
_________________________________________________________
_________________________________________________________
_________________________________________________________
Effective Date and Signature
This Durable Power of Attorney will become effective on the date below and will continue until it is revoked by the Principal or as provided by law.
Effective Date: _________________________________________
The Principal and a witness or notary (if required by law) must sign this document for it to be valid.
Principal's Signature: ____________________________________
Date: __________________
Witness or Notary Acknowledgment (if required):
This document was acknowledged before me on (date): _______________
By: _____________________________________________
Notary Public/Attorney/Witness Signature: ________________________
My Commission Expires: __________________________________