Florida Durable Power of Attorney
This Durable Power of Attorney is created pursuant to the Florida Power of Attorney Act, Florida Statutes §§ 709.2101 to 709.2402. By signing this document, the Principal grants certain legal authority to an Agent or Attorney-in-Fact to make decisions on the Principal’s behalf. This power remains in effect even if the Principal becomes incapacitated.
Principal Information
Full Legal Name: ____________________________
Address: ____________________________
City: ___________________ State: FL Zip Code: ___________
Date of Birth: __________________
Agent (Attorney-in-Fact) Information
Full Legal Name: ____________________________
Address: ____________________________
City: ___________________ State: FL Zip Code: ___________
Phone Number: __________________
Alternate Agent (Optional)
Full Legal Name: ____________________________
Address: ____________________________
City: ___________________ State: FL Zip Code: ___________
Phone Number: __________________
Powers Granted
Select the powers you wish to grant to your Agent. Initial next to each power you are granting.
- _____ Banking and Financial Transactions
- _____ Real Property Transactions
- _____ Personal Property Transactions
- _____ Business Operating Transactions
- _____ Insurance 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
- _____ All of the above
Special Instructions (Optional)
Provide any special instructions you want your Agent to follow here: ___________________________________________________________
______________________________________________________________________________________________________________________
Effective Date and Signatures
This Durable Power of Attorney shall become effective immediately upon signing and shall remain effective until it is revoked by the Principal or upon the death of the Principal.
Principal’s Signature: ____________________________ Date: __________________
Agent's Acknowledgment
I, ____________________________ (Agent's name), hereby accept this appointment as Attorney-in-Fact and swear or affirm that I will act in the Principal’s best interest according to the powers granted to me in this Durable Power of Attorney and under the laws of the State of Florida.
Agent’s Signature: ____________________________ Date: __________________
Alternate Agent's Acknowledgment (if applicable)
I, ____________________________ (Alternate Agent's name), hereby accept this appointment as an Alternate Attorney-in-Fact and swear or affirm that I will act in the Principal’s best interest, only in the absence or inability of the primary Agent, according to the powers granted to me in this Durable Power of Attorney and under the laws of the State of Florida.
Alternate Agent’s Signature: ____________________________ Date: __________________
Witnesses
The law requires that this Durable Power of Attorney must be signed in the presence of two witnesses, who also need to sign below.
1st Witness Name: ____________________________
Signature: ____________________________ Date: __________________
2nd Witness Name: ____________________________
Signature: ____________________________ Date: __________________
Notarization (if required or desired)
This section should be completed by a Notary Public if notarization is required or desired for additional legal standing.