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Notice: The powers granted by this document are broad and sweeping. They are defined in the Connecticut Uniform Power of Attorney Act, which expressly permits the use of any other or different form of power of attorney desired by the parties concerned. The grantor of any power of attorney or the agent may make application to a Probate Court for an accounting as provided in subsection (d) of section 45a-175 of the general statutes. This power of attorney does not authorize the agent to make health care decisions for you.
Know All Men by These Presents, which are intended to constitute a GENERAL POWER OF ATTORNEY pursuant to Connecticut Statutory Short Form Power of Attorney Act:
I, , residing at , , , hereby appoint Each Agent may act independently, without the consent of the other Agent. The Agents must act jointly, with the consent of the other Agent.
or if we become legally separated or divorced, If either Agent is unable to serve for any reason, the other Agent shall serve alone. If either Agent is unable to serve for any reason, I appoint , of , , , as my Successor Agent to serve alone. If either Agent is unable to serve for any reason or if we become legally separated or divorced, I appoint , of , , as my Successor Agent to serve alone. If both Agents are unable to serve (either together or independently) I appoint , , , to act as my Alternate Successor Agent to serve alone. I hereby revoke any and all general powers of attorney that previously have been signed by me. I hereby revoke any and all special powers of attorney that previously have been signed by me. I hereby revoke any and all general powers of attorney and special powers of attorney that previously have been signed by me. However, the preceding sentence shall not have the effect of revoking any powers of attorney that are directly related to my health care that previously have been signed by me.
.
insurance or annuity accounts
retirement accounts
payable on death savings accounts
payable on death checking accounts
| . Provide for the support and protection of myself, my spouse, or of any minor child I have a duty to support or have established a pattern of prior support, including, without limitation, provision for food, lodging, housing, medical services, recreation and travel; |
. Maintain and/or operate any business that I may own.
. Employ professional and business assistance as may be appropriate, including attorneys, accountants, and real estate Agents.
my homestead as described in the attached Exhibit. any homestead that I now own or may own in the future. my homestead legally described as:
If the Agent is my spouse, then I also hereby appoint , of , as my substitute Agent solely for the purpose of releasing any dower, homestead or other inchoate interest or other property rights (of whatever nature), which under local law may not be released by my spouse.
. Make gifts from my assets to members of my family and to such other persons or charitable organizations with whom I have an established pattern of giving (or if it is appropriate to make such gifts for estate planning and/or tax purposes), to file state and federal gift tax returns, and to file a tax election to split gifts with my spouse, if any. No Agent acting under this instrument, except as specifically authorized in this instrument, shall have the power or authority to (a) gift, appoint, assign or designate any of my assets, interests or rights, directly or indirectly, to such Agent, such Agent's estate, such Agent's creditors, or the creditors of such Agent's estate, (b) exercise any powers of appointment I may hold in favor of such Agent, such Agent's estate, such Agent's creditors, or the creditors of such Agent's estate, or (c) use any of my assets to discharge any of such Agent's legal obligations, including any obligations of support which such Agent may owe to others, excluding those whom I am legally obligated to support.
. To transfer any of my assets to the trustee of any revocable trust created by me, if such trust is in existence at the time of such transfer.
. To utilize my assets to fund a trust not created by me, but to which I have either established a pattern of funding, or to fund a trust created by my Agent for my benefit or the benefit of my dependents, heirs or devisees upon the advice of a financial adviser.
. To create, sign, modify or revoke any trust agreements or other trust documents in an attempt to manage or create a trust that was created for my benefit or the benefit of my dependants, heirs or devisees. This shall include the creation, modification or revocation of any inter vivos, family living, irrevocable or revocable trusts.
. To exercise fiduciary responsibilities that I have a right to delegate.
. Subject to other provisions of this document, my Agent may disclaim any interest, which might otherwise be transferred or distributed to me from any other person, estate, trust, or other entity, as may be appropriate. However, my Agent may not disclaim assets to which I would be entitled, if the result is that the disclaimed assets pass directly or indirectly to my Agent or my Agent's estate.
. Have access to my healthcare and medical records and statements regarding billing, insurance and payments.
. Act on my behalf for the purposes of managing, distributing, and terminating my digital assets. For the purposes of this Power of Attorney, digital assets shall mean electronic assets that are stored on my computers, electronic devices, or on any online account, as identified in Schedule A of this Power of Attorney. Online accounts include, but are not limited to, social-networking sites, online backup services, servers, email accounts, photo and document sharing sites, financial and business accounts, domain names, virtual property, websites, and blogs. An instructional document, titled, Letter of Instructions with associated websites, usernames, passwords, and related information, is hereby incorporated by reference into this Will and shall be distributed to my Agent designated in this Power of Attorney. My Agent shall have the power and authority to manage, conduct, and to exercise all of my legal rights and powers relating to my digital assets, including all rights and powers that I may acquire in the future. My Agents powers shall include, but not be limited to, the power to access, download, and backup digital assets, convert my file formats, access any and all devices necessary to manage digital assets, and clear computer caches and delete files.
. Open, maintain or close bank accounts (including, but not limited to, checking accounts, savings accounts, and certificates of deposit), brokerage accounts, retirement plan accounts, and other similar accounts with financial institutions. This power shall include the authority to conduct any business with any banking or financial institution with respect to any of my accounts, including, but not limited to, making deposits and withdrawals, negotiating or endorsing any checks or other instruments with respect to any such accounts, obtaining bank statements, passbooks, drafts, money orders, warrants, and certificates or vouchers payable to me by any person, firm, corporation, or political entity.
. Open, maintain or close the following specific accounts. This power shall include the authority to conduct any transaction for these accounts, including, but not limited to, making deposits and withdrawals, negotiating or endorsing any checks or other instruments with respect to any such accounts, obtaining bank statements, passbooks, drafts, money orders, warrants, and certificates or vouchers payable to me by any person, firm, corporation, or political entity.
Perform any act necessary to deposit, negotiate, sell, or transfer any note, bond, security, or draft of the United States of America, including U.S. Treasury Securities.
Institute, supervise, prosecute, defend, intervene in, abandon, compromise, arbitrate, settle, dismiss, and appeal from any and all legal, equitable, judicial or administrative hearings, actions, suits, proceedings, attachments, arrests or distresses, involving me in any way.
. . . Sell or convey any interest of mine in real estate (whether currently owned or later acquired). Sell or convey any interest of mine in real estate located at Sell or convey any interest of mine in real estate located at
The total sale price must be at least .
If the Agent is my spouse, then I also hereby appoint of , , as my substitute Agent solely for the purpose of releasing any dower, homestead or other inchoate interest or other property rights (of whatever nature), which under local law may not be released by my spouse.
. . . Mortgage or encumber any interest of mine in real estate (whether currently owned or later acquired). Mortgage or encumber any interest of mine in real estate located at: Mortgage or encumber any interest of mine in real estate located at:
If the Agent is my spouse, then I also hereby appoint of , , as my substitute Agent solely for the purpose of releasing any dower, homestead or other inchoate interest or other property rights (of whatever nature), which under local law may not be released by my spouse.
. . . Manage, insure, improve, repair, collect rents, execute leases, or take any other action that a landlord might take, with respect to any interest of mine in real estate (whether currently owned or later acquired). Manage, insure, improve, repair, collect rents, execute leases, or take any other action that a landlord might take, with respect to any interest of mine in real estate located at: Manage, insure, improve, repair, collect rents, execute leases, or take any other action that a landlord might take, with respect to any interest of mine in real estate located at: . . . Sell or convey any personal property that I might own now or in the future, tangible or intangible, on such terms and conditions as my Agent deems appropriate. Sell or convey .
This power shall include the power to (i) sign contracts of sale and documents to transfer title (including bills of sale), and (ii) accept a security interest for any unpaid portion of the purchase price.
This power shall include the power to (i) obtain credit upon such terms as my Agent may deem appropriate, subject to the limitations (if any) stated above, (ii) sign any documents (including notes, credit agreements, security agreements, and financing statements), and (iii) take any other action that may be required to complete the above transactions.
, , .
This power shall include the power to: (i) make and carry out decisions regarding sales, purchases, employees, loans, and equipment, and (ii) take any action needed (at the discretion of my Agent) to operate the business.
This power shall be limited to the power to make decisions in the ordinary course of business, including, but not limited to, decisions regarding sales, purchases, employees, and equipment.
. Prepare, sign, and file documents with any governmental body or agency. Prepare, sign, and file documents with any governmental body or agency. Prepare, sign, and file documents with any governmental body or agency
. Prepare, sign, and file income, gift and other tax returns of all kinds with federal, state, local, and other governmental bodies, and any Power of Attorney form appointing an Agent required by the Internal Revenue Service and/or any state or local taxing authority.
. Obtain information or documents from any government or its agencies, and represent me in all tax matters, including the authority to negotiate, compromise, or settle any matter with such government or agency.
. Prepare applications, provide information, and perform any other act reasonably requested by any government or its agencies in connection with governmental benefits (including medical, military and social security benefits), and to appoint anyone, including my Agent, to act as my "Representative Payee" for the purpose of receiving Social Security benefits.
. Act on my behalf with respect to the following matters: . Act on my behalf with respect to the following matters: . Act on my behalf with respect to the following matters:-Exercise all stock rights on my behalf as my proxy, including all rights with respect to stocks, bonds, debentures, commodities, options or other investments.
-Enter into binding contracts on my behalf.
-Purchase, maintain, surrender, collect, or cancel (a) life insurance or annuities of any kind on my life or on the life of anyone in whom I have an insurable interest, (b) liability insurance protecting me and my estate against third party claims, (c) hospital insurance, medical insurance, Medicare supplement insurance, custodial care insurance, and disability income insurance for me or any of my dependents, and (d) casualty insurance insuring assets of mine against loss or damage due to fire, theft, or other commonly insured risk; to pay all insurance premiums, to select any options under such policies, to increase coverage under any such policy, to borrow against any such policy, to pursue all insurance claims on my behalf, to adjust insurance losses, and the foregoing powers shall apply to private and public plans, including but not limited to Medicare, Medicaid, SSI and Worker's Compensation; to designat and change beneficiaries of insurance policies insuring my life and beneficiaries under any annuity contract in which I have an interest; to decrease coverage under or cancel any of these policies described above; to receive and make such disposition of the cash value on termination of any such policy as my Agent deems appropriate. However, my Agent shall have no power or authority whatsoever with respect to any interest in or incidents of ownership in any policy of insurance I may own on the life of my Agent.
-Create and contribute to an employee benefit plan, including a plan for a self-employed individual, for my benefit; to elect retirement on my behalf; to select any payment option under any IRA or employee benefit plan in which I am a participant, including plans for self-employed individuals, or to change options I have selected; to make voluntary contributions to such plans; to make "roll-overs" of plan benefits into other retirement plans; to apply for and receive payments and benefits; to waive rights given to nonemployee spouses under state or federal law; to borrow money or purchase assets from such plans, if authorized by such plans; to make revocable and irrevocable beneficiary designations and to change revocable beneficiary designations; to consent and/or waive consent in connection with the designation of beneficiaries and the selection of joint and survivor annuities under any employee benefit plan.
-Employ professional and business advisors as may be appropriate, including attorneys, accountants, and real estate Agents.
-Add, delete or change beneficiaries to any financial accounts I own including insurance policies, annuities, retirement accounts, payable on death savings or checking account or other investments.
-Add, delete or change beneficiaries to
insurance or annuity accounts
retirement accounts
payable on death savings accounts
payable on death checking accounts
Act on my behalf for the purposes of managing, distributing, and terminating my digital assets. For the purposes of this Power of Attorney, digital assets shall mean electronic assets that are stored on my computers, electronic devices, or on any online account, as identified in Schedule A of this Power of Attorney. Online accounts include, but are not limited to, social-networking sites, online backup services, servers, email accounts, photo and document sharing sites, financial and business accounts, domain names, virtual property, websites, and blogs. An instructional document, titled, Letter of Instructions with associated websites, usernames, passwords, and related information, is hereby incorporated by reference into this Will and shall be distributed to my Agent designated in this Power of Attorney. My Agent shall have the power and authority to manage, conduct, and to exercise all of my legal rights and powers relating to my digital assets, including all rights and powers that I may acquire in the future. My Agents powers shall include, but not be limited to, the power to access, download, and backup digital assets, convert my file formats, access any and all devices necessary to manage digital assets, and clear computer caches and delete files.
My Agent shall not be liable for any loss that results from a judgment error that was made in good faith. However, my Agent shall be liable for willful misconduct or the failure to act in good faith while acting under the authority of this Power of Attorney. A Successor Agent shall not be liable for acts of a prior Agent.
My Agent shall provide an accounting for all funds handled and all acts performed as my Agent as required under state law or upon my request or the request of any authorized personal representative, fiduciary or court of record acting on my behalf.
I hereby appoint
My Digital Agent shall not be entitled to any compensation, during my lifetime or upon my death, for any services provided as my Digital Agent. My Digital Agent shall be entitled to reasonable compensation for any services provided as my Digital Agent. My Digital Agent shall not be entitled to reimbursement of expenses incurred as a result of carrying out any provision of this Power of Attorney. My Digital Agent shall be entitled to reimbursement of all reasonable expenses incurred as a result of carrying out any provision of this Power of Attorney.
This Power of Attorney is granted in, and shall be governed by the laws of the state of Connecticut; however, I intend that this Power of Attorney be universally recognized and that it be universally admissible to recordation. In the event that I become a resident of another jurisdiction, or obtain property, including real property or any other property interest, in another jurisdiction, it remains my intention that the laws of Connecticut shall continue to govern this Power of Attorney.
This Power of Attorney shall become effective immediately. on . upon written certification by my physician that I am incapacitated or mentally incapable of managing my financial affairs, and shall not be affected by my disability or lack of mental competence, except as may be provided otherwise by an applicable state statute. This is a Durable Power of Attorney. immediately, and shall not be affected by my disability or lack of mental competence, except as may be provided otherwise by an applicable state statute. This is a Durable Power of Attorney. on , and shall not be affected by my disability or lack of mental competence, except as may be provided otherwise by an applicable state statute. This is a Durable Power of Attorney. This Power of Attorney shall continue effective until or until I lack sufficient mental competence to understand and handle my financial and personal affairs or until I lack sufficient mental competence to understand and handle my financial and personal affairs. This Power of Attorney may be revoked by me at any time by providing written notice to my Agent.
Dated ____________________, ______, at , .
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| Witness Signature: | ___________________________________ |
| Name: |
| City: |
| State: |
| Witness Signature: | ___________________________________ |
| Name: |
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STATE OF ,
COUNTY OF , ss:
The foregoing instrument was acknowledged before me this _____ day of ____________________, ______, by .
_________________________________
Signature of person taking acknowledgment
WITNESS ATTESTATION
The foregoing power of attorney was, on the date written above, published and declared by in our presence to be his/her power of attorney. We, in his/her presence and at his/her request, and in the presence of each other, have attested to the same and have signed our names as attesting witnesses.
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,
___________________________________
,
Notice to Person Executing Power of Attorney:
A Power of Attorney is an important legal document. By signing the Power of Attorney, you are authorizing another person to act for you, the principal. Before you sign this Power of Attorney, you should know these important facts:
Your Agent (attorney-in-fact) has no duty to act unless you and your Agent agree otherwise in writing.
This document gives your Agent the powers to manage, dispose of, sell and convey your real and personal property, and to use your property as security if your Agent borrows money on your behalf, unless you provide otherwise in this Power of Attorney.
Your Agent will have the right to receive reasonable payment for services provided under this Power of Attorney unless you provide otherwise in this Power of Attorney.
The powers you give your Agent will continue to exist for your entire lifetime, unless you state that the Power of Attorney will last for a shorter period of time or unless you otherwise terminate the Power of Attorney. The powers you give your Agent in this Power of Attorney will continue to exist even if you can no longer make your own decisions respecting the management of your property, unless you provide otherwise in this Power of Attorney.
You can change or correct the terms of this Power of Attorney only by executing a new Power of Attorney, or by executing an amendment through the same formalities as an original. You have the right to revoke or terminate this Power of Attorney at any time, so long as you are competent.
This Power of Attorney must be dated and must be acknowledged before a notary public or signed by two witnesses. If the Power of Attorney is signed by two witnesses, the witnesses must be mentally competent and they must witness the principal's signing of the Power of Attorney or (2) the principal's signing or acknowledgment of his or her signature. A Power of Attorney that may affect real property should be acknowledged before a notary public so that it may easily be recorded.
You should read this Power of Attorney carefully. When effective, this Power of Attorney will give your Agent the right to deal with property that you now have or might acquire in the future. The Power of Attorney is important to you. If you do not understand the Power of Attorney, or any provision of it, then you should obtain the assistance of an attorney or other qualified person.
| ______________________________________ | _____________________________ |
| Date |
Notice to Person Accepting the Appointment as Attorney-in-Fact:
By acting or agreeing to act as the Agent (attorney-in-fact) under this Power of Attorney, you assume the fiduciary and other legal responsibilities of an Agent. These responsibilities include:
| 1. | The legal duty to: act solely in the interest of the principal; act loyally, with care, competence, and diligence; and avoid conflicts of interest. |
| 2. | The legal duty to keep a record of all transactions made on behalf of the principal, including the responsibility to produce receipts, ledgers and other records of all deposits, disbursements or other transactions involving the principal's assets or indebtedness. |
| 3. | To cooperate with the principal's Agent for health care decisions, should the principal appoint such an Agent, in making decisions in accordance with the principal's desires or in the best interest of the principal if the principal's wishes are not known. |
| 4. | The legal duty to preserve the principal's estate plan, if one exists, and the principal's desires for such plan to be preserved. |
| 5. | The legal duty to keep the principal's property separate and distinct from any other property owned or controlled by you. |
| 6. | The legal duty to terminate actions as Agent (Attorney-in-Fact) under this Power of Attorney upon the occurrence of any of the following: |
| a. | Principal's death; |
| b. | Revocation of the Power of Attorney of principal; |
| c. | The arrival of any date stated in the Power of Attorney, which states the termination of the Power of Attorney, if any; or |
| d. | No additional action is required under the Power of Attorney. |
| 7. | If you are the spouse of the principal, the Power of Attorney terminates upon legal separation or dissolution of the marriage. |
| 8. | You may be held responsible and liable for any intentional actions which violate or abuse your authority under this Power of Attorney as provided by the state and federal laws governing this Power of Attorney. |
| 9. | You have the right to seek legal advice if you do not understand your duties as Agent or any provisions in the Power of Attorney. |
You may not transfer the principal's property to yourself without full and adequate consideration or accept a gift of the principal's property unless this Power of Attorney specifically authorizes you to transfer property to yourself or accept a gift of the principal's property. If you transfer the principal's property to yourself without specific authorization in the Power of Attorney, you may be prosecuted for fraud and/or embezzlement. If the principal is 65 years of age or older at the time that the property is transferred to you without authority, you may also be prosecuted for elder abuse. In addition to criminal prosecution, you may be sued in civil court.
I have read the foregoing notice and I understand the legal and fiduciary duties that I assume by acting or agreeing to act as the Agent (attorney-in-fact) under the terms of this Power of Attorney.
Date:
Signed:
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Name of First Co-Digital Agent:
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General Special Durable
The Power of Attorney must be registered in the office of the register of deeds in order for it to be effective after the principal becomes incompetent. Until then, registration is unnecessary.
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It's fast and easy to give or get the support you need using a free Connecticut Power of Attorney template from Rocket Lawyer:
This solution is, in most cases, much less expensive than working with a traditional lawyer. If needed, you may prepare this PoA on behalf of an elderly parent, a spouse, or another relative, and then help that person sign after you've drafted it. Keep in mind that for this document to be legally valid, the principal must be a mentally competent adult when they sign. If the principal has already been declared incompetent, a court-appointed conservatorship might be required. When dealing with this situation, it is best to connect with a lawyer .
Anyone who is over 18 should have a Power of Attorney. Although it may be difficult to acknowledge, there might come a time when you are no longer able to make your own decisions. There may also be moments when you are merely unavailable. Typical circumstances where power of attorney would be helpful include:
Whether your Connecticut Power of Attorney is being created in response to an unexpected emergency or as part of a long-term plan, witnesses and/or notarization are highly encouraged as a best practice for protecting your agent if someone disputes their privileges and authority.
There are multiple ways to categorize Power of Attorney documents. They are mainly dependent on what powers are given, when they will come into effect, and how long they will remain valid. Often, you'll see them separated into these four groups:
When producing your free Connecticut Power of Attorney with Rocket Lawyer, you can elect to have the agent's power start immediately, on a desired day, or only when you are no longer capable. Your Power of Attorney can end on a particular date or upon your death.
Connecticut Power of Attorney forms are usually simple to make, but you or your agent might still need advice. Hiring a lawyer to proofread your Connecticut Power of Attorney could be costly. An easier and more cost-effective alternative is through the Rocket Lawyer On Call® network. With a Premium membership, you can have your documents examined by an attorney with relevant experience. You can rest assured that Rocket Lawyer is here for you.
The fees associated with hiring your average attorney to draft a Power of Attorney might add up to between two hundred and five hundred dollars, based on your location. Unlike most other Power of Attorney template websites that you may come across elsewhere, Rocket Lawyer offers Premium members up to a 40% discount when hiring a lawyer, so an attorney can take action on your behalf if you ever require help.
Upon finishing your customized document using Rocket Lawyer, you'll be able to view it on any device, anytime. You also can engage with your document in one or all of these ways: making edits, printing it out, and/or signing it. Alongside your Power of Attorney, there is a series of recommended actions to take once your document is completed. You will need to give a copy of the fully signed document to your agent(s), financial institutions, and other impacted parties.
The requirements will vary by state; however, in Connecticut, your Power of Attorney must be acknowledged by a notary public and signed by two witnesses. If your agent will manage real estate transactions, the Power of Attorney will need to be acknowledged by a notary public and recorded or filed with the county. Finally, as a general principle, witnesses will need to not be under the age of 18, and no witness should also be named as your PoA agent.
See Connecticut Power of Attorney law: Chapter 15c
