Massachusetts General Power of Attorney
This General Power of Attorney is a legal document wherein the person signing (hereafter referred to as the "Principal") grants authority to another person (hereafter referred to as the "Agent" or "Attorney-in-Fact") to act on the Principal's behalf in various matters to the extent allowed by the law. The powers herein are granted in accordance with the Massachusetts Uniform Probate Code, M.G.L. Chap. 190B, §5-501.
Principal Information:
- Full Name: ________________
- Address: ________________
- City, State, ZIP: ________________
- Phone Number: ________________
Agent Information:
- Full Name: ________________
- Address: ________________
- City, State, ZIP: ________________
- Phone Number: ________________
By this document, the Principal authorizes the Agent to act on the Principal's behalf and interest in any lawful way with respect to the following initialed subjects:
- __ Real estate transactions
- __ Banking and other financial institution transactions
- __ Personal and family maintenance
- __ Taxes
- __ Insurance
- __ Benefits from Social Security, Medicare, Medicaid, or other governmental programs, or military service
- __ Healthcare
- __ Estate, trust, and other beneficiary transactions
- __ Claims and litigation
- __ Personal and family matters
This General Power of Attorney is effective immediately and will continue until it is revoked by the Principal or terminated by the Principal's death or incapacity, unless a specific termination date is otherwise mentioned herein.
Termination Date (if applicable): ________________
Acknowledgement by Principal:
I, ________________ (Principal's Full Name), understand that this General Power of Attorney grants broad powers to the Agent, and I have read and understood all its terms. I sign this document willingly and under no duress or undue influence.
Date: ________________
Principal's Signature: ________________
Principal's Printed Name: ________________
Acknowledgement by Agent:
I, ________________ (Agent's Full Name), accept the appointment as Agent and acknowledge the obligations and duties as imposed by law, and I agree to act only within the scope of authority granted to me by this General Power of Attorney.
Date: ________________
Agent's Signature: ________________
Agent's Printed Name: ________________
Witness Acknowledgement:
This document was signed by the Principal in the presence of the undersigned witnesses, who in turn, at the Principal's request and in the Principal's presence, and in the presence of each other, have hereunto subscribed our names as witnesses. The Principal appears to be of sound mind and under no duress or undue influence.
Witness 1 Signature: ________________
Witness 1 Printed Name: ________________
Witness 2 Signature: ________________
Witness 2 Printed Name: ________________
Notarization (if required):
This document was acknowledged before me on (date) ________________ by ________________ (Principal's Full Name).
Notary Public's Signature: ________________
Notary Public's Printed Name: ________________
My commission expires: ________________
