Power of Attorney Form - Ohio

Power of Attorney
[This form is from Ohio Revised Code section 1337.18. The powers granted by this document
are broad and sweeping. They are explained in Ohio Revised Code section 1337.20. If you
have any questions about these powers, obtain legal advice. You can use any different form of
power of attorney you may desire. This document does not authorize anyone to make health-
care decisions for you. You can revoke this power of attorney at any time.]
Principal (Person Granting the Power):
Name: ______________________________________________________________________
Address: ____________________________________________________________________
Telephone: ______________ ____________________________________________________
1. Notice to Principal.
As the principal, you are using this document to give authority to another person, known
as your agent or attorney-in-fact, to make decisions regarding your money and property. Your
agent will have the powers that you indicate below to make decisions about your money and
property without advance notice to you or approval by you.
Unless expressly authorized in the power of attorney, a power of attorney does not grant
authority to an agent to do any of the following:
(a) Create, modify, or revoke a trust;
(b) Fund with your property a trust not created by you or a person authorized to create
a trust for your benefit;
(c) Make or revoke a gift of your property in trust or otherwise;
(d) Create or change rights of survivorship in your property or in property in which you
may have an interest;
(e) Designate or change the designation of a beneficiary to receive any property,
benefit, or contractual right on your death, such as insurance benefits and
retirement benefits;
(f) Create in the agent or a person to whom the agent owes a legal duty of support the
right to receive property, a benefit, or a contractual right in which you have an
interest;
(g) Delegate the powers granted under the power of attorney to another person.
(h) Elect or change a retirement allowance plan of payment on your behalf under Ohio
Revised Code Chapter 145., 742., 3305., 3307., 3309., or 5505., other than a joint
and survivor annuity leaving one-half to your spouse if you are married, a single life
annuity if you are single, or any plan that includes a partial lump sum option; except
that no express authority is necessary to elect a plan that meets the minimum
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