Sample Power of Attorney Statutory Short Form - New York

N.Y. Statutory Short Form Power of Attorney
Effective 09/12/2010
POWER OF ATTORNEY
NEW YORK STATUTORY SHORT FORM
(a) CAUTION TO THE PRINCIPAL:
Your Power of Attorney is an important document. As the “principal,” you give the person
whom you choose (your “agent”) authority to spend your money and sell or dispose of your
property during your lifetime without telling you. You do not lose your authority to act even
though you have given your agent similar authority.
When your agent exercises this authority, he or she must act according to any instructions you
have provided or, where there are no specific instructions, in your best interest. “Important
Information for the Agent” at the end of this docum ent describes your agent’s responsibilities.
Your agent can act on your behalf only after signing the Power of Attorney before a notary
public.
You can request information from your agent at any time. If you are revoking a prior Power of
Attorney, you should provide written notice of the revocation to your prior agent(s) and to any
third parties who may have acted upon it, including the financial institutions where your
accounts are located.
You can revoke or terminate your Power of Attorney at any time for any reason as long as you
are of sound mind. If you are no longer of sound mind, a court can remove an agent for acting
improperly.
Your agent cannot make health care decisions for you. You may execute a “Health Care Proxy”
to do this.
The law governing Powers of Attorney is contained in the New York General Obligations Law,
Article 5, Title 15. This law is available at a law library, or online through the New York State
Senate or Assembly websites, www.senate.state.ny.us or www.assem bly.state.ny.us.
If there is anything about this document that you do not understand, you should ask a lawyer of
your own choosing to explain it to you.
(b) DESIGNATION OF AGENT(S):
I, , hereby appoint:
[name and address of principal]
as my agent(s)
[name(s) and address(es) of agent(s)]
If you designate more than one agent above, they must act together unless you initial the
statement below.
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