Free Kentucky Power of Attorney Form


Sample Kentucky Power of Attorney

POWER OF ATTORNEY


THIS Power of Attorney
is given by me, _______________ (the “Principal”), presently of _______________, _______________, in the Commonwealth of Kentucky, on this _________ day of _____________, 20___.

    Previous Power of Attorney

  1. I REVOKE any previous Power of Attorney granted by me.
  2. Attorney-in-fact

  3. I APPOINT __________________, of ___________________________, __________________, Kentucky, to act as my Attorney-in-fact.
  4. Governing Law

  5. This document will be governed by the laws of the Commonwealth of Kentucky. Further, my Attorney-in-fact is directed to act in accordance with the laws of the Commonwealth of Kentucky at any time he or she may be acting on my behalf.
  6. Liability of Attorney-in-fact

  7. My Attorney-in-fact will not be liable to me, my estate, my heirs, successors or assigns for any action taken or not taken under this document, except for willful misconduct or gross negligence.
  8. Effective Date

  9. This Power of Attorney will start immediately and will cease to be in effect upon a finding of my mental incapacity or mental infirmity which may occur after my execution of this Power of Attorney.
  10. Powers of Attorney-in-fact

  11. My Attorney-in-fact has authority to do anything on my behalf that I may lawfully do by an Attorney-in-fact (the “General Power”).
  12. Specific Powers

  13. Without restricting its generality in any way, the following power(s) are specifically included within the foregoing General Power:

    Initial the line at each authority you grant

      X_____Real Estate Transactions

    1. To deal with any interest I may have in real property and sign all documents on my behalf concerning my interest, including, but not limited to, real property I may subsequently acquire or receive. These powers include, but are not limited to, the ability to:

       

      i.

      Purchase, sell, exchange, accept as gift, place as security on loans, convey with or without covenants, rent, collect rent, sue for and receive rents, eject and remove tenants or other persons, to pay or contest taxes or assessments, control any legal claim in favor of or against me, partition or consent to partitioning, mortgage, charge, lease, surrender, manage or otherwise deal with real estate and any interest therein; and

       

      ii.

      Execute and deliver deeds, transfers, mortgages, charges, leases, assignments, surrenders, releases and other instruments required for any such purpose.

    2. X_____Maintain Property and Make Investments

    3. To retain any assets owned by me at the date this Ordinary Power of Attorney becomes effective, and the power to reinvest those assets in similar investments. In addition, my Attorney-in-fact may invest my assets in any new investments, of his or her choosing, regardless of whether or not they are authorized by any applicable legislation.

    4. X_____Banking Transactions

    5. To do any act that I can do through an Attorney-in-fact with a bank or other financial institution. This power includes, but is not limited to, the power to:

       

      i.

      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;

       

      ii.

      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;

       

      iii.

      Borrow money from any banking or financial institution if deemed necessary by my Attorney-in-fact, and to manage all aspects of the loan process, including the placement of security and the negotiation of terms;

       

      iv.

      Perform any act necessary to deposit, negotiate, sell or transfer any note, security, or draft of the United States of America, including U.S. Treasury Securities;

       

      v.

      Have access to any safe deposit box that I might own, including its contents; and

       

      vi.

      Create and deliver any financial statements necessary to or from any bank or financial institution.

    6. X_____Business Operating Transactions

    7. To take any action my Attorney-in-fact deems necessary with any business that I may own or have an interest in by doing any act which can be done through an Attorney-in-fact. This power includes, but is not limited to, the power to execute, seal and deliver any instrument; participate in any legal business of any kind; execute partnership agreements and amendments; to incorporate, reorganize, consolidate, merge, sell, or dissolve any business; to elect or employ officers, directors and agents; and to exercise voting rights with respect to any stock I may own, either in person or by proxy.

    8. X_____Insurance Transactions

    9. To do any act that I can do through an Attorney-in-fact with any insurance policy. This power includes, but is not limited to, the power to pay premiums, start, modify or terminate policies, manage all cash payouts, borrow from insurers and third parties using insurance policies as collateral, and to change the beneficiaries on any insurance policies on my life. Unless my Attorney-in-fact was already a beneficiary of any policy before the signing of this document, my Attorney-in-fact cannot name himself or herself as a beneficiary of such policy.

    10. X_____Claims and Litigation Matters

    11. To institute, maintain, defend, compromise, arbitrate or otherwise dispose of, any and all actions, suits, attachments or other legal proceedings for or against me. This power includes, but is not limited to, the power to: appear on my behalf, and the power to settle any claim against me in whichever forum or manner my Attorney-in-fact deems prudent, and to receive or pay any resulting settlement.

    12. X_____Tax Matters

    13. To act for me in all matters that affect my local, state and federal taxes and to prepare, sign, and file documents with any governmental body or agency, including, but not limited to, authority to:

       

      i.

      Prepare, sign and file income and other tax returns with federal, state, local and other governmental bodies, and to receive any refund checks; and

       

      ii.

      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.

    14. X_____Government Benefits

    15. To act on my behalf in all matters that affect my right to allowances, compensation and reimbursements properly payable to me by the Government of the United States or any agency or department thereof. This power includes, but is not limited to, the power to prepare, file, claim, defend or settle any claim on my behalf and to receive and manage, as my Attorney-in-fact sees fit, any proceeds of any claim.

    16. X_____Retirement Benefit Transactions

    17. To act for me and represent my interests in all matters affecting any retirement savings or pension plans I may have. This power includes, but is not limited to, the power to continue contributions, change contribution amounts, change investment strategies and options, move assets to other plans, receive and manage payouts, and add or change existing beneficiaries. My Attorney-in-fact cannot add himself or herself as a beneficiary unless he or she is already a designated beneficiary as of the signing of this document.

    18. X_____Family Care

    19. To make whatever expenditures are required for the maintenance, education, benefit, medical care and general advancement of me, my spouse and dependent children, and other persons that I have chosen or which I am legally required to support, any of which may include my Attorney-in-fact. This power includes, but is not limited to, the power to pay for housing, clothing, food, travel and other living costs.

    20. X_____Chattel and Goods Transactions

    21. To purchase, sell or otherwise deal with any type of personal property I may currently or in the future have an interest in. This includes, but is not limited to, the power to purchase, sell, exchange, accept as gift, place as security on loans, rent, lease, to pay or contest taxes or assessments, mortgage or pledge.

    22. X_____Estate Transactions

    23. To do any act that I can do through an Attorney-in-fact with regard to all matters that affect any trust, probate estate, conservatorship, or other fund from which I may receive payment as a beneficiary. This power includes the power to 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 Attorney-in-fact cannot disclaim assets to which I would be entitled, if the result is that the disclaimed assets pass directly or indirectly to my Attorney-in-fact or my Attorney-in-fact’s estate.

    24. X_____Living Trust Transactions

    25. 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. This property can include real property, stocks, bonds, accounts, insurance policies or other property.

    26. X_____Gift Transactions

    27. To make gifts to my spouse, children, grandchildren, great grandchildren, and other family members on special occasions, including birthdays and seasonal holidays, including cash gifts, and to such other persons 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), in such amounts as my Attorney-in-fact may decide in his or her absolute discretion, having regard to all of the circumstances, including the gifts I made while I was capable of managing my own estate, the size of my estate and my income requirements.

    28. X_____Charity Transactions

    29. To continue to make gifts to 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), in such amounts as my Attorney-in-fact may decide in his or her absolute discretion, having regard to all of the circumstances, including the gifts I made while I was capable of managing my own estate, the size of my estate and my income requirements.

    30. X_____Employ Required Professionals

    31. To appoint and employ any agents, servants, companions, or other persons, including nurses and other health care professionals for my care and the care of my spouse and dependent children, and accountants, attorneys, clerks, workers and others for the management, preservation and protection of my property and estate, at such compensation and for such length of time as my Attorney-in-fact considers advisable.

      X_____Manage Real Estate

    32. To manage the property owned by me, or in which I have an interest, located at _____________________________________________________, and municipally known as _____________________________________________________. This power includes, but is not limited to, the power to receive rents, make repairs, pay expenses including the insuring of the property and generally to deal with my property as effectually as I myself could do; to take all lawful proceedings by way of action or otherwise, for recovery of rent in arrears, or for eviction of tenants; and to commence, carry on and defend all actions, suits and other proceedings touching my property or any part of it.

    33. X_____Manage Specific Financial Account

    34. To control my accounts with ____________________ Bank, located at _________________________________________, Account Number(s)__________________________________________. This power includes the authority to conduct any business with respect to any of my listed accounts, including, but not limited to, making deposits and withdrawals, negotiating or endorsing any cheques 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, and to perform any act necessary to deposit, negotiate, sell or transfer any note, security or draft.

  14. Attorney-in-fact Compensation

  15. My Attorney-in-fact will receive no compensation except for the reimbursement of all out of pocket expenses associated with the carrying out of my wishes.
  16. Co-owning of Assets and Mixing of Funds

  17. My Attorney-in-fact may not mix any funds owned by him or her in with my funds and all assets should remain separately owned if at all possible.
  18. Personal Gain from Managing My Affairs

  19. My Attorney-in-fact is not allowed to personally gain from any transaction he or she may complete on my behalf.
  20. Delegation of Authority

  21. My Attorney-in-fact may not delegate any authority granted under this document.
  22. Attorney-in-fact Restrictions

  23. This Power of Attorney is not subject to any conditions or restrictions other than those noted above.
  24. Notice to Third Parties

  25. Any third party who receives a valid copy of this Power of Attorney can rely on and act under it. A third party who relies on the reasonable representations of my Attorney-in-fact as to a matter relating to a power granted by this Power of Attorney will not incur any liability to the Principal or to the Principal’s heirs, assigns, or estate as a result of permitting the Attorney-in-fact to exercise the authority granted by this Power of Attorney up to the point of revocation of this Power of Attorney. Revocation of this Power of Attorney will not be effective as to a third party until the third party receives notice and has actual knowledge of the revocation.
  26. Severability

  27. If any part of any provision of this document is ruled invalid or unenforceable under applicable law, such part will be ineffective to the extent of such invalidity only, without in any way affecting the remaining parts of such provisions or the remaining provisions of this document.
  28. Acknowledgment

  29. I, _______________, being the Principal named in this Power of Attorney hereby acknowledge:
    1. I have read and understand the nature and effect of this Power of Attorney;
    2. I am of legal age in the State of Kentucky to grant a Power of Attorney; and
    3. I am voluntarily giving this Power of Attorney.

IN WITNESS WHEREOF
I hereunto set my hand and seal at the City of ________________ in the Commonwealth of Kentucky, this _________ day of _____________, 20___.

SIGNED, SEALED, AND DELIVERED

     

in the presence of:

     
       

Witness: ______________________ (Sign)

     

Witness Name: ______________________

     

Address: ___________________________

   

__________________________________

___________________________________

   

_______________ (Principal)

       

Witness: ______________________ (Sign)

     

Witness Name: ______________________

     

Address: ___________________________

     

___________________________________

   


WITNESS CERTIFICATE

I, _________________________, currently residing at __________________________, in the City of __________________, in the State of ____________________, hereby acknowledge that:

  1. I witnessed the signing of the Power of Attorney of _______________ dated this _________ day of _____________, 20___.
  2. I am an adult with capacity to witness the signing of the Power of Attorney and I am the subscribing witness thereto.
  3. In my opinion, _______________ had the capacity to understand the nature and effect of the Power of Attorney at the time the Power of Attorney was signed and the Principal signed it freely and voluntarily without any compulsion or influence from any person.
  4. I am not the Attorney-in-fact named in the Power of Attorney nor am I the Attorney-in-fact’s spouse or other family member.

_________________________

_________________________

(Signature of Witness)

(Date)


WITNESS CERTIFICATE

I, _________________________, currently residing at __________________________, in the City of __________________, in the State of ____________________, hereby acknowledge that:

  1. I witnessed the signing of the Power of Attorney of _______________ dated this _________ day of _____________, 20___.
  2. I am an adult with capacity to witness the signing of the Power of Attorney and I am the subscribing witness thereto.
  3. In my opinion, _______________ had the capacity to understand the nature and effect of the Power of Attorney at the time the Power of Attorney was signed and the Principal signed it freely and voluntarily without any compulsion or influence from any person.
  4. I am not the Attorney-in-fact named in the Power of Attorney nor am I the Attorney-in-fact’s spouse or other family member.

_________________________

_________________________

(Signature of Witness)

(Date)

Kentucky Power of Attorney Form

You don’t have to be a pessimist to prepare a living will or to ask your spouse or sibling to make the tough call of pulling out the plug when it comes down to it. Preparing these document, especially the one to be used in the event of illness, only means that you are prepared for what may come.

Despite being a tough decision to sign a document that entrusts someone else with authority over your affairs, it’s crucial. The document you prepare and sign to legalize someone as your decision-maker is a power of attorney or POA. A power of attorney refers to a legal instrument which you use to grant another party authority to act legally in your place when you cannot act. As the individual authorizing another, the state calls you the principal and the person who gets your authority is your agent or attorney-in-fact.

Even though third parties don’t have to oblige to the directives of the POA, they get legal protection should they choose to honor the POA. This is because the Kentucky laws regulate POAs.

While filling out your free Kentucky power of attorney form, you should understand that the powers contained in the document could be springing or non-springing. What this means is that the powers are executable only when their need springs up (say the principal is incapacitated and unable to make decisions) or they could be executable immediately the document is signed and notarized. The difference in execution times is what brings forth the springing and the non-springing powers of attorney respectively.

Also, note that your free power of attorney form in Kentucky could be ordinary, general, or durable. They could also be limited or special.

  • Powers of Attorney – Types

    • 1. Kentucky Durable Powers of Attorney Laws

In Kentucky, the durable POA refers to a legal document that you sign to assign someone else the power to make financial and healthcare decisions in your place. Basically, the agent uses the POA to communicate to third parties what you would have wanted. Since your wishes may not be what other people wish to deal with, you’ll need to choose a trustworthy person to be your agent.

Besides deciding whether the doctors pull the plugs or not, the agent could pay the bills in your place, invest your money, sell or rent your property, and even sue on your behalf, when you are incapacitated.

In the state of Kentucky under the revised statutes in chapter 31 and sections 621 to .643 of the Living Will directives Act, the following are the conditions and legal requirements for the execution of the DPOA.

The specific powers of the agent and allowed actions to prolong life

Under the statutes mentioned above, the agent has the authority to make the tough decision on health care if the principal is incapacitated. The decisions made by the agent are communicated in the same way as the principal would have. However, the agent cannot communicate their own wishes. This means that the agent, also, the principal’s surrogate should recommend actions to the doctor as per the wishes of the principal

  • Some of the directives communicated by the agent include withholding or refusing the use of artificial nutrition and hydration if the following happen:

    • If death looms and doctors expect it to happen within days

    • If the patient cannot eat manually

    • If the burden that comes with providing artificial hydration and nutrition outweighs expected benefits

    • The principal becomes unconscious permanently and if there exists an advanced directive authorizing withholding or the withdrawal of hydration and nutrition.

  • Legal Requirements that warrant the execution of the DPOA

    • If an adult of sound mind prepares it. Note that the agent (surrogate) cannot make any decisions if a doctor determines, in good faith, that the principal is in no position to make the decisions

    • The document should in written form, dated, and with the principal’s signature.

    • It should name one or even two adults as an agent. However, if the DPOA names two people as an agent, they have to agree to make unanimous decisions.

    • At least 2 adult witnesses should be signed with the principal present. Alternatively, it could be notarized.

Revocation of the DPOA

For revocation, you need a verbal statement communicating the principal’s intention to revoke the document, in the presence of an adult and one of the adults should be a healthcare provider

The destruction through defacing or burning of the DPOA revokes the document.

The revocation is immediate, and an oral revocation overrides previously written directives.

Interstate validity: as long as the directives from a different state complies (fully or partially) with the Kentucky laws, then it is executable

  • A doctor who isn’t willing to comply with the Kentucky laws should transfer the patient to willing doctor or facility. And, if a doctor acts in good faith, they will not be liable.

    • 2. Kentucky Limited POA Law

The limited powers of attorney are best put to use when a principal wishes to grant an agent specific powers. The powers granted enable the agent to take care of an affair when a principal is away or when they cannot complete the tasks because of incapacitation.

  • The powers are active unless the principal sends a revocation notice to the agent and third parties following the directives of the agent.

    • 3. Kentucky POA Affidavit Law

Covered in Section 384.020 of the POA and health care laws, this is a law governing the affidavit used by an agent to absence a death notification. The affidavit sets forth the fact that the agent didn’t know about the termination or revocation notice for the POA, death or absence of the principal at the time they acted.

The affidavit could be used as a recordable instrument if necessary and when authenticated for the record.

Looking to fill out your general or special POA today? Use our free power of attorney forms available online and accessible in all cities in the state of Kentucky including Louisville, Lexington, Bowling Green, Owensboro or Covington etc.

Sample

KY Power of Attorney

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