Free Vermont Power of Attorney Form


Sample Vermont Power of Attorney

POWER OF ATTORNEY


THIS Power of Attorney
is given by me, _______________ (the “Principal”), presently of _______________, _______________, in the State of Vermont, 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 ___________________________, __________________, Vermont, to act as my Attorney-in-fact.
  4. Governing Law

  5. This document will be governed by the laws of the State of Vermont. Further, my Attorney-in-fact is directed to act in accordance with the laws of the State of Vermont 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 Vermont 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 State of Vermont, this _________ day of _____________, 20___.

SIGNED, SEALED, AND DELIVERED

     

in the presence of:

     
       

Witness: ______________________ (Sign)

     

Witness Name: ______________________

     

Address: ___________________________

   

__________________________________

___________________________________

   

_______________ (Principal)

       

Witness: ______________________ (Sign)

     

Witness Name: ______________________

     

Address: ___________________________

     

___________________________________

   


ACCEPTANCE BY AGENT

I, __________________ the undersigned agent (the Agent ), execute this Power of Attorney, and by such execution hereby affirm that I: (A) accept the appointment as Agent; (B) understand the duties under the power of attorney and under the law; (C) understand that I have a duty to act if expressly required to do so in the power of attorney consistent with 14 V.S.A. §3506(c); (D) understand that I am expected to use my special skills or expertise on behalf of the Principal, if so specified in the Power of Attorney; and (E) acknowledge the additional duties of the Agent set forth in 14 V.S.A. §3505.

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)


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)

Families end up locked in heated arguments, family conflicts arise, and just because one member of the family decided that they knew better than everyone else about what their ailing and unconscious relative would have wished for, the decisions made end up driving a wedge, splitting these families. And, if asked, all they say is that they wish they knew what the person, now hooked to machines or even dead, would have wanted. A sad reality, isn’t it?

Rather than put your family through the same agony as others go through, why not let your wishes known? While a living will work, a power of attorney, also known as a POA, is preferable when you wish to give a family member of your friend the right to make the tough calls when you cannot.

A legally binding document which you access after filling in a free power of attorney form in Vermont, a POA is a legal instrument that authorizes someone else to act as your agent (an executor of your affairs/ attorney-in-fact) when you cannot make the same tough calls. The document will not last forever, and the powers it bestows are expected to terminate in future when it expires according to its terms when the principal or the agent pass on.

What if you want your agent to control a specific area of your business? Does the law have provisions for this?

Well, yes. The laws in Vermont, like every other state, has instituted different types of POA documents. So, you cannot hand over power over your health and finances when the only thing you want is for your agent to give medical directives when you are incapacitated.

The law also protects you using types of POA called springing powers of attorney. What this means is that the powers of the POA are only executable when you are unconscious and unable to make any sound decisions or when a decision requires your presence, and you need someone to sign a check or transact when you are absent.

Also, you can terminate the powers of the POA whenever you want to.

  • This brings us to the types of POA you could sign and the ones you need to be aware of when signing the free Vermont power of attorney form.

    • 1. Vermont Durable Power of Attorney Laws

Even though your living will is a legally binding document that outlines your wishes, the durable POA (DPOA) is what you go for to grant your trusted person authority to act and to give directives as per your wishes. The person with the durable POA will decide whether you stay on life support for a few more hours or not. In Vermont, the durable POA could also extend to a patient’s wishes regarding what is to be done to them when they succumb – the agent decides how the body of a deceased is disposed of.

Creating a Durable POA in Vermont

The first step in creating your durable POA involved the choosing an agent. They should someone you trust to make decisions as per your wishes. Note that creation of Durable POA should be according to the laws and provisions of Tit. 14 §3451, et seq. of the Vermont Durable POA for Healthcare.

With an agent appointed, you need to put in writing the name of the agent and your wishes. In Vermont, it’s a requirement that the POA names the agent. And, the document needs to be signed with at least one witness present who should also sign the document. The agent also needs to sign the document.

Once these three parties sign it (principal, agent, and witness), the POA should be taken to the notary for signing in the presence of the notary. Since banks have notaries, you can sign it there.

Note that the agent’s signature mustn’t be notarized and the agent can sign the document in your (principal’s) absence.

When signing the POA, you choose the time, date or events that make the POA executable.

Special Powers of the POA

Withdrawing or consenting to treatment, care, services or procedures, and diagnosis, among others. However, the powers granted by the durable POA exclude consenting to admission to an institution or sterilization.

Revocation of the DPOA

  • It’s revoked by:

    • The principal notifying their healthcare provider or the agent their intentions of revoking the powers, in writing or verbally.

    • The execution of a subsequent DPOA

    • Divorce

Like other states, any doctor acting in good faith gets immunity from criminal, civil or professional liabilities. And, an unwilling physician should let the agent know and help them choose a physician who will honor the wishes of the principal.

  • Lastly, a DPOA from a different state is eligible in Vermont if it complies with the laws of Vermont.

    • 2. Vermont Limited POA Law

  • This refers to a legally binding document allowing a principal to grant their agent specific powers which are only executable if the agent is incapacitated or unable to act. It’s revocable at any time through the issuance of a revocation notice sent to the agent and third parties acting on the agent’s directives.

    • 3. Vermont POA for Childcare Law

A nonparent can make medical decisions to your child or sign them up for events in your place if you give them a signed and a notarized POA for childcare. It applies for a temporary period and the powers revocable at any time using a signed revocation form delivered to the non-parent in person.

You could also get a POA for stock transactions, sale of motor vehicle, real estate or bank account matters.

So, which POA do you need? See, you can get our free online power of attorney form from anywhere in Vermont including Burlington city.

Sample

VT Power of Attorney

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