POWER OF ATTORNEY

THIS POWER OF ATTORNEY is made as of [DATE], by [DONOR NAME] ("Donor").

1. APPOINTMENT

I, [DONOR FULL NAME], of [ADDRESS], being of sound mind, appoint:

• Name: [ATTORNEY NAME]
• Address: [ADDRESS]
• Phone: [PHONE]

as my true and lawful attorney (the "Attorney") to act on my behalf as set out in this document.

2. SCOPE OF AUTHORITY

[SELECT ONE OR BOTH]

[ ] GENERAL POWER OF ATTORNEY

My Attorney may act on my behalf in all matters, including but not limited to:

• Financial and banking transactions
• Real property transactions (buy, sell, mortgage)
• Personal property transactions
• Business operations
• Legal proceedings (commence, defend, settle)
• Tax matters
• Investment decisions
• Employment matters
• Government benefits
• [OTHER MATTERS]

[ ] LIMITED/SPECIFIC POWER OF ATTORNEY

My Attorney's authority is limited to:

• [DESCRIBE SPECIFIC MATTER(S)]
• [E.G., SELL PROPERTY AT ADDRESS / MANAGE BANK ACCOUNT #]

3. SPECIFIC POWERS

My Attorney may, without limitation:

1. Sign documents on my behalf.
2. Access and manage my bank accounts.
3. Buy, sell, or manage real and personal property.
4. Enter into contracts.
5. [OTHER SPECIFIC POWERS]

4. EFFECTIVE DATE

• [ ] This Power of Attorney is effective immediately upon execution.
• [ ] This Power of Attorney becomes effective only if I become incapacitated (springing POA).
  • Incapacity determined by: [MEDICAL DOCTOR / COURT / WRITTEN ASSESSMENT]

5. DURATION

• This Power of Attorney remains in effect [INDEFINITELY / UNTIL DATE / UNTIL REVOKED].
• [IF APPLICABLE: It survives my incapacity.]
• [IF APPLICABLE: It does NOT survive my incapacity — non-enduring.]

6. RESTRICTIONS

My Attorney may NOT:

• [MAKE OR CHANGE MY WILL]
• [GIVE GIFTS TO THEMSELVES OR OTHERS — UNLESS SPECIFIED BELOW]
• [OTHER RESTRICTIONS]

7. COMPENSATION

• [ ] No compensation.
• [ ] Reimbursement of expenses only.
• [ ] Compensation at $[RATE].

8. SUBSTITUTE ATTORNEY

If my Attorney is unable or unwilling to act, I appoint:

• Substitute Attorney: [NAME]
• Address: [ADDRESS]

9. ACCOUNTING

• My Attorney shall keep accurate records of all transactions.
• [IF APPLICABLE: Shall provide accounts to: NAME at FREQUENCY]

10. REVOCATION

• I may revoke this Power of Attorney at any time, in writing, while I have capacity.
• Revocation must be delivered to the Attorney and all relevant third parties.

11. GOVERNING LAW

• This Power of Attorney is governed by the laws of [JURISDICTION].
• It is executed in accordance with [RELEVANT LEGISLATION].

Donor: _______________________ Date: __________

Attorney: _______________________ Date: __________

Witness 1: _______________________ Date: __________

Witness 2: _______________________ Date: __________

Notary Public: _______________________ Date: __________

NOTE: Requirements for witnesses and notarization vary by jurisdiction. Some jurisdictions require specific statutory forms. Consult local legislation for formal requirements.