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Durable Power of Attorney Form

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UTAH 75-5 DURABLE POWER OF ATTORNEY FORM

I. NOTICE - This legal document grants you (Hereinafter referred to as the “Principal”) the right to transfer unlimited financial powers to someone else (Hereinafter referred to as the “Attorney-in-Fact”), unlimited financial powers are described as: all financial decision making power legal under law. The Principal’s transfer of financial powers to the Attorney-in-Fact are granted upon authorization of this agreement, and stay in effect in the event of incapacitation by the Principal (incapacitation is described in Paragraph II). This agreement does not authorize the Attorney-in-Fact to make medical decisions for the Principal. The Principal continues to retain every right to all their financial decision making power and may revoke this Durable Power of Attorney Form at anytime. The Principal may include restrictions or requests pertaining to the financial decision making power of the Attorney-in-Fact. It is the intent of the Attorney-in-Fact to act in the Principal’s wishes put forth, or, to make financial decisions that fit the Principal’s best interest. All parties authorizing this agreement must be at least 18 years of age and acting under no false pressures or outside influences. Upon authorization of this Durable Power of Attorney Form, it will revoke any previously valid Durable Power of Attorney Form.

II. INCAPACITATION – The powers granted to the Attorney-in-Fact by the Principal in this Durable Power of Attorney Form stay in effect upon incapacitation by the Principal, incapacitation is describes as: A medical physician stating verbally or in writing that the Principal can no longer make decisions for them self.

III. REVOCATION - The Principal has the right to revoke this Durable Power of Attorney Form at anytime. Any revocation will be effective if the Principal either:

A. Authorizes a new Durable Power of Attorney Form.

B. Authorizes a Power of Attorney Revocation Form.

IV. WITNESS & NOTARY - This document is not valid as a Durable Power of Attorney unless it is acknowledged before a notary public or is signed by at least two adult witnesses who are present when the Principal signs or acknowledges the Principal’s signature. It is recommended to have this Durable Power of Attorney Form notarized.

V. PRINCIPAL - I, , residing at

City of , State of , appoint the following as my Attorney-in-Fact, whom I trust with any and all my financial decision making power immediately upon the authorization of this form, and in the event that I should become incapacitated:

VI. ATTORNEY-IN-FACT - , residing at

City of , State of grant the Attorney-in-Fact the legal authority to act on my behalf for any power legal under law in regard to my financial decisions under the State of .

VII. SUCCESSOR ATTORNEY-IN-FACT (Optional) – If the Attorney-in-Fact named above cannot or is unwilling to serve, then I appoint , residing at

City of , State of grant the Attorney-in-Fact the legal authority to act on my behalf for any power legal under law in regard to my financial decisions under the State of .

VIII. TERMS & CONDITIONS - Upon authorization by all parties, the Attorney-in-Fact accepts their designation to act in the Principal’s best interests for all financial decisions legal under law.

TO GRANT ONE OR MORE, BUT FEWER THAN ALL, OF THE FOLLOWING POWERS, INITIAL THE LINE IN FRONT OF EACH POWER YOU ARE GRANTING. TO WITHHOLD A POWER, DO NOT INITIAL THE LINE IN FRONT OF IT. YOU MAY, BUT NEED NOT, CROSS OUT EACH POWER WITHHELD.

Note: If you initial Item A or Item B, which follow, a notarized signature will be required on behalf of the Principal.

(A) Real property transactions. To lease, sell, mortgage, purchase, exchange, and acquire...

(B) Tangible personal property transactions. To lease, sell, mortgage, purchase, exchange, and acquire...

(C) Stock and bond transactions. To purchase, sell, exchange, surrender, assign, redeem, vote...

(D) Commodity and option transactions. To organize or continue and conduct any business...

(E) Banking and other financial institution transactions. To make, receive, sign, endorse...

(F) Business operating transactions. To conduct, engage in, and otherwise transact...

(G) Insurance and annuity transactions. To exercise or perform any act, power, duty...

(H) Estate, trust, and other beneficiary transactions. To accept, receipt for, exercise...

(I) Claims and litigation. To commence, prosecute, discontinue, or defend all actions...

(J) Personal and family maintenance. To hire accountants, attorneys at law, consultants...

(K) Benefits from Social Security, Medicare, Medicaid, or other governmental programs...

(L) Retirement plan transactions. To contribute to, withdraw from and deposit funds...

(M) Tax matters. To prepare, to make elections, to execute and to file all tax...

IX. THIRD PARTIES – I, the Principal, agree that any third party receiving a copy via physical copy, email, or fax that I, the Principal, will indemnify and hold harmless any and all claims that may be put forth in reference to this Durable Power of Attorney Form.

X. COMPENSATION – The Attorney-in-Fact agrees not to be compensated for acting in the presence of the Principal. The Attorney-in-Fact may be, but not entitled to, reimbursement for all: food, travel, and lodging expenses for acting in the presence of the Principal.

XI. DISCLOSURE - I intend for my attorney-in-fact under this Power of Attorney to be treated, as I would be with respect to my rights regarding the use and disclosure of my individually identifiable health information or other medical records. This release authority applies to any information governed by the Health Insurance Portability and Accountability Act of 1996 (aka HIPAA), 42 USC 1320d and 45 CFR 160-164

XII. PRINCIPAL’S SIGNATURE - I, , the Principal, sign my name to this power of attorney this day of and, being first duly sworn, do declare to the undersigned authority that I sign and execute this instrument as my power of attorney and that I sign it willingly, or willingly direct another to sign for me, that I execute it as my free and voluntary act for the purposes expressed in the power of attorney and that I am eighteen years of age or older, of sound mind and under no constraint or undue influence.

Signature of Principal

XIII. ATTORNEY-IN-FACT’S SIGNATURE - I, have read the attached power of attorney and am the person identified as the attorney-in-fact for the principal. I hereby acknowledge and accept my appointment as Attorney-in-Fact and that when I act as agent I shall exercise the powers for the benefit of the principal; I shall keep the assets of the principal separate from my assets; I shall exercise reasonable caution and prudence; and I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal.

Signature of Attorney-in-Fact

Date

XIV. SUCCESSOR ATTORNEY-IN-FACT’S SIGNATURE (Optional) - I, have read the attached power of attorney and am the person identified as the successor attorney-in-fact for the principal. I hereby acknowledge that I accept my appointment as Successor Attorney-in-Fact and that, in the absence of a specific provision to the contrary in the power of attorney, when I act as agent I shall exercise the powers for the benefit of the principal; I shall keep the assets of the principal separate from my assets; I shall exercise reasonable caution and prudence; and I shall keep a full and accurate record of all actions, receipts, and disbursements on behalf of the principal.

Signature of Successor Attorney-in-Fact

Date

Notary Acknowledgement (Must be completed by Notary)

State of County of Subscribed, Sworn and acknowledged before me by , the Principal, and subscribed and sworn to before me by , witness, this day of .

Notary Signature

Notary Public

In and for the County of

State of

My commission expires: Seal

Acknowledgement and Acceptance of Appointment as Attorney-in-Fact

I, have read the attached power of attorney and am the person identified as the attorney-in-fact for the principal. I hereby acknowledge that accept my appointment as Attorney-in-Fact and that when I act as agent I shall exercise the powers for the benefit of the principal; I shall keep the assets of the principal separate from my assets; I shall exercise reasonable caution and prudence; and I shall keep a full and accurate of all actions, receipts and disbursements on behalf of the principal.

Signature of Attorney-in-Fact

Date

Acceptance of Appointment as successor Attorney-in-Fact

I, have read the attached power of attorney and am the person identified as the successor attorney-in-fact for the principal. I hereby acknowledge that I accept my appointment as Successor Attorney-in-Fact and that, in the absence of a specific provision to the contrary in the power of attorney, when I act as agent I shall exercise the powers for the benefit of the principal; I shall keep the assets of the principal separate from my assets; I shall exercise reasonable caution and prudence; and I shall keep a full and accurate record of all actions, receipts, and disbursements on behalf of the principal.

Signature of Successor Attorney-in-Fact

Date

Witness Attestation

I, , the first witness, and I the second witness, sign my name to the foregoing power of attorney being first duly sworn and do not declare to the undersigned authority that the principal signs and executed this instrument as him or her, and that I, in the presence and hearing of the principal, sign this power of attorney as witness to the principal’s signing and that to the best of my knowledge the principal is eighteen years of age or older, of sound mind and under no constraint or undue influence.

Signature of First Witness

Signature of Second Witness

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What the Durable Power of Attorney Form Is and When It Applies

A Durable Power of Attorney Form is a legal document where a principal appoints an agent (attorney-in-fact) to manage financial, legal, or health-related matters on the principal’s behalf even after the principal becomes incapacitated. Durability language keeps the POA effective despite incapacity; without it the authority typically ends at incapacity. States use different form formats and execution rules, but the core purpose is consistent: allow a trusted agent to act for the principal under defined powers, effective date, and any specified limitations.

Why a Durable Power of Attorney Matters

A properly executed durable POA prevents guardianship proceedings, enables timely bill payment and asset management, and documents the principal’s choice of decision-maker. It clarifies authority, reduces court intervention, and preserves continuity for personal, financial, and healthcare matters when the principal cannot act for themselves.

Why a Durable Power of Attorney Matters

Who Typically Uses a Durable Power of Attorney

Individuals planning for incapacity, caregivers, and professional fiduciaries commonly prepare durable POAs to delegate authority in advance.

  • Elderly individuals needing financial continuity for bill paying and asset oversight.
  • Adults with progressive illness or disability requiring prospective management authority.
  • Families and caregivers coordinating healthcare decisions and benefit access.

A durable POA is useful at any adult life stage; review and update it after major life events such as marriage, divorce, or relocation.

Step-by-Step: How to Complete the Form

Follow these sequential steps to prepare an enforceable durable POA. Confirm state execution requirements before signing.

  • 01
    1. Gather IDs: Collect government IDs for principal and agent before filling fields.
  • 02
    2. Complete Fields: Enter names, addresses, effective date, and enumerated powers.
  • 03
    3. Select Notarization: Choose in-person or RON per state requirements and proofing rules.
  • 04
    4. Execute: Sign and notarize with required witnesses; retain original and distribute copies.

How Execution and Use Typically Work

This sequence shows how a durable POA moves from drafting to practical use by third parties such as banks or healthcare providers.

  • Draft: Draft powers and effective triggers clearly in plain language.
  • Execute: Sign before a notary and any required witnesses per state law.
  • Distribute: Provide originals or certified copies to banks, lawyers, and caregivers.
  • Use: Agent presents identification and the POA when acting for the principal.

Setting Up a Digital Completion Workflow

Configure a secure e-sign and witness flow to meet legal requirements and reduce processing time.

Field Configuration
Principal Signature Require signer authentication and date field, set to required.
Notary Block Include notary acknowledgement and space for official stamp or RON certificate.
Witness Fields Add witness name and signature fields where the state mandates witnesses.
Document Retention Enable audit trail and secure storage for the mandated retention period.

Technical Requirements for eSigning and eNotarization

Use platforms that support audit trails, identity proofing, and the file formats your recipients accept.

  • File Formats: PDF, DOCX accepted by most institutions.
  • Integrations: Connect with cloud storage and CRM systems.
  • Authentication: Support SMS, KBA, or advanced signer verification.

Timing Considerations and Typical Deadlines

Plan execution around known time-sensitive events and statutory triggers to ensure the POA takes effect when intended.

Effective Date Entry:

Specify MM/DD/YYYY to avoid ambiguity about when authority begins.

Notary Scheduling:

Schedule notary or RON before any capacity change is anticipated.

Agent Acceptance:

Have the agent sign and acknowledge before acting under the POA.

Recordkeeping:

Provide certified copies to institutions promptly after execution.

Review Cycle:

Revisit and update POA after major life events such as marriage or relocation.

Key Sections to Include in a Professional Durable POA

A comprehensive durable POA clearly identifies parties, enumerates powers, and states execution and limitation clauses to reduce ambiguity and improve acceptance by third parties.

Identification

Principal and agent full legal names, addresses, and contact details to establish identity and reduce institution-level rejections.

Durability Clause

Explicit language stating the POA remains effective upon the principal’s incapacity to avoid interpretive disputes.

Scope of Powers

Detailed list of authorities (bank accounts, real property, tax matters) and any exclusions to limit unintended authority.

Effective Trigger

State whether authority is immediate or 'springing' upon certified incapacity and specify objective standards if springing.

Successor Agents

Names and order of alternates to ensure continuity if the primary agent cannot serve.

Execution Formalities

Notary acknowledgment, witness signatures, and any state-specific attestations required for enforceability.

Essential Data Elements to Include

Principal Name: Full legal name
Agent Name: Full legal name
Agent Contact: Street address
Effective Date: MM/DD/YYYY
Powers Summary: Banking, real estate, taxes
Notary Block: Notary signature line

Risks and Legal Consequences of Errors

Invalid Execution: Document may be void
Third-Party Refusal: Banks may decline acceptance
Agent Liability: Fiduciary breach exposure
Fraud Risk: Unauthorized transactions possible
Statute Conflicts: State law may override clauses
Outdated Form: May lack current legal language

Common Preparation Mistakes to Avoid

  • Failing to include an explicit durability clause so the POA terminates upon incapacity rather than remaining effective.
  • Leaving the scope of powers vague; broad language can lead to institutional refusals or litigation over agent authority.
  • Using inconsistent names or addresses across documents, which can trigger identity verification failures at banks or title companies.
  • Skipping notarization or required witness steps for your state, resulting in nonenforceability and possible court intervention.

Comparing eSignature Pricing and Key Capabilities

Price and feature trade-offs matter when choosing an eSignature provider for legal documents like durable POAs; signNow is shown first for comparison.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial Yes, 7-day trial Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies by plan Varies by plan Varies by plan

Frequently Asked Questions About Durable Power of Attorney Forms

Common questions address validity, notarization, revocation, e-signature acceptance, and storage. Answers note typical legal and practical steps to reduce enforcement risk.


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