New York Power of Attorney
This Power of Attorney is made in accordance with New York State law.
Principal Information:
- Full Name: ___________________________
- Address: ___________________________
- City, State, Zip Code: ___________________________
- Date of Birth: ___________________________
Agent Information:
- Full Name: ___________________________
- Address: ___________________________
- City, State, Zip Code: ___________________________
- Phone Number: ___________________________
Effective Date: This Power of Attorney shall become effective on the date signed, unless otherwise specified.
Grant of Authority: The Principal grants the Agent the authority to act on behalf of the Principal in the following matters:
- Real estate transactions
- Banking transactions
- Health care decisions
- Tax matters
- Legal matters
Special Instructions:
If there are any specific powers that should be excluded or any special instructions, please state them here: ___________________________
Signature of Principal: ___________________________
Date: ___________________________
Witness Information:
- Full Name: ___________________________
- Address: ___________________________
Signature of Witness: ___________________________
Date: ___________________________
Notary Acknowledgment:
State of New York, County of ____________________:
On this ____ day of __________, 20___, before me came ___________________________, to me known and known to me to be the individual described in and who executed the foregoing instrument.
_____________________________ (Notary Public)