State of Georgia
County of
STATUTORY FORM POWER OF ATTORNEY
IMPORTANT INFORMATION
This power of attorney authorizes another person (your agent) to make decisions
concerning your property for you (the principal). Your agent will be able to make decisions and
act with respect to your property (including your money) whether or not you are able to act for
yourself. The meaning of authority over subjects listed on this form is explained in O.C.G.A.
Chapter 6B of Title 10.
This power of attorney does not authorize the agent to make health care decisions for you.
You should select someone you trust to serve as your agent. Unless you specify otherwise,
generally the agent’s authority will continue until you die or revoke the power of attorney or the
agent resigns or is unable to act for you. If you revoke the power of attorney, you must
communicate your revocation by notice to the agent in writing by certified mail and file such notice
with the clerk of superior court in your county of domicile.
Your agent is not entitled to any compensation unless you state otherwise in the Special
Instructions. Your agent shall be entitled to reimbursement of reasonable expenses incurred in
performing the acts required by you in your power of attorney.
This form provides for designation of one agent. If you wish to name more than one agent,
you may name a successor agent or name a coagent in the Special Instructions. Coagents will not
be required to act together unless you include that requirement in the Special Instructions.
If your agent is unable or unwilling to act for you, your power of attorney will end unless
you have named a successor agent. You may also name a second successor agent.
This power of attorney shall be durable unless you state otherwise in the Special
Instructions.
This power of attorney becomes effective immediately unless you state otherwise in the
Special Instructions.
This Durable Power of Attorney shall revoke all powers of attorney previously executed
by me, including any powers of attorney previously executed by me for a specific or limited
purpose. It shall revoke any power executed as part of a contract signed by me or for the
management of any bank or securities account.
If you have questions about the power of attorney or the authority you are granting to your agent,
you should seek legal advice before signing this form.