Limited Power of Attorney - Kentucky

LIMITED POWER OF ATTORNEY — KENTUCKY

Before you use this: Identify the specific transaction, acts, property, amount limit, and end time before signing. This form is for a property transaction within KRS Chapter 457; a health-care decision, government-prescribed power, or dealer-assisted motor-vehicle title transfer may follow a different route. For land, attach its legal description and arrange any required recording.

1. Principal and agent

I, [PRINCIPAL FULL LEGAL NAME], of [ADDRESS], appoint [AGENT FULL LEGAL NAME], of [ADDRESS], as my agent solely for the transaction described below.

2. Limited grant

Specific transaction and counterparty: [DESCRIBE]

Acts the agent may perform and documents the agent may sign: [LIST EACH ACT AND DOCUMENT]

Property, account, or asset involved: [IDENTIFY; FOR LAND, ATTACH LEGAL DESCRIPTION]

Maximum payment, receipt, or commitment: $[AMOUNT / NONE]

Additional conditions: [DESCRIBE / NONE]

My agent may communicate with the named counterparty and obtain records only as reasonably needed to perform the listed acts. A blank act or property description grants no authority. This instrument grants no general authority over my other property or affairs.

3. Powers withheld

My agent may not create, amend, revoke, or terminate a trust; make a gift; create or change survivorship rights or beneficiary designations; delegate this authority; waive my right to a joint and survivor annuity; exercise my fiduciary powers; access the content of my electronic communications; transfer my property to the agent for the agent's own benefit; make health-care decisions; or execute or change a will. None of the exceptional powers in KRS 457.245(1) is granted.

4. Effect, durability, and end

This power takes effect when executed. It is durable and is not terminated by my later incapacity.

My agent's authority ends when the stated purpose is accomplished and, in any event, no later than [DATE AND TIME, INCLUDING TIME ZONE]. It may end sooner upon my death, revocation, court action, or another event under KRS 457.100. This power does not revoke any prior power unless I identify it here: [PRIOR INSTRUMENT TO REVOKE / NONE].

5. Agent's duties

My agent must act only within this grant, in good faith, and in accordance with my reasonable expectations to the extent actually known or otherwise in my best interest. My agent must keep records of receipts, disbursements, and transactions. This instrument does not waive the mandatory duties in KRS 457.140(1).

6. Principal's signature

I sign this limited power of attorney voluntarily on [__/__/____] at [CITY, STATE].

Principal's signature: ____________________________________

Printed name: [PRINCIPAL FULL LEGAL NAME]

7. Acknowledgment

Commonwealth of Kentucky, County of [COUNTY].

On [__/__/____], [PRINCIPAL FULL LEGAL NAME] personally appeared before me, was identified to my satisfaction, and acknowledged signing this instrument voluntarily.

Notary public or other authorized officer: ____________________________________

Printed name and title: [NAME AND TITLE]

Commission number, if notary public: [________________]
Commission expiration, if applicable: [DATE] Official seal, if applicable: [SEAL]

8. Agent's receipt (optional)

I acknowledge receipt of this instrument and agree to act only within its stated limits.

Agent's signature: ____________________________________ Date: [__/__/____]

9. Land-recording instruction

If this power authorizes a conveyance whose recording is required to protect against creditors and purchasers, lodge or record this power in the proper recording office as KRS 382.370 requires. If a power is recorded, a later revocation must also be lodged for record or noted on its record in the manner that section specifies. Coordinate both documents with the county clerk before use.