Limited Power of Attorney - New York

LIMITED POWER OF ATTORNEY

NEW YORK NONSTATUTORY FORM

Before you use this: Complete the transaction and limits below before signing. Print the final instrument in legible type of at least 12 points. The principal must acknowledge the signature and sign or acknowledge it before two qualified witnesses; the agent must separately sign and acknowledge acceptance. For a real-property conveyance, identify the property precisely and coordinate recording with the county recording officer.

CAUTION TO THE PRINCIPAL

Your Power of Attorney is an important document. As the "principal," you give the person whom you choose (your "agent") authority to spend your money and sell or dispose of your property during your lifetime without telling you. You do not lose your authority to act even though you have given your agent similar authority.

When your agent exercises this authority, he or she must act according to any instructions you have provided or, where there are no specific instructions, in your best interest. "Important Information for the Agent" at the end of this document describes your agent's responsibilities.

Your agent can act on your behalf only after signing the Power of Attorney before a notary public.

You can request information from your agent at any time. If you are revoking a prior Power of Attorney, you should provide written notice of the revocation to your prior agent(s) and to any third parties who may have acted upon it, including the financial institutions where your accounts are located.

You can revoke or terminate your Power of Attorney at any time for any reason as long as you are of sound mind. If you are no longer of sound mind, a court can remove an agent for acting improperly.

Your agent cannot make health care decisions for you. You may execute a "Health Care Proxy" to do this.

The law governing Powers of Attorney is contained in the New York General Obligations Law, Article 5, Title 15. This law is available at a law library, or online through the New York State Senate or Assembly websites, www.nysenate.gov or www.nyassembly.gov.

If there is anything about this document that you do not understand, you should ask a lawyer of your own choosing to explain it to you.

1. Principal and agent

I, [PRINCIPAL FULL LEGAL NAME], of [PRINCIPAL ADDRESS], appoint [AGENT FULL LEGAL NAME], of [AGENT ADDRESS], as my agent solely for the authority stated below. I am at least 18 years old and sign with capacity.

2. Specific authority granted

My agent may act for me only in connection with this transaction or purpose: [DESCRIBE THE SPECIFIC TRANSACTION, COUNTERPARTY AND IDENTIFYING NUMBER OR PROPERTY].

My agent may take these actions, and no others: [LIST EACH PERMITTED ACT, DOCUMENT AND RECIPIENT; IDENTIFY ANY ACCOUNT OR REAL PROPERTY PRECISELY].

Principal's initials approving this specific grant: [____]

The maximum amount my agent may pay, receive, or commit on my behalf, if applicable, is $[AMOUNT / NONE]. Additional conditions: [CONDITIONS / NONE].

My agent may sign documents necessary to perform the listed acts, receive transaction records, and communicate with the identified counterparty, but these incidental acts do not enlarge the listed authority. An unfilled description or limit grants no authority.

3. Express limits

This instrument grants no authority to make gifts, transfer assets to the agent, change beneficiaries or survivorship interests, create or modify a trust, delegate this authority, or make health-care decisions. My agent may not use my property for the agent's own benefit. No general subject-matter authority is granted by this instrument.

4. Effective date and end

This authority becomes effective when my agent signs and acknowledges acceptance below, and no earlier than [__/__/____ / DATE OF PRINCIPAL'S EXECUTION]. It ends upon completion of the stated purpose and, in any event, no later than [__/__/____ / NO EARLIER FIXED END DATE]. My death, my revocation, or another event specified in New York law may end it sooner. My later incapacity alone does not end this power of attorney.

Executing this instrument does not revoke any earlier power of attorney. If I revoke this instrument, I will deliver a signed and dated revocation to the agent and notify persons who may rely on it. If this instrument was recorded, I will record the revocation in the same office.

5. Principal's signature and acknowledgment

I sign this limited power of attorney voluntarily.

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

Printed name: [PRINCIPAL FULL LEGAL NAME]

Acknowledgment

State of [STATE] County of [COUNTY]

On [__/__/____], before me, the undersigned notarial officer, personally appeared [PRINCIPAL FULL LEGAL NAME], known to me or proved to me by satisfactory evidence to be the person who signed this instrument, and acknowledged executing it.

Notarial officer's signature: ____________________________________

Printed name and title: [________________________________] Commission expires: [__/__/____]

6. Witnesses

The principal signed this instrument in my presence or acknowledged the principal's signature to me in the principal's presence. I am not named in this instrument as an agent or a permissible gift recipient.

IMPORTANT INFORMATION FOR THE AGENT

When you accept the authority granted under this Power of Attorney, a special legal relationship is created between you and the principal. This relationship imposes on you legal responsibilities that continue until you resign or the Power of Attorney is terminated or revoked. You must:

1. act according to any instructions from the principal, or, where there are no instructions, in the principal's best interest;
2. avoid conflicts that would impair your ability to act in the principal's best interest;
3. keep the principal's property separate and distinct from any assets you own or control, unless otherwise permitted by law;
4. keep a record of all transactions conducted for the principal or keep all receipts of payments and transactions conducted for the principal; and
5. disclose your identity as an agent whenever you act for the principal by writing or printing the principal's name and signing your own name as "agent" in either of the following manners: (Principal's Name) by (Your Signature) as Agent, or (your signature) as Agent for (Principal's Name).

You may not use the principal's assets to benefit yourself or anyone else or make gifts to yourself or anyone else unless the principal has specifically granted you that authority in the modifications section of this document or a Non-Statutory Power of Attorney. If you have that authority, you must act according to any instructions of the principal or, where there are no such instructions, in the principal's best interest. You may resign by giving written notice to the principal and to any co-agent, successor agent, monitor if one has been named in this document, or the principal's guardian if one has been appointed. If there is anything about this document or your responsibilities that you do not understand, you should seek legal advice.

Liability of agent: The meaning of the authority given to you is defined in New York's General Obligations Law, Article 5, Title 15. If it is found that you have violated the law or acted outside the authority granted to you in the Power of Attorney, you may be liable under the law for your violation.

7. Agent's acceptance and acknowledgment

I, [AGENT FULL LEGAL NAME], have read this instrument and the Important Information for the Agent. I accept the appointment and its limits.

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

Agent's acknowledgment

State of [STATE] County of [COUNTY]

On [__/__/____], before me, the undersigned notarial officer, personally appeared [AGENT FULL LEGAL NAME], known to me or proved to me by satisfactory evidence to be the person who signed this instrument, and acknowledged executing it.

Notarial officer's signature: ____________________________________

Printed name and title: [________________________________] Commission expires: [__/__/____]

Sources and References

• New York Senate, General Obligations Law §§ 5-1501, 5-1501B, 5-1505, 5-1511, and 5-1513: https://legislation.nysenate.gov/pdf/laws/GOB5-1501B
• New York Senate, Real Property Law §§ 294 and 326: https://legislation.nysenate.gov/pdf/laws/RPP294