Limited Power of Attorney - Utah
LIMITED POWER OF ATTORNEY (UTAH)
One identified payment
Before signing: Complete every material payment field. The principal must understand that this document appoints an agent to handle the principal's financial affairs and sign before a notary or other officer authorized to take acknowledgments. If the principal lives or is about to live in a hospital, assisted living, skilled nursing, or similar facility, do not name its owner, operator, health-care provider, or employee as agent under this payment form unless that person is the principal's spouse, legal guardian, or next of kin. The Medicaid-only exception in Utah Code § 75A-2-105(2) does not authorize this payment. This form grants no land authority.
I, [PRINCIPAL FULL LEGAL NAME], of [ADDRESS], appoint [AGENT FULL LEGAL NAME], of [ADDRESS], as my agent only for the payment below.
Institution and account: [INSTITUTION, ACCOUNT TYPE, AND LAST FOUR DIGITS]
Recipient: [RECIPIENT'S FULL LEGAL NAME AND ADDRESS]
Obligation: [SPECIFIC INVOICE OR CONTRACT IDENTIFIER]
Maximum total payment including fees: $[AMOUNT]
Payment method and destination: [METHOD AND RECIPIENT ACCOUNT OR DELIVERY ADDRESS]
My agent may ask the institution for the balance needed to confirm this payment, sign and deliver one instruction in my name to pay the named obligation within the ceiling, receive confirmation, and give me the receipt. The agent may not split the payment to evade the ceiling, choose another recipient or destination, incur debt, change the account, or acquire an interest in my property. A blank material field gives no discretion to supply that term.
I grant no general banking or all-acts authority. I do not expressly grant any of the eight special powers in Utah Code § 75A-2-201(1): changing a trust; making a gift; changing survivorship rights or a beneficiary designation; delegating authority; waiving survivor-annuity rights; exercising delegable fiduciary powers; or disclaiming property or exercising a power of appointment. The agent may not make or change my will or make health-care decisions for me.
Duration and agent duties
This power takes effect when I execute it. It is durable; my later incapacity alone does not end it. It ends when this payment is complete or at [TIME] on [EXPIRATION DATE], whichever comes first, and may end sooner under law. It does not revoke an earlier power of attorney.
My agent must act within this grant, in good faith, and according to my reasonable expectations to the extent actually known; otherwise the agent must act in my best interest. The agent must keep the payment instruction, confirmation, and receipt.
Principal's signature and acknowledgment
I sign this limited power of attorney before the officer below on [__/__/____] at [CITY, UTAH].
Principal's signature: ____________________________________
Printed name: [PRINCIPAL FULL LEGAL NAME]
State of Utah, County of [COUNTY]. This instrument was acknowledged before me on [__/__/____] by [PRINCIPAL FULL LEGAL NAME].
Notarial officer's signature: ____________________________________
Printed name and title: [________________________________] Official stamp: [STAMP]
Commission expires: [__/__/____]
Sources and References
- Utah Legislature, current § 75A-2-105 and chapter 2 authority rules.
About this template
- Last updated
- October 5, 2026
- Citations checked
- October 5, 2026
- Jurisdiction
- Utah
- Category
- Estate Planning & Wills
Legal authority
- Utah Code § 75A-2-104 (durability)
- Utah Code § 75A-2-105(1)-(2) (acknowledged execution, capacity, and facility-agent restrictions)
- Utah Code § 75A-2-109(1) (effective time)
- Utah Code § 75A-2-110(1), (6) (termination and earlier powers)
- Utah Code § 75A-2-114(1)-(2) (agent duties and records)
- Utah Code § 75A-2-201(1)-(2) (specific authority and self-benefit limit)
Estate planning documents decide what happens to your property, your children, and your medical care when you cannot make those decisions yourself. Wills, trusts, powers of attorney, and health care directives each serve different purposes and each have to meet state law requirements for signing, witnessing, and notarization. A document that looks fine on the page but was not executed correctly can be rejected in probate, which is exactly when it is too late to fix.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on October 5, 2026.
Utah Code § 75A-2-104 (checked October 5, 2026): "A power of attorney created under this chapter is durable unless it expressly provides that it is terminated by the incapacity of the principal."
Utah Code § 75A-2-105(1)(a) (checked October 5, 2026): "A principal may sign a power of attorney, or direct another individual in the principal's conscious presence to sign the principal's name on the power of attorney, if:"
Utah Code § 75A-2-105(1)(a)(i) (checked October 5, 2026): "the power of attorney is signed before a notary public or other individual authorized by the law to take acknowledgments; and"
Utah Code § 75A-2-105(1)(a)(ii) (checked October 5, 2026): "the principal has sufficient mental capacity at the time that the power of attorney is executed to understand that the principal is appointing an agent to handle the principal's financial affairs."
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