Indiana Durable Power of Attorney
This Durable Power of Attorney is created under the laws of the State of Indiana. It allows the person you designate to make decisions on your behalf if you become unable to do so.
By signing this document, you grant the following rights to your Attorney-in-Fact (the person you choose to act on your behalf):
- Manage your financial affairs.
- Make healthcare decisions on your behalf.
- Sign documents and contracts in your name.
Principal Information
Principal Name: ________________________________________
Principal Address: ________________________________________
City: ________________________________________
State: ________________________________________
Zip Code: ________________________________________
Attorney-in-Fact Information
Attorney-in-Fact Name: ________________________________________
Attorney-in-Fact Address: ________________________________________
City: ________________________________________
State: ________________________________________
Zip Code: ________________________________________
Effective Date
This Durable Power of Attorney will become effective on the following date:
Date: ________________________________________
Durability Clause
This Power of Attorney shall remain in effect even if I become incapacitated.
Signature
By signing below, I affirm that I understand the contents of this Durable Power of Attorney and voluntarily choose to grant the above powers to my Attorney-in-Fact.
Principal Signature: ___________________________________
Date: ________________________________________
Witnesses:
- _________________________________________________________
- _________________________________________________________
Notary Public:
State of Indiana, County of ________________
Subscribed and sworn to before me this _____ day of __________, 20____.
Notary Signature: ______________________________________
My Commission Expires: ______________________