Fillable Form California Uniform Statutory Form Power of Attorney

What is the California Uniform Statutory Form Power of Attorney?

The California Uniform Statutory Form Power of Attorney is a California State legal document used to appoint another person as an Agent by granting them power of attorney, which gives them the right to make decisions on a person’s behalf with regard to healthcare or other indicated subjects should they be unable to make a decision themselves for any reason. In the case of a minor, the California Uniform Statutory Template Power of Attorney must be filled out to assign the responsibility of medical decisions to another person if their immediate family or guardian is not available or present.

When a person falls ill or is injured and must be sent to the hospital, certain medical decisions may have to be made depending on the severity of their disease or injury. These decisions are usually related to surgical procedures or medication, and will (assuming that the patient is of age) be left to the patient to make a decision by default. However, in case the patient is unable to make their own decisions or when medical professionals are not certain that the patient is of sound mind to be able to make a proper decision, the responsibility of the choice then falls to a person’s next of kin (their closest immediate family member(s)) or their assigned Healthcare Agent.

Similar conditions apply to many different kinds of financial and business decisions. Such decisions will generally be left to a designated decision-maker, or a business may have a chain of command that will be followed by default for any and all major decisions. The California Uniform Statutory Power of Attorney can be used to designate someone else besides the pre-selected person, or to properly officialize the designation of a person as the primary decision-maker should the original person be unavailable for any reason.

An Agent as assigned by the California Uniform Statutory PDF Power of Attorney may also be called a power of attorney, or an appointed Agent or surrogate. It differs from a Living Will in that a Living Will allows a person to declare what treatments they wish to or do not wish to undergo, will generally not cover other decisions such as financial or legal decisions, and does not give anyone else the authority to actually make any decisions on a person’s behalf, while an Agent assigned through this form is given the authority to make decisions in certain situations declared within the form itself.

It is important to make the California Uniform Statutory Form Power of Attorney Fillable by ensuring sure that the person you are giving power of attorney to is aware of the following:

• Your personal attitudes towards health, illness, death, and dying
• Your preferences or needs with regards to healthcare
• Your religious beliefs
• Your feelings on health care providers, institutions, and caregivers.
• Your preferences regarding business or finances
• The status of your dependents

There may be other things of value that must be kept in mind as the California Uniform Statutory Power of Attorney is filled out, depending on what you are giving the Agent the authority to make decisions on.

It is also generally advised to have an “alternate” Agent or power of attorney in mind, to serve as a backup in the event that the originally appointed Agent is not available. To be considered valid, the signing and filling out of the Fillable California Uniform Statutory Form Power of Attorney must be brought to a Notary for notarization, or be signed in the presence of two witnesses that are not being appointed as an Agent or backup Agent.

Who needs to use the California Uniform Statutory Form Power of Attorney?

Any person who wishes to grant another person or other persons the power to make decisions on their behalf regarding medical care or financial decisions must fill out the California Uniform Statutory Power of Attorney Template. It is important to fill out the form as soon as possible to ensure that the document can be properly noted and recognized as valid when it is needed.

How to fill out the California Uniform Statutory Form Power of Attorney?

The California Uniform Statutory Power of Attorney PDF is a very simple form to fill out. Make sure to download it in PDF before printing it so as to preserve its format and contents.

Make sure to read each section carefully, and that the person being appointed as your Agent is aware of their appointment.

Preamble

This preamble simply states that this document is durable, meaning it will last for as long as it is not canceled by either the Agent or the person filing it, and that this document gives the assigned Agent the authority to perform and make decisions regarding any actions or procedures outlined within.

Notice to Person Being Appointed

This section serves as a notice for the person being appointed as an Agent. Make sure that they read through this section carefully.

The power of attorney granted to the Agent through this form comes with the following responsibilities:

1. They must act solely in the interest of the principal (the person filing this form) and avoid any conflicts of interest.
2. They must keep their property separate and distinct from the principal’s, and may not transfer to themselves or dispose of such property unless directed to by the principal.

Date

Enter the date when the Agent signed this form.

Signature of Agent

Have the Agent sign the form in the space provided.

Name of Agent

Enter the Agent’s full legal name.

Uniform Statutory Form Power of Attorney

This section is a reminder that the powers granted by this document are broad and sweeping, and that legal advice may be consulted in order to address any questions and concerns.

Name of Principal

Enter the name of the principal.

Name of Agent

Enter the name of the person being appointed as an Agent.

Address of Agent

Enter the Agent’s residential address.

Declaration

This section declares which powers the principal is granting to the Agent. Note the following guidelines:

• If the principal wishes to grant all of the powers outlined below, they need only initial Line (N), and ignore all other Lines.
• To grant only a select few powers, the principal need only initial the relevant Line(s) associated with the power they wish to grant.
• To specifically withhold a power, the principal may either not initial the line associated with that power, or cross it out.

Indicate which of the following powers the principal may grant by marking the relevant line. You may choose from the following:

• Real Property Transactions
• Tangible Personal Property Transactions
• Stock and Bond Transactions
• Commodity and Option Transactions
• Banking and other Financial Institution Transactions
• Business Operating Transactions
• Insurance and Annuity Transactions
• Estate, Trust, and other Beneficiary Transactions
• Claims and Litigation
• Personal and Family Maintenance
• Benefits from Social Security, Medicare, Medicaid, or other Governmental Programs, or civil or military service.
• Retirement Plan Transactions
• Tax Matters
• All of the above listed powers

Special Instructions

Enter any particular instructions the principal may have that would limit or extend the powers granted to the Agent. You may use a separate sheet of paper if necessary.

Unless otherwise indicated, this power of Attorney will remain effective for as long as it is not canceled or terminated.

If the principal does not wish for this power of attorney to remain effective even if the principal becomes incapacitated, strike the preceding sentence.

If More than One Agent

If more than one Agent was designated, enter whether the Agents should act separately or jointly in the space provided. Make sure to read the succeeding paragraph for more details.

Third Party Receipt

This section outlines that the principal agrees that any third party that receives a copy of this document may act under it, and revocation of the power of attorney will not affect said third party until they are made aware of the revocation, themselves.

Date Signed

Enter the date when the principal signed the form.

Signature

Have the principal sign the form in the space provided.

Social Security Number

Enter the principal’s Social Security Number (SSN).

Acknowledgement of Notary Public

This section is for the use of the Notary, in order to certify that the form has been notarized.

County

Enter the county of California that the form was notarized in.

Date

Enter the date when the principal appeared before the Notary.

Name of Notary

Enter the Notary’s full legal name.

Name of Principal

Enter the principal’s full legal name.

Signature

Have the Notary sign the form in the space provided.

Acknowledgement of Agent

Name of Agent

Enter the appointed Agent’s full legal name.

Signature of Agent

Have the appointed Agent sign the form in the space provided.

Tips when filling out the California Uniform Statutory Form Power of Attorney

Filling out the California Uniform Statutory Form Power of Attorney is very simple. However, due to its length, it is important to ensure that all parties involved have read and understand all of the terms stated in the form. This will help to avoid any issues and make responsibilities given through this form clear to all parties.

Keep the form in a safe and secure place. This is important, as the California Uniform Statutory Form Power of Attorney is a legal document that will be considered usable by any third party that obtains the form. In order to avoid this being abused, make sure that the form is kept in a safe and organized area, and that it is submitted or delivered through safe and trustworthy means.

Seek legal advice. While Notaries may be legal professionals, their role is to prevent fraud. It may be beneficial to consult another legal professional in order to gain more information on the form and the terms outlined within.

Practice good contract management. Create a copy of the accomplished form and store it in a safe and organized area. This will be useful for future legal purposes, or even simply as backup in the event that something should happen to the original.