Massachusetts General Power of Attorney
This General Power of Attorney is granted on this ___ day of ____________, 20__, in accordance with the laws of the Commonwealth of Massachusetts, specifically the Massachusetts Uniform Probate Code, M.G.L. Ch. 190B.
I, _________________ (the "Principal"), residing at _________________, in the County of _________________, Commonwealth of Massachusetts, appoint _________________ (the "Agent"), residing at _________________, in the County of _________________, Commonwealth of Massachusetts, as my Attorney-in-Fact ("Agent") to act on my behalf in any lawful way with respect to the following initialed subjects:
- 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, and Medicaid, or any other governmental program, or military service
- Retirement plan transactions
- Tax matters
This General Power of Attorney shall not be affected by my subsequent disability or incapacity. This authority is to be exercised in the best interest of the Principal, under the laws of the Commonwealth of Massachusetts, and is subject to any special instructions in this document.
In witness whereof, I have hereunto set my hand and seal on the date first above written.
Principal's Signature: _________________________
Principal's Name Printed: _________________________
Agent's Signature: _________________________
Agent's Name Printed: _________________________
This document was signed in the presence of:
Witness 1 Signature: _________________________
Witness 1 Name Printed: _________________________
Witness 2 Signature: _________________________
Witness 2 Name Printed: _________________________
State of Massachusetts
County of _______________
On this ___ day of ____________, 20__, before me, the undersigned, a notary public in and for said state, personally appeared the above-named Principal, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained. In my presence, and in the presence of the witnesses, who also appeared before me on the date above written and subscribed their names to this document.
Notary Public's Signature: _________________________
Notary Public's Printed Name: _________________________
My Commission Expires: _________________________