Connecticut Power of Attorney
This Power of Attorney document is designed to comply with Connecticut General Statutes, Title 1, Chapter 55. It allows you, the principal, to appoint someone to handle your financial and legal matters in your absence or if you become unable to do so.
Principal's Information:
Name: ________________________________
Address: ______________________________
City: _________________________________
State: _______________ Zip Code: ________
Agent's Information:
Name: ________________________________
Address: ______________________________
City: _________________________________
State: _______________ Zip Code: ________
Effective Date:
This Power of Attorney will become effective on: _______________.
Powers Granted:
The agent will have the authority to act on behalf of the principal in the following matters:
- Real estate transactions
- Banking and financial affairs
- Investment decisions
- Tax matters
- Insurance claims and policies
- Legal matters
Limitation of Powers:
The agent is not authorized to:
- Make healthcare decisions for the principal
- Change the principal's beneficiaries
- Commit fraud or illegal acts on behalf of the principal
Revocation:
This Power of Attorney may be revoked by the principal at any time, in writing.
Signature of Principal:
_______________________________ (Signature) Date: ____________
Witness Information:
Witness 1 Name: ________________________________
Witness 1 Signature: ____________________________ Date: ____________
Witness 2 Name: ________________________________
Witness 2 Signature: ____________________________ Date: ____________
Notary Public:
State of Connecticut
County of _______________
Subscribed and sworn before me, this ____ day of ______________, 20___.
_______________________________ (Notary Signature)
My Commission Expires: _______________