Washington Power of Attorney
This document is a Power of Attorney according to the laws of the State of Washington, pursuant to RCW 11.125.
Principal Information
- Full Name: ____________________________
- Address: ____________________________
- City, State, Zip: ____________________________
Agent Information
- Full Name: ____________________________
- Address: ____________________________
- City, State, Zip: ____________________________
- Relationship to Principal: ____________________________
Grant of Authority
The Principal hereby grants the Agent the authority to act on their behalf regarding the following matters:
- Financial transactions including banking and real estate.
- Health care decisions and access to medical records.
- Legal matters including litigation and settlement.
- Tax matters with the Internal Revenue Service and state authorities.
Effective Date
This Power of Attorney shall become effective immediately upon execution unless specifically stated otherwise below:
Effective Date: ____________________________
Durability
This Power of Attorney shall not be affected by the subsequent disability or incapacity of the Principal.
Signatures
By signing below, the Principal affirms that they understand the nature and purpose of this Power of Attorney.
Principal Signature: ____________________________
Date: ____________________________
Witness Signature: ____________________________
Date: ____________________________
Notary Acknowledgment
State of Washington, County of ______________.
On this ____ day of __________, 20__, before me, a notary public, personally appeared _________________________________, known to me to be the person whose name is subscribed to this instrument, and acknowledged that they executed the same.
Notary Public Signature: ____________________________
My Commission Expires: ____________________________