Pennsylvania Power of Attorney Form Create a Pennsylvania Power of Attorney Form

... Pennsylvania

Home
Power of Attorney
Pennsylvania

Pennsylvania Power of Attorney Form

Published Dec 24, 2025

1 Downloads

A Pennsylvania Power of Attorney Form is a legal instrument granting an agent authority to act on a principal's behalf regarding financial or medical matters.

Create a Pennsylvania Power of Attorney Form

Poa Type

What type of Power of Attorney do you want to create?

General Power of Attorney Limited/Special Power of Attorney Durable Power of Attorney Springing Power of Attorney Medical/Healthcare Power of Attorney

Select the type of authority you wish to grant. 'General' grants broad powers; 'Limited/Special' restricts authority to specific acts; 'Durable' remains in effect if the Principal becomes incapacitated; 'Springing' only becomes effective upon a specified event.

Pennsylvania Power of Attorney Form Preview

View Document

Create

Download PDF

0% Complete 0/0 Fields

PENNSYLVANIA POWER OF ATTORNEY FORM

NOTICE

THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO HANDLE YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO SELL OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU.

THIS POWER OF ATTORNEY DOES NOT IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS, BUT WHEN POWERS ARE EXERCISED, YOUR AGENT MUST USE DUE CARE TO ACT FOR YOUR BENEFIT AND IN ACCORDANCE WITH THIS POWER OF ATTORNEY.

YOUR AGENT MAY EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU BECOME INCAPACITATED, UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THESE POWERS OR YOU REVOKE THESE POWERS OR A COURT ACTING ON YOUR BEHALF TERMINATES YOUR AGENT'S AUTHORITY.

YOUR AGENT MUST KEEP YOUR FUNDS SEPARATE FROM YOUR AGENT'S FUNDS.

A COURT CAN TAKE AWAY THE POWERS OF YOUR AGENT IF IT FINDS YOUR AGENT IS NOT ACTING PROPERLY.

POWERS AND DUTIES OF AN AGENT UNDER A POWER OF ATTORNEY ARE EXPLAINED MORE FULLY IN 20 PA.C.S. CH. 56.

IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER OF YOUR OWN CHOOSING TO EXPLAIN IT TO YOU.

I HAVE READ OR HAD EXPLAINED TO ME THIS NOTICE AND I UNDERSTAND ITS CONTENTS.

Signature of Principal: _________________________

Date:

I. APPOINTMENT OF AGENT

This Power of Attorney is made on , by and between:

The Principal:
Name:
Address:
State of Residence: Pennsylvania

The Agent:
Name:
Address:
Phone:

I, the Principal, hereby appoint the Agent named above to act as my true and lawful attorney-in-fact to manage my affairs in accordance with the following terms and conditions.

II. EFFECTIVE DATE AND DURABILITY

This Power of Attorney shall become effective: (Check one)

Immediately upon the date of my signature below

Upon my disability or incapacity (Springing Power of Attorney)

I shall be considered disabled or incapacitated if two (2) licensed physicians certify in writing that I am unable to manage my financial affairs.

Durability Provision:
Pursuant to 20 Pa.C.S. § 5604, this Power of Attorney is DURABLE and shall not be affected by my subsequent disability, incapacity, or incompetence. It shall remain in effect until my death or until revoked by me in writing.

III. GRANT OF GENERAL POWERS

I grant my Agent and any successor Agent general authority to act for me with respect to the following subjects as defined in 20 Pa.C.S. Chapter 56:

(Check to grant power)

Real Property Transactions - To buy, sell, lease, mortgage, and manage real estate.

Tangible Personal Property Transactions - To buy, sell, and manage personal property.

Stock and Bond Transactions - To buy, sell, and exchange stocks, bonds, and mutual funds.

Commodity and Option Transactions - To engage in commodity and option transactions.

Banking and Financial Institution Transactions - To open, close, and manage bank accounts; write checks; and conduct safe deposit box transactions.

Business Operating Transactions - To manage, operate, and sell any business interest I may own.

Insurance and Annuity Transactions - To purchase, maintain, surrender, or borrow against insurance policies and annuities.

Estates, Trusts, and Other Beneficiary Transactions - To represent me in all matters regarding estates and trusts.

Claims and Litigation - To commence, defend, settle, or compromise legal claims and litigation.

Personal and Family Maintenance - To provide for the support and standard of living of myself and my family.

Benefits from Governmental Programs - To apply for and receive government benefits (e.g., Social Security, Medicare, Medicaid).

Retirement Plan Transactions - To manage retirement plans, IRAs, and roll-overs.

Tax Matters - To prepare, sign, and file tax returns and represent me before tax authorities.

IV. SPECIFIC AUTHORITY (OPTIONAL)

My Agent MAY NOT do any of the following specific acts for me UNLESS I have CHECKED the specific authority listed below:

Create, amend, revoke, or terminate an inter vivos trust.

Make a gift. (Subject to the limitations of 20 Pa.C.S. § 5601.2).

Create or change rights of survivorship.

Create or change a beneficiary designation.

Delegate authority granted under the power of attorney.

Waive the principal's right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan.

Exercise fiduciary powers that the principal has authority to delegate.

V. SPECIAL INSTRUCTIONS

The Agent shall adhere to the following special instructions or limitations:

VI. NOMINATION OF GUARDIAN

If a court decides that it is necessary to appoint a guardian of my estate or guardian of my person, I hereby nominate my Agent to serve in that capacity.

VII. RELIANCE BY THIRD PARTIES

Any third party who receives a copy of this Power of Attorney may rely on it. Revocation of this Power of Attorney is not effective as to a third party until the third party has actual knowledge of the revocation. I agree to indemnify the third party for any claims that arise against the third party because of reliance on this Power of Attorney.

VIII. SUCCESSOR AGENT (OPTIONAL)

Appoint a Successor Agent?

If my Agent resigns, dies, becomes incapacitated, is not qualified to serve, or declines to serve, I appoint the following person as Successor Agent:

Name:
Address:
Phone:

IX. GOVERNING LAW

This Power of Attorney shall be governed by, construed, and enforced in accordance with the laws of the Commonwealth of Pennsylvania, specifically Title 20, Chapter 56 of the Pennsylvania Consolidated Statutes.

X. SIGNATURE AND ACKNOWLEDGMENT

IN WITNESS WHEREOF, I have hereunto signed my name on the date first written above.

PRINCIPAL

Signature: _________________________

Print Name: _______________

Date:

WITNESS ATTESTATION

The Principal signed this document in our presence, and we, in the presence of the Principal and each other, sign as witnesses. We certify that the Principal appears to be of sound mind and under no duress, fraud, or undue influence.

Witness 1:
Signature: _________________________
Print Name:
Address:
Date:

Witness 2:
Signature: _________________________
Print Name:
Address:
Date:

Include Notary Public Section?

NOTARY ACKNOWLEDGMENT

Commonwealth of Pennsylvania
County of

On this , before me, the undersigned Notary Public, personally appeared _______________ (Principal's Name), known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he/she executed the same for the purposes therein contained.

IN WITNESS WHEREOF, I have hereunto set my hand and official seal.

Signature of Notary Public: _________________________
My Commission Expires:

(Seal)

AGENT'S ACKNOWLEDGMENT

(Required by 20 Pa.C.S. § 5601(d))

I, _______________ (Name of Agent), have read the attached Power of Attorney and am the person identified as the Agent for the Principal. I hereby acknowledge that when I act as Agent:

I shall act in accordance with the Principal's reasonable expectations to the extent actually known by me and, otherwise, in the Principal's best interest, act in good faith and act only within the scope of authority granted to me by the Principal in the Power of Attorney.
I shall act with the care, competence, and diligence ordinarily exercised by agents in similar circumstances.
I shall keep a record of all receipts, disbursements, and transactions made on behalf of the Principal.
I shall cooperate with a person who has authority to make health care decisions for the Principal to carry out the Principal's reasonable expectations to the extent actually known by me and, otherwise, act in the Principal's best interest.
I shall attempt to preserve the Principal's estate plan, to the extent actually known by me, if preserving the plan is consistent with the Principal's best interest and based on all relevant factors.

I UNDERSTAND THAT I MAY BE SUBJECT TO CRIMINAL PROSECUTION IF I ABUSE THE AUTHORITY GRANTED TO ME BY THE POWER OF ATTORNEY.

AGENT

Signature: _________________________

Print Name: _______________

Date:

PDF Preview

What is a Pennsylvania Power of Attorney Form?

A Pennsylvania Power of Attorney Form functions as a legal instrument authorizing one individual, referred to as the principal, to designate another person, known as the agent or attorney-in-fact, to act on their behalf in financial, legal, or healthcare matters. This document establishes a fiduciary relationship where the appointed agent must manage the principal's affairs according to specific instructions and statutory standards. Residents of the Commonwealth utilize this tool to ensure business continuity, asset management, and medical decision-making capabilities exist during periods of absence or incapacitation.

Types of Pennsylvania Power of Attorney Form

The Commonwealth recognizes distinct categories of delegation documents, each serving specific legal purposes and offering varying degrees of authority.

General Power of Attorney - Grants the agent broad authority to handle almost all financial and legal affairs for the principal, effectively allowing the agent to step into the shoes of the principal for most transactions.
Durable Power of Attorney - Contains specific language stating that the agent's authority remains effective even if the principal becomes mentally incapacitated or disabled.
Limited Power of Attorney - Restricts the agent's authority to specific transactions, time periods, or distinct tasks such as selling a piece of real estate or handling a single business deal.
Medical Power of Attorney - Designates a healthcare representative to make medical decisions for the principal if they are unable to communicate their wishes, often created alongside a living will.
Springing Power of Attorney - Remains inactive until a specific event occurs, typically the incapacitation of the principal as determined by a medical professional.

Pennsylvania Legal Statutes and Regulations

The creation and enforcement of power of attorney documents in Pennsylvania fall under Title 20 of the Pennsylvania Consolidated Statutes. These laws dictate the necessary formalities for a valid document.

General Provisions and Definitions - Establishes the fundamental rules for creating a valid power of attorney and defines key terms used throughout the statute (20 Pa. C.S. § 5601).
Notice to Principal - Mandates that a specific warning notice signed by the principal must appear at the beginning of the document to ensure the principal understands the gravity of the powers granted (20 Pa. C.S. § 5601(c)).
Acknowledgment by Agent - Requires the agent to sign an acknowledgment of their duties and responsibilities before acting under the power of attorney (20 Pa. C.S. § 5601(d)).
Witness and Notary Requirements - Stipulates that the document must be signed by the principal, notarized, and witnessed by two individuals who are not the agent (20 Pa. C.S. § 5601(b)).
Healthcare Agents - Governs the appointment and authority of healthcare representatives distinct from financial agents (20 Pa. C.S. § 5451 et seq.).

Required Elements for Validity

Pennsylvania law imposes strict formatting and execution requirements to prevent fraud and abuse. A document failing to meet these standards may be rejected by financial institutions or courts.

Capacity of Principal - The individual creating the document must be at least 18 years old and of sound mind at the time of signing.
Statutory Notice - The form must include the precise statutory notice language found in Pennsylvania law, signed by the principal.
Agent Acknowledgment - The agent must sign an affidavit acknowledging their fiduciary duties, including the obligation to act in the principal's best interest.
Proper Execution - The principal must sign the document in the presence of a notary public and two credible witnesses.
Witness Restrictions - The designated agent cannot serve as one of the witnesses to the principal's signature.

Duties and Responsibilities of the Agent

An agent appointed under a Pennsylvania Power of Attorney Form assumes a fiduciary role, requiring them to act with the highest standard of care. State law outlines specific obligations to protect the principal.

Fiduciary Standard - The agent acts solely for the benefit of the principal and must avoid conflicts of interest (20 Pa. C.S. § 5601.3).
Record Keeping - Agents must maintain accurate records of all receipts, disbursements, and transactions made on behalf of the principal.
Competence and Diligence - The agent must act with the care, competence, and diligence ordinarily exercised by agents in similar circumstances.
Cooperation - Agents must cooperate with anyone who has the authority to make healthcare decisions for the principal to ensure the principal's wishes are carried out.

Revocation of Authority

A principal retains the right to revoke a power of attorney at any time, provided they maintain the mental capacity to do so. Revocation effectively terminates the agent's authority to act.

Written Revocation - The most effective method involves creating a formal written document stating that the previous power of attorney is revoked.
Notice to Third Parties - Financial institutions and other entities relying on the original document must receive notice of the revocation to stop accepting the agent's authority.
Destruction of Documents - Destroying all original copies of the power of attorney serves as a method of revocation, though written notice remains preferable for clarity.
Court Order - A court may revoke a power of attorney if it determines the agent is abusing their power or acting contrary to the principal's best interests.

FAQs

Recording is generally not required for the document to be valid between the principal and agent. Recording with the Recorder of Deeds becomes necessary if the agent handles real estate transactions or if the principal wishes to provide public notice of the agent's authority.

Pennsylvania law generally prohibits self-dealing unless the power of attorney document explicitly grants the authority to make gifts to the agent. Without specific authorization in the document, transferring assets to the agent constitutes a breach of fiduciary duty.

The authority granted under any power of attorney document ends immediately upon the death of the principal. The executor or administrator of the principal's estate then assumes control over financial matters and asset distribution.

Generic forms may not be valid if they lack the specific "Notice to Principal" and "Acknowledgment by Agent" language mandated by Pennsylvania statutes. Forms must strictly adhere to the state's formatting and content requirements to ensure acceptance by third parties.

An agent cannot use a power of attorney to create, amend, or revoke the principal's Last Will and Testament. Pennsylvania law specifically excludes the power to alter a will from the authority that can be delegated to an agent.

Pennsylvania law requires the principal's signature to be witnessed by two individuals who are at least 18 years old. The notary public may not serve as one of the two required witnesses, and the agent is also disqualified from witnessing the signature.

Do you have a question about a Pennsylvania Power of Attorney Form?

0/1000

This is general information only. Always consult a legal professional for specific advice.

Example questions:

Loading example questions...

Loading recent questions...

No questions have been asked yet.

Be the first to ask a question!

Not the form you're looking for?

Try our legal document generator to create a custom document

Community Discussion

Share your experience and help others

Comments (0)

Name

Your email will not be displayed publicly. It is used for validation purposes only and will never be used to send unwanted emails or sold to third parties.

Comment

Replying to

No comments yet. Be the first to comment!

Legal Notice: Comments are personal opinions and do not constitute legal advice. Always consult a qualified attorney for matters specific to your situation.