Rhode Island Durable Power of Attorney Template
This Durable Power of Attorney ("Agreement") is designed to comply with the laws of the State of Rhode Island, specifically referencing the Rhode Island General Laws Chapter 18-16, also known as the "Rhode Island Short Form Power of Attorney Act". By completing this document, you (the "Principal") appoint another person (the "Agent") to make decisions on your behalf. Please ensure all provided information is accurate and complete.
Principal Information
- Full Name: _______________________________
- Address: __________________________________
- City, State, Zip: __________________________
- Phone Number: _____________________________
Agent Information
- Full Name: _______________________________
- Address: __________________________________
- City, State, Zip: __________________________
- Phone Number: _____________________________
Powers Granted
This Durable Power of Attorney grants the Agent authority to act on the Principal's behalf in the following areas (initial next to each power you grant):
- ____ 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 military service
- ____ Retirement plan transactions
- ____ Tax matters
Special Instructions
If you wish to limit any of the powers granted above or add any special instructions for the Agent, provide the details below:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Effective Date and Duration
This Durable Power of Attorney shall become effective immediately upon signing and shall remain in effect indefinitely unless a specific termination date is noted here: _______________________.
Signature of Principal
I, _________________________ [Principal’s Name], a competent adult, sign this Rhode Island Durable Power of Attorney on this date: _______________________.
Principal’s Signature: ________________________________________
Principal’s Printed Name: _____________________________________
Signature of Agent
I, _________________________ [Agent’s Name], accept my designation as Agent and swear to act in the Principal's best interest according to the powers granted in this Durable Power of Attorney and under the laws of the State of Rhode Island.
Agent’s Signature: ____________________________________________
Agent’s Printed Name: _________________________________________
Witnesses (As required by Rhode Island law)
- Witness #1 Signature: ______________________________________
Printed Name: _______________________________________________
- Witness #2 Signature: ______________________________________
Printed Name: _______________________________________________
Notarization
This document was acknowledged before me on _________________________ [date] by _________________________ [name of Principal].
Notary Public: _______________________________________________
Commission Expires: __________________________________________