Ohio Durable Power of Attorney
This Durable Power of Attorney is established in accordance with the laws of the State of Ohio, specifically under the Ohio Revised Code, Chapter 1337, allowing a designated individual (the "Agent") to act on behalf of the signer (the "Principal"). This document remains in effect unless revoked by the Principal or upon the Principal's death.
Principal Information
Full Name: ____________________________
Physical Address: ____________________________, ____________________, Ohio, _______
Phone Number: ____________________________
Agent Information
Full Name: ____________________________
Physical Address: ____________________________, ____________________, Ohio, _______
Alternate Agent’s Full Name (Optional): ____________________________
Alternate Agent’s Physical Address (Optional): ____________________________, ____________________, Ohio, _______
Authorization
By this document, the Principal authorizes the above-named Agent to act on the Principal's behalf in all affairs affecting:
- Real Estate Transactions
- Financial and Banking Affairs
- Legal and Judicial Proceedings
- Tax Matters
- Government Benefits
- Healthcare Decisions (if no separate Medical Power of Attorney exists)
Terms and Conditions
This Durable Power of Attorney will become effective upon the signing of this document and will remain in effect indefinitely unless a termination date is specified herein:
Termination Date (Optional): ____________________________
Signatures
Principal’s Signature: ____________________________ Date: _____________
Agent’s Signature: ____________________________ Date: _____________
If an alternate Agent is designated, their acceptance of appointment is required:
Alternate Agent’s Signature (Optional): ____________________________ Date: _____________
Acknowledgment by Notary Public
This section to be completed by a Notary Public, affirming the identities of the individuals signing the Ohio Durable Power of Attorney document.
State of Ohio,
County of _______________________
On this day, _______________, before me appeared ___________________ [Principal], and ___________________ [Agent/Alternate Agent] known to me (or satisfactorily proven) to be the individuals whose names are subscribed to the within instrument, and acknowledged that they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
Notary Public’s Signature: ____________________________ Date: _____________
Notary Public’s Printed Name: ____________________________
My Commission Expires: _____________