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This document prepared by: ....
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IMPORTANT INFORMATION FOR AGENT
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1AGENT'S DUTIES
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2When you accept the authority granted under this power
3of attorney, a special legal relationship is created between
4you and the principal. This relationship imposes upon you
5legal duties that continue until you resign or the power of
6attorney is terminated or revoked. You must do all of the
7following:
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8(1) Do what you know the principal reasonably expects you
9to do with the principal's property or, if you do not know the
10principal's expectations, act in the principal's best interest.
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11(2) Act in good faith.
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12(3) Do nothing beyond the authority granted in this power
13of attorney.
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14(4) Disclose your identity as an agent whenever you act
15for the principal by writing or printing the name of the
16principal and signing your own name as "agent" in the
17following manner:
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.... (principal's name) by .... (your signature) as agent
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19Unless the special instructions in this power of attorney
20state otherwise, you must also do all of the following:
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21(1) Act loyally for the principal's benefit.
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22(2) Avoid conflicts that would impair your ability to act in
23the principal's best interest.
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24(3) Act with care, competence, and diligence.
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1(4) Keep a record of all receipts, disbursements, and
2transactions made on behalf of the principal.
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3(5) Cooperate with any person that has authority to make
4health-care decisions for the principal to do what you know
5the principal reasonably expects or, if you do not know the
6principal's expectations, to act in the principal's best interest.
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7(6) Attempt to preserve the principal's estate plan if you
8know the plan and preserving the plan is consistent with the
9principal's best interest.
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10Termination of Agent's Authority
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11You must stop acting on behalf of the principal if you
12learn of any event that terminates this power of attorney or
13your authority under this power of attorney. Events that
14terminate a power of attorney or your authority to act under
15a power of attorney include all of the following:
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16(1) Death of the principal.
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17(2) The principal's revocation of the power of attorney or
18your authority.
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19(3) The occurrence of a termination event stated in the
20power of attorney.
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21(4) The purpose of the power of attorney is fully
22accomplished.
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23(5) If you are married to the principal, a legal action is
24filed with a court to end your marriage, or for your legal
25separation, unless the Special Instructions in this power of
1attorney state that such an action will not terminate your
2authority.
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3(6) if you are the principal's domestic partner and your
4domestic partnership is terminated, unless the special
5instructions in this power of attorney state that such an
6action will not terminate your authority.
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7Liability of Agent
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8The meaning of the authority granted to you is defined in
9the Uniform Power of Attorney for Finances and Property Act
10in chapter 244 of the Wisconsin statutes. If you violate the
11Uniform Power of Attorney for Finances and Property Act in
12chapter 244 of the Wisconsin statutes or act outside the
13authority granted, you may be liable for any damages caused
14by your violation.
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15If there is anything about this document or your duties
16that you do not understand, you should seek legal advice.
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OPTIONAL SIGNATURE OF AGENT
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I HAVE READ AND ACCEPT THE DUTIES AND LIABILITIES OF THE
19AGENT AS SPECIFIED IN THIS POWER OF ATTORNEY.
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Agent's signature .... Date ....
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(APPENDIX FOLLOWS)
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22244.62 Agent's certification. The following optional form may be used by an
23agent to certify facts concerning a power of attorney for finances and property:
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1AGENT'S CERTIFICATION AS TO THE VALIDITY OF POWER
2
OF ATTORNEY
for finances and property AND AGENT'S
3AUTHORITY
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State of ....
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County of ....
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I, .... (name of agent), certify under penalty of perjury that .... (name of principal)
7granted me authority as an agent or successor agent in a power of attorney dated .....
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I further certify that to my knowledge:
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(1) The principal is alive and has not revoked the power of attorney or my
10authority to act under the power of attorney, and the power of attorney and my
11authority to act under the power of attorney have not terminated.
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(2) If the power of attorney was drafted to become effective upon the happening
13of an event or contingency, the event or contingency has occurred.
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(3) If I was named as a successor agent, the prior agent is no longer able or
15willing to serve.
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(4) .... (insert other relevant statements).
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SIGNATURE AND ACKNOWLEDGMENT
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Agent's signature .... Date ....
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Agent's name printed ....
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Agent's address ....
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Agent's telephone number ....
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This document was acknowledged before me on .... (date), by .... (name of agent).
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(Seal, if any)
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Signature of notary ....
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My commission expires: ....
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1This document prepared by: ....
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2244.63 Distribution of forms. The department of health and family services
3shall prepare and provide copies of the Wisconsin statutory form power of attorney
4for finances and property for distribution in quantities to financial institutions,
5health care professionals, hospitals, nursing homes, multipurpose senior centers,
6county clerks and local bar associations and individually to private persons. The
7department of health and family services may charge a reasonable fee for the cost
8of preparation and distribution of the forms.
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9244.64 Relation to power of attorney for health care. The execution of
10a Wisconsin statutory form power of attorney for finances and property under this
11chapter does not confer on the agent any of the powers or duties conferred on a health
12care agent by the power of attorney for health care under ch. 155.
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13Section
17. 854.08 (5) (a) of the statutes is amended to read:
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854.08
(5) (a) In this subsection, "agent" means an agent under a durable power
15of attorney, as defined in s.
243.07 (1) (a) 244.02 (3).
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(1) This act takes effect on the first day of the 4th month beginning after
18publication.