Background information

An enduring power of attorney is a legal document that allows you (the "principal" ) to nominate one or more persons (referred to as "attorneys" ) to act on your behalf. An enduring power of attorney gives the attorney the authority to manage your legal and financial affairs, including buying and selling real estate, shares and other assets, operating your bank accounts and spending money on your behalf.

The attorney’s power continues even if for any reason you lose your mental capacity to manage your own affairs. Once you lose your mental capacity you cannot revoke this power of attorney. If you want the power of attorney to cease if you lose your mental capacity, use the General Power of Attorney form. An attorney under an enduring power of attorney cannot make decisions about your lifestyle or health. These decisions can only be made by a guardian (whether an enduring guardian appointed by you or a guardian appointed by the Civil and Administrative Tribunal or the Supreme Court).

The prescribed witness certificate in clause 6 of this form must be completed. Before acting as your attorney/s, the attorney/s (including any substitute attorney/s) must sign the acceptance in clause 7 of this form.

Please read the Important information set out at the end of this document. It includes notes to assist in completing this document and more fully explains the role and responsibilities of an attorney.

1. Appointment of attorney by the Principal

I, {principalsName}
of address at {principalsAddress}
(“Principal”)

appoint

{detailsOf[1]}

of

{detailsOf[2]}

to be my attorney ('Attorney').

1. Appointment of attorney by the Principal

I, {principalsName}
of address at {principalsAddress}
(“Principal”)

appoint

{detailsOf[1]}

of

{detailsOf[2]}

and also appoint

{detailsOf99[1]}

of

{detailsOf99[2]}

to be my attorneys ('Attorneys').

My Attorneys are to be appointed:

{detailsOf99[3]}

Nomination of substitute attorney/s (optional)
[If your attorney/s vacates office, you have the option to nominate someone else to take their place.]

If my attorney/s vacate/s office, I {principalsName} of {principalsAddress}
appoint:
{detailsOf101[1]}

of

{detailsOf101[2]}

to be my substitute attorney/s.
(“Substitute attorney/s”).

My Substitute attorney/s are to be appointed:

{detailsOf101[3]}

Powers

My attorney/s may exercise the authority conferred on my attorney/s by Part 2 of the Powers of Attorney Act 2003 to do anything on my behalf I may lawfully authorise an attorney to do.

I give this power of attorney with the intention that it will continue to be effective if I lack the capacity through loss of mental capacity after its execution.

Your signature to make the appointment

{principalsSignature}

{principalsName}

{date}

{prescribedWitness}

{prescribedWitness115[1]}

{prescribedWitness115[2]}

{prescribedWitness115[3]}

{prescribedWitness115[4]}

Certificate under section 19 of the Powers of Attorney Act 2003

I,
{prescribedWitness115[1]}, {prescribedWitness115[2]} of {prescribedWitness115[3]}

certify the following:
(a) I explained the effect of this power of attorney to the principal before it was signed.
(b) the principal appeared to understand the effect of this power of attorney.
(c) I am a Prescribed witness.
(d) I am not an attorney under this power of attorney.
(e) I have witnessed the signature of this power of attorney by the principal.

{prescribedWitness}

{prescribedWitness115[4]}

Acceptance by Attorney

I, {detailsOf[1]} of {detailsOf[2]}

(a) I accept that I must always act in the principal's best interests.
(b) I accept that as attorney I must keep my own money and property separate from the principal's money and property.
(c) I accept that I should keep reasonable accounts and records of the principal's money and property.
(d) I accept that, unless expressly authorised, I cannot gain a benefit from being an attorney.
(e) I accept that I must act honestly in all matters concerning the principal's legal and financial affairs.

Failure to do any of the above may incur civil and/or criminal penalties.

{attorneysSignature}

{date106}

Acceptance by second Attorney

I, {detailsOf99[1]} of {detailsOf99[2]}

(a) I accept that I must always act in the principal's best interests.
(b) I accept that as attorney I must keep my own money and property separate from the principal's money and property.
(c) I accept that I should keep reasonable accounts and records of the principal's money and property.
(d) I accept that, unless expressly authorised, I cannot gain a benefit from being an attorney.
(e) I accept that I must act honestly in all matters concerning the principal's legal and financial affairs.

Failure to do any of the above may incur civil and/or criminal penalties.

{secondAttorney}

{date109}

Acceptance by substitute Attorney

I, {detailsOf101[1]} of {detailsOf101[2]}

(a) I accept that I must always act in the principal's best interests.
(b) I accept that as attorney I must keep my own money and property separate from the principal's money and property.
(c) I accept that I should keep reasonable accounts and records of the principal's money and property.
(d) I accept that, unless expressly authorised, I cannot gain a benefit from being an attorney.
(e) I accept that I must act honestly in all matters concerning the principal's legal and financial affairs.

Failure to do any of the above may incur civil and/or criminal penalties.

{substituteAttorneys111}

{date112}