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The cut-off to make an Enduring Power of Attorney was the 1st October 2007. EPAs are now no longer available. EPAs made prior to midnight on the 30th September 2007 continue to be valid
Important:
Before you submit the form, please read the Enduring Power Of Attorney Page as it contains information and prices that you may wish to know.
N.B. An Enduring Power of Attorney issued in England or Wales is only effective in relation to assets and affairs in those countries under English Law.
Fill in the form as fully as possible. If some boxes seem too small just keep typing as they are designed to scroll and will accommodate what you enter.
Donors Surname (i.e. Person giving Power of Attorney):
and FULL forenames:
Donor's title:
Address of Donor including the post code:
Telephone:
work mobile
Email address:
Date of Birth: essential
I am the Donor
Go to section "Attorney(s)"
I am filling in this form on behalf of the Donor Fill in remainder
of section.
YOUR surname:
Forenames:
Address:
Email :
YOUR telephone:
Work: Evenings/Weekends:
Mobile:
Is the Donor aware you are arranging an Enduring Power of Attorney? Yes No
...... if not, why not?
Is the Donor fully capable of understanding the nature an effect of an Enduring power
of Attorney? (i.e. of "Sound Mind") Yes No
Attorney(s)
1st (or only) Attorney
Surname: FULL forenames:
Address:
2nd Attorney (if any)
Surname: FULL forenames:
Address:
If 2 attorneys have been appointed, do you wish them to:
be able to act independently of each other
OR
only act together in agreement with each other (see note 1 in Enduring Power of Attorney Notes)
Restrictions
Do you want your attorney(s) to:
ACT in relation to all your property and affairs
OR
only Act in relation to the following property and affairs
(detail below what property your attorney(s)can deal with on your behalf)
(see
note 2 in Enduring Power of Attorney Notes)
Set out below any other restrictions applicable to your attorney(s)'s powers:
(see note 3 in
Enduring Power of Attorney Notes
Document Format
Communication
Indicate how you would like the relevant communications sent to you.
By Email to
By post: Yes No
We will telephone if we need to discuss any aspect of your instructions
Yes No
To whom do you wish the invoice to be sent?
Name:
Address:
Other information
Any additional information we should know?
Thank you for your instructions.
Please check you have completed the form carefully then submit
it.
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