![]() ![]() If there are such areas, report them in Item 2. If there are any Special Instructions or Provisions the Principal wishes to impose upon the defined powers, they must be listed on the blank line after the statement beginning with the words “In exercising the grant of authority…” The area labeled “Limitations of Authority, will give the Principal a place to report areas where the Principal may forbid or restrict the Attorney-in-Fact from wielding Principal Authority. The Principal should read this area carefully then, give some thought to any concerns he or she may have. The next few paragraphs will give a robust description of some of the actions and decisions under the Attorney-in-Fact’s control. Enter the Daytime and/or Cell Phone Number of the Attorney-in-Fact on the line under the words “Telephone Number.”ģ – The Medical Powers Of Decisions Granted Through This Document The final empty line in this area will request some immediate Contact Information. This should be immediately followed by the complete Residential Address of the Attorney-in-Fact. ![]() The next blank line, under the word “Name,” should have the Legal Name of the Attorney-in-Fact entered on it. If the Legal Name of the Grantor contains a Middle Name or Title, this should be included. The first line will need the First and Last Name of the Principal granting Authority here. It may be opened by using one of the three buttons below the image preview on the right.Ģ – The Principal’s Designation And Appointment Of The Attorney-in-Fact The form on this page will provide the required language to produce a Health Care Power of Attorney in Kansas. 58-632 (Statutory Form)ĭownload: Adobe PDF, MS Word, OpenDocumentġ – This Form May Be Opened As A PDF, MS WORD, or ODT File Signing Requirements – Two (2) Witnesses or a Notary Public ( § 58-632). ![]()
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