Valley Docs & Paralegal Services, LLC
Information Forms - Powers of 
Attorney (POA) Information
 

Definitions:

Testator - Male creator of document
Testatrix - Female creator of document
Agent or Attorney-In-Fact- Appointed by testatrix or testator to
    make decisions on his or her behalf
Alternate - Second choice if first appointee is unable to fulfill
    obligations

General Information

1)    Your name:               

2)    Your email address:  

Powers of Attorney (POA) Questionnaire

1)    Current Resident Address:

    

2)    Current Resident Phone Number:

    

3)    Fill in the Following Table:

 Information

Testatrix

Testator

 Social Security Numbers
 Date of Birth
 Agent or Attorney-In-
 Fact for POAs (A-I-F) 
 (Name)
 City & State for Agent 
 (A-I-F)
 Successor Agent or 
 (A-I-F) for POAs (Name)
 City & State for
 Successor or (A-I-F)
 Autopsy - Yes or No     Yes       No     Yes       No
 

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Copyright © 2005.  Valleydocs LLC.  All rights reserved.
Revised: June 08, 2005