Arizona Limited (Special) Power of Attorney Form

The Arizona limited (special) power of attorney form is a device which allows for an Agent to act on behalf of an individual for a specific duty or set of responsibilities as specified within the document. This type of power of attorney is limited in the sense that it does not allow the Agent to perform all tasks which would initially be accomplished by the Principal, and instead restrains the Agent to the powers detailed within the POA form. In compliance with the statutes surrounding the completion of a Durable Power of Attorney form, an Arizona Limited Power of Attorney form must be completed in the presence of a Notary Public, it must contain clear language stating the intent of the Principal, it must be signed by the Principal, and it must be witnessed by a person other than the Agent, the Agent’s spouse, the agent’s children, and the notary (§14-5501).

How To Write

Step 1 – Begin by downloading the packet provided. Read the first 4 pages of these documents to better educate yourself with regard to what would work best for you as the principal.

Step 2 – Section 1 of Forms – Once you’ve completed the review of the packet information and you reach the forms, you will begin completing the forms by providing the following information:

  • Select which form you would prefer and check the box in front of your selection

Step 3 – Section 2 – Identify the principal as well as the attorney in fact also known as the agent by providing the following information:

  • Principal’s Name
  • Physical Address of Principal’s Residence
  • City, State, Zip Code
  • Principal’s Date of Birth
  • AND (on the second line in section 2)
  • Attorney In Fact/Agent’s Name
  • Physical Address of Residence
  • City, State, Zip Code
  • Attorney In Fact/Agent’s Date of Birth

Step 4 – Section 3 – In this section of the document, you (the principal) will write or type into the lines provided, the specific powers that you wish to allow your named attorney in fact/agent, to perform on your behalf in the event you become incompetent, incapacitated and/or disabled. You may be as limited or as broad as you wish.

  • As you create these instructions, if more room is required, you may add a sheet to continue the description of what specifically you wish your attorney in fact to be limited to.

Step 5 – Section 4 – In this section you will select which document you would prefer. Once you’ve made your selection, you must provide the following information:

  • If you’re checking “regular” – In the blank lines in the paragraph below enter a date in which you would like the document to be available to your agent for use.
  • In the next paragraph, you would complete the lines with the date that the document would be revoked and no longer in force for use
  • If you’re checking “durable” – You would simply state a date in which the document is available to your agent. This may be immediately or a date in the future. This selection would require revocation in writing and delivery to your agent and any businesses who have an interest.

Step 6 – Section 6 – In this section the principal will require a notary public. Do not provide signatures until you are being witness by a notary and the notary can legally swear to the fact that you are present. You will require a witness.

  • Once you are before the notary, fill in the blank lines under “For Principal.”
  • Enter the name of the principal
  • Enter the date that the principal is signing the document
  • Read the remainder of the
  • At the end of the paragraph, enter the Principal’s signature
  • AND
  • The witness must enter their name
  • Sign on the witness’ signature line

Step 7 – The remainder of the document is to be completed by the notary public. Once all of their information is entered after you and your witness have signed the document(s), the notary seal must be clearly affixed.

Make copies of this document to provide to your attorney in fact, as well, to any businesses you may wish to make aware of the document. You may also like to keep a copy of the final page, which would be the frequently asked questions and read though them if needed. If you have any problems completing this document, you may wish to consult with an attorney.