Iowa Limited (Special) Power of Attorney Form

The Iowa limited power of attorney form is used for when an individual wishes to bestow power unto an another (the Agent or Attorney-in-Fact) to allow them to carry-out a specific function on their behalf. As opposed to a general power of attorney form, the limited power of attorney provides permission for very specified functions as to limit the scope of the authority granted. This allows for certain critical functions to be left to the Principal to manage. As stated in Section 633B.105 of the 2015 Iowa Code, the power of attorney must be signed by the Principal in the presence of a Notary Public (the agent named within the document cannot be used to notarize the form).

How to Write

Step 1 – Titled Sections – The Principal must read the following titled sections:

  • Notice
  • Incapacitation
  • Revocation
  • Witness and Notary

Step 2 – Principal’s Information – Enter the following:

  • The Principal’s printed name
  • Street Address
  • City
  • State
  • AND
  • The Agent’s name
  • Street Address
  • City
  • State
  • Enter the state where Powers will be executed
  • AND
  • Select a Successor Agent (Optional) and enter the Successor’s Name
  • Street Address
  • City
  • State
  • Enter the state where powers of attorney shall be executed

Step 3 – Titled Sections – Principal must carefully read the additional titled sections as follows:

  • Terms and Conditions
  • third Parties
  • Compensation
  • Disclosure

Step 4 – Signatures – Before a Notary Public, all parties must the following information:

  • Printed name of the Principal
  • Provide the Date of the Signature in dd/mm/yyyy format
  • Enter the Principal’s Signature
  • AND
  • Print the Name of the Agent/Attorney In Fact
  • Agent must read the entire paragraph
  • Agent must enter their signature
  • Date the signature in mm/dd/yyyy format
  • AND
  • Provide the full Name of the Successor Agent
  • Successor should review the entire paragraph
  • Enter the Successor Agent’s  Signature
  • Date the Signature in mm/dd/yyyy format
  • AND
  • After the Notary Public has witnessed all signatures, the Notary shall complete the required information that the Notary must provide in writing and affix the official notary seal

Step 5 – Acknowledgement and Acceptance of Appointment by the Principal – Both Agents must read the paragraphs that pertain to each (respectively) and enter the following:

  • Agent’s Printed Name
  • Signature of Agent
  • Date of Signature in mm/dd/yyyy format
  • AND
  • Print the Successor Agent’s Name
  • Signature of the Successor Agent
  • Date the Signature in mm/dd/yyyy format