Louisiana Limited (Special) Power of Attorney Form

The Louisiana limited (special) power of attorney form is used when an individual  chooses to elect an Agent to serve as their Attorney-in-Fact for the purposes of carrying out specific duties as listed within the document. The document will become effective upon the signing by both parties (must be witnessed by Notary Public as well as two witnesses) and it can be terminated at any time by the Principal. As opposed to a general power of attorney form (linked above), the “special” power of attorney form allows the Principal to state the exact terms of the agreement, itemizing the tasks to be carried out by the Attorney-in-Fact.

How to Write

Step 1 – The Parties – Provide the following:

  • Enter the name of the Principal
  • AND
  • The name of the elected Agent
  • Enter the name of the Parrish in which the document is implemented

Step 2 – In page Notary Acknowledgement – On behalf of the Principal only:

  • The notary shall date the document in dd/mm./yyyy format
  • The Notary shall enter their name
  • Enter the name of the Parrish in which the Notary works

Step 3 – The Principal’s Information – Enter:

  • The Principal’s Name
  • Street or PO Box (mailing address)
  • City and Zip Code
  • Social Security Number for the Principal
  • AND
  • The Agent’s Name
  • Mailing Address
  • Agent’s City and Zip Code
  • Agent’s Social Security Number
  • AND
  • The Principal must review the remainder of the document

Step 4 – This document will require three witnesses – Enter the following information:

  • Enter All Witnesses Signatures
  • Enter the date of the document in dd/mm/yyyy format
  • City name
  • State
  • The Principal must enter their signature
  • The Notary mus also enter their name and ID number

Step 5 – Included with this document is an “Acceptance” form for the Agent – Submit the following information:

  • The Agent’s name
  • AND
  • The Principal’s name
  • Date the signatures in dd/mm/yyyy format
  • AND
  • Enter the name of the witnesses names
  • Date the signatures in dd/mm/yyyy format
  • City
  • State
  • AND
  • Provide the Witnesses Signatures
  • Enter the Signature of the Principal

Once the notary has witnessed all signatures on each document, the notary shall enter their signature and ID and provide their notary seal (if any)