North Carolina Limited (Special) Power of Attorney Form

The North Carolina limited (special) power of attorney form is used when delegating specific responsibility or authority to an individual. The individual receiving the appointed authorization, referred to as the “Agent”, will be permitted to handle the Principal’s affairs while the Principal is physically unavailable (e.x. military leave, trip overseas, incarceration). However, the Agent’s authority will be limited to that which has been described within the form, meaning that the Principal may create stipulations regarding the amount of time their authority is permitted. This type of form must be signed by the Principal in front of a notary public (§ 32A-1).

How to Write

Step 1 – The Parties – The Principal must download the document and enter:

  • The Principal’s full name
  • AND
  • The Agent’s full name

Step 2 – Principal Approved Powers –

  • The Principal shall review all of the matters covered by this document in statements 1 through 9. If “Other” enter any other approved acts allowed by the Principal

Step 3 – Limited Powers Information –

The Principal must carefully review all of the information contained in this paragraph and enter:

  • The Expiration of the powers in mm/dd/yyyy format
  • Principal’s address
  • AND
  • Agent’s address
  • Agent’s Day Phone
  • Agent’s Evening Phone

Step 4 – Signature –

  • Date the signature in dd/mm/yyyy format
  • Submit the Principal’s signature

Step 4 – Notarization –

The Notary will witness the completion of the document and signatures on the document. The Notary will then complete the state required information in acknowledgment of the validity of signatures and the existence of the document