Washington Limited (Special) Power of Attorney Form

The Washington limited (special) power of attorney form is used to permit an individual (the Agent) to carry out specific acts on the behalf of a Principal. The authority granted is limited to the responsibilities relayed in the document and it will often remain in effect until completion of the specified tasks. As opposed to a durable power of attorney, the powers granted to the Attorney-in-Fact will not remain upon incapacitation of the Principal. Once the document has been completed, it should be signed by the Principal and the signature should be acknowledged in the presence of a Notary Public.

How to Write

Step 1 – Notice to Principal – Review the following titles:

  • Notice
  • Incapacitation
  • Revocation
  • Witness and Notary

Step 2 – Parties – Submit:

  • Principal’s name
  • Street Address
  • City
  • State
  • AND
  • Agent’s name
  • Street Address
  • City
  • State
  • The state whereas the powers shall be utilized
  • AND
  • Successor Agent’s name (optional)
  • Street Address
  • City
  • State
  • The state where the powers document shall be used

Step 4 – Additional Titles – Read the following titles:

  • Terms and Conditions
  • Third Parties
  • Compensation
  • Disclosure

Step 5 – Signatures – Must be witnessed:

  • Prinicpal’s Printed Name
  • Date the signature in dd/mm format
  • Principal’s Signature
  • AND
  • Agent’s Printed Name
  • Agent’s Signature
  • Date the signature in mm/dd/yyyy format
  • AND
  • Enter the printed name of the Successor Agent (optional)
  • Successor Agent’s signature
  • Date the Successor’s signature in mm/dd/yyyy format

Step 6 – Notary Acknowledgement –

  • Notary shall witness all signatures
  • Notary complete the remainder of the form

Step 7 – Acknowledgement and Acceptance of Appointment as Agent and Successor Agent –

  • Agents must read acceptance information
  • Enter the name of the Agents (respective)
  • Agents signatures
  • Date the signatures in mm/dd/yyyy formats

Step 8 – Witness Attestation – The witnesses must review the attestation – Enter the following:

  • Witnesses – enter their printed names
  • Witnesses submit their respective signatures