New York Limited (Special) Power of Attorney Form

The New York limited (special) power of attorney form allows a Principal to give authority to an Agent so that they may handle specific responsibilities while the Principal is away and/or unable to do so.  The Agent will have full authorization to conduct himself/herself within the scope of the form and within the timeframe established (if any). Generally speaking, a form of this nature is established for a single event such as the purchasing of property, or for a specific time frame. For instance, the Attorney-in-Fact may be responsible for receiving the Principal’s mail for the amount of time dictated within the document.

Must be signed in the presence of a notary public and two (2) witnesses.

How to Write

Step 1 – Download the Document  – Before proceeding the Principal should read the following:

  • Notice
  • Incapacitation
  • Revocation
  • Witness and Notary
  • Terms and Conditions
  • Third Parties
  • Compensation
  • Disclosure

Step 2 – Enter the Principal’s Information –

  • Name the Principal
  • Principal’s Address
  • City
  • State
  • AND
  • Agent’s name
  • Agent’s Address
  • City
  • State
  • AND
  • Provide the name of the Successor Agent
  • Successor’s Address
  • City
  • State

Step 3 – Signatures – To be signed before a Notary only – Enter:

  • Principal’s Signature
  • Date the Principal’s signature in dd/mm/yyyy format
  • AND
  • Agent’s Printed Name
  • Enter the Agent’s Signature
  • Date of the Agent’s signature in mm/dd/yyyy format
  • AND
  • Successor Agent’s Printed Name
  • Alternate Successor’s Signature
  • Date the Successor’s signature in mm/dd/yyyy format

Step 4 – Notarization –

Once the Notary witnesses all signatures, the notary will then enter all of the requirements to acknowledge the document, also affixing the official seal.

Step 5 – Acknowledgement and Acceptance of Agents – Agent’s must review the acknowledgements– Provide the following:

  • Printed name of the Agent(s)
  • Agent (s) signatures(s)
  • Date(s) of signatures in mm/dd/yyyy format
  • AND

The Witnesses must review the Witness Attestation

Submit the following:

  • Printed names of the Witnesses
  • Signatures of the Witnesses