Tennessee General Durable Power of Attorney for Property & Finances (Upon Disability)

Tennessee General Durable Power of Attorney
for Property & Finances (Upon Disability)

TENNESSEE GENERAL DURABLE POWER OF ATTORNEY

For Property and Finances

(Effective Only Upon My Disability or Incapacity)

NOTICE TO PRINCIPAL — READ THIS CAREFULLY

This power of attorney is an important legal document. It gives the person you name as your agent broad powers over your property and financial affairs, which may include the power to sell or otherwise dispose of your real and personal property without advance notice to you or approval by you. These powers are explained more fully in Tenn. Code Ann. Title 34, Chapter 6, Part 1 (the Uniform Durable Power of Attorney Act).

This is a DURABLE power of attorney that takes effect only upon your disability or incapacity. It remains effective after you become disabled or incapacitated once it has taken effect.

Your agent is in a fiduciary relationship with you to the extent the agent acts under this document. The law requires your agent to adequately account to you, and to any legal representative appointed for you, for actions taken under this power of attorney (Tenn. Code Ann. § 34-6-107).

This document does NOT give your agent authority to make medical treatment or health care decisions for you. A Tennessee durable power of attorney for health care is a separate document under Tenn. Code Ann. Title 34, Chapter 6, Part 2.

You may revoke this power of attorney at any time while you are competent, by a signed writing delivered to your agent and to anyone relying on it. It terminates at your death. A court can restrain or prohibit your agent's actions notwithstanding the powers granted here (Tenn. Code Ann. § 34-6-108(d)).

If there is anything about this document you do not understand, you should ask a Tennessee lawyer of your own choosing to explain it before you sign.

I have read or had explained to me this Notice and I understand its contents.

_____________________________________________ ____________________

(Signature of Principal) (Date)

ARTICLE I — APPOINTMENT OF AGENT

I, the undersigned principal:

Name: ____________________________________________________________

Address: ____________________________________________________________

appoint the following person as my agent (attorney in fact), to act for me as provided in this power of attorney:

Name: ____________________________________________________________

Address: ____________________________________________________________

Telephone: ________________________________________________________

Successor Agents. If the agent named by me dies, resigns, becomes incapacitated, or declines or is unable to serve, I name the following successor agent(s), each to act alone and successively in the order named:

First successor: ____________________________________________________

Second successor: ____________________________________________________

ARTICLE II — DURABILITY AND EFFECTIVENESS

This power of attorney shall become effective upon the disability or incapacity of the principal.

It is a durable power of attorney under Tenn. Code Ann. § 34-6-102 with a deferred effective date under Tenn. Code Ann. § 34-6-111. Until the determination described below is made, my agent has no authority over my property or financial affairs except the limited authority described in this Article.

Determination of disability or incapacity (initial ONE; if I make no election, the first option applies). I am "disabled" or "incapacitated" for purposes of this power of attorney when I am unable to manage my property or financial affairs effectively:

_______ (DEFAULT) Upon the written certification of one licensed physician who has examined me, stating that I am disabled or incapacitated as defined above. A certification form is attached as Exhibit A.

_______ Upon the written determination of ____________________________________________ [name of individual I trust to make this determination], stating that I am disabled or incapacitated as defined above.

Access to medical records before this power takes effect. Under Tenn. Code Ann. § 34-6-111, notwithstanding anything to the contrary in this document, this power of attorney is effective at the date of signing for the limited purpose of authorizing my agent to have access to my medical records, physicians, and other medical personnel and to discuss my health situation, and my agent is my personal representative under the HIPAA rules for that limited purpose — determining whether I am disabled or incapacitated so that the general provisions of this power of attorney become effective.

Reliance. Any person may rely in good faith on a certification or determination that is regular on its face, and on my agent's affidavit under Tenn. Code Ann. § 34-6-105(c), a form of which is included with this document.

ARTICLE III — GRANT OF AUTHORITY (STATUTORY POWERS INCORPORATED BY REFERENCE)

I clearly express my intention, under Tenn. Code Ann. § 34-6-108(a), to incorporate into this power of attorney by reference the powers enumerated in Tenn. Code Ann. § 34-6-109 that I select below. Each incorporated power applies to my agent with the same effect, and subject to the same judicial interpretation and control, as though the language of Tenn. Code Ann. § 34-6-109 were set forth verbatim in this instrument.

HOW TO GRANT POWERS: To grant ALL of the listed powers, initial the "ALL POWERS" line at the end of this Article and ignore the other lines. To grant some but not all, initial the line in front of each power you are granting. A power whose line you do not initial is NOT granted. You may also delete or limit powers in the Special Instructions in Article V (Tenn. Code Ann. § 34-6-108(b)).

The short description on each line is a convenience summary only; the text of Tenn. Code Ann. § 34-6-109 governs the meaning and scope of each power.

INITIAL _______ (1) General acts — do, sign, or perform any act I could do if personally present (this is the broadest power).

INITIAL _______ (2) Bank deposits and withdrawals — receive and disburse money, sign checks and withdrawal receipts, open or close accounts in my name alone or jointly.

INITIAL _______ (3) Real and personal property — buy, sell, lease, alter, maintain, pledge, or otherwise deal with property, and sign deeds, deeds of trust, closing statements, options, notes, and bills of sale.

INITIAL _______ (4) Tax returns — make, sign, and file income, gift, property, and other tax returns or declarations.

INITIAL _______ (5) Insurance — acquire, maintain, cancel, or deal with life, accident, disability, hospitalization, medical, or casualty insurance, and prosecute benefit claims. (Does NOT include changing beneficiary designations — see Article IV.)

INITIAL _______ (6) Family support — provide for the support and protection of me, my spouse, and my dependent minor children, including food, lodging, housing, medical services, recreation, and travel.

INITIAL _______ (7) Safe deposit boxes — free and private access, including authority to have a box drilled, to deposit and withdraw, and to give discharge.

INITIAL _______ (8) United States government payments — receive and receipt for money due from the United States or its agencies, act as my representative payee, and redeem U.S. bonds and securities.

INITIAL _______ (9) Hire professionals — contract for or employ agents, accountants, advisors, attorneys, and others in connection with the powers granted.

INITIAL _______ (10) U.S. bonds for estate taxes — buy United States government bonds redeemable at par in payment of federal estate taxes imposed at my death.

INITIAL _______ (11) Borrowing and credit — borrow money, secure borrowings, and use credit cards held in my name.

INITIAL _______ (12) Financial institution accounts — establish, use, and terminate checking, savings, money market, and agency accounts, including with securities brokers and corporate fiduciaries.

INITIAL _______ (13) Investments and loans — invest and reinvest money and property, lend money or property, and renew, extend, or modify loans, in accordance with the fiduciary investment standards of Tenn. Code Ann. § 35-3-117.

INITIAL _______ (14) Business operations — engage in and transact any lawful business in my name, whether as partner, joint venturer, or stockholder, and vote stock or enter voting trusts.

INITIAL _______ (15) Club dues and charitable pledges — pay dues to clubs or organizations I belong to and make charitable contributions in fulfillment of pledges I made.

INITIAL _______ (16) Fund my revocable trust — transfer my property to a revocable trust I created that provides for my care and support. (Does NOT include creating, amending, or revoking a trust — see Article IV.)

INITIAL _______ (17) Claims and litigation — sue, defend, or compromise lawsuits and legal actions, and employ counsel.

INITIAL _______ (18) Reimbursement — reimburse my agent or others for reasonable costs and expenses actually incurred and paid on my behalf.

INITIAL _______ (19) Retirement plans and IRAs — create, contribute to, borrow from, and deal with employee benefit plans and IRAs for my benefit, select payment options, roll over benefits, and apply for and receive payments. (Does NOT include changing beneficiary designations — see Article IV.)

INITIAL _______ (20) Institutional power forms — sign additional power of attorney forms required by the Internal Revenue Service, financial or brokerage institutions, or others, naming my agent on those forms.

INITIAL _______ (21) Personal and medical records — request, receive, and review information about my personal affairs and my physical or mental health, including legal, medical, and hospital records, sign releases to obtain it, and disclose it as my agent deems appropriate.

INITIAL _______ (22) Funeral and burial — make advance arrangements for my funeral and burial, including purchase of a burial plot and marker, if I have not already done so.

INITIAL _______ (23) Digital assets — access any catalogue of electronic communications I send or receive, and any other digital asset in which I have a right or interest, under the Revised Uniform Fiduciary Access to Digital Assets Act (Tenn. Code Ann. Title 35, Chapter 8). (Does NOT include the CONTENT of my electronic communications — see Article IV.)

INITIAL _______ ALL POWERS — I incorporate Tenn. Code Ann. § 34-6-109 in its entirety.

IMPORTANT: Even the "ALL POWERS" election does NOT grant the powers listed in Article IV below. Tennessee law (Tenn. Code Ann. § 34-6-108(c)) does not permit those powers to be granted by incorporation; each is granted only if you separately initial it in Article IV.

ARTICLE IV — EXPRESS GRANTS (INITIAL EACH POWER YOU INTEND TO GIVE)

Under Tenn. Code Ann. § 34-6-108(c), my agent does NOT have any of the following powers unless I expressly grant them here. INITIAL EACH POWER YOU INTEND TO GRANT. IF YOU DO NOT INITIAL A POWER, MY AGENT DOES NOT HAVE IT.

INITIAL _______ (1) Gifts — to make gifts, grants, or other transfers of my property without consideration (Tenn. Code Ann. §§ 34-6-108(c)(1), 34-6-110). If I initial this power, the following election applies (initial ONE; if I make no election, option (i) applies):

_______ (i) gifts consistent with my personal history of making or joining in lifetime gifts (the Tenn. Code Ann. § 34-6-110(a) standard);

_______ (ii) gifts limited, per recipient per year, to the annual federal gift-tax exclusion amount;

_______ (iii) gifts unlimited as to amount and recipient.

If I have NOT initialed the gift power above: my agent has NO authority to make gifts, grants, or other transfers without consideration, except in fulfillment of charitable pledges I made while competent, and Tenn. Code Ann. § 34-6-110 shall not be construed to confer gift authority on my agent.

INITIAL _______ (2) Trust powers — to exercise any power of revocation, amendment, or appointment that I hold over the income or principal of any trust (Tenn. Code Ann. § 34-6-108(c)(2)).

INITIAL _______ (3) Create trusts — to create one or more trusts on my behalf and transfer my property into them.

INITIAL _______ (4) Beneficiary designations — to create or change beneficiary designations on death benefits payable on my death under any life insurance policy, employee benefit plan, or individual retirement account (Tenn. Code Ann. § 34-6-108(c)(5)).

INITIAL _______ (5) Survivorship rights — to change, add, or delete any right of survivorship designation on any property, real or personal, that I own alone or with others (Tenn. Code Ann. § 34-6-108(c)(6)).

INITIAL _______ (6) Disclaimers — to renounce or disclaim any property, interest in property, or powers to which I may become entitled, whether by gift or by testate or intestate succession (Tenn. Code Ann. § 34-6-108(c)(7)).

INITIAL _______ (7) Elective share — to exercise, refuse, release, or abandon any right to claim an elective share in any estate or under any will (Tenn. Code Ann. § 34-6-108(c)(8)).

INITIAL _______ (8) Content of electronic communications — to access the content of my electronic communications, as permitted by Tenn. Code Ann. § 34-6-112 and the Revised Uniform Fiduciary Access to Digital Assets Act.

Powers this document never grants: my agent may not act for me in any fiduciary office I hold (except to renounce or resign it), may not exercise incidents of ownership over a life insurance policy I own on my agent's life, and may not make medical treatment or health care decisions for me (Tenn. Code Ann. §§ 34-6-108(c)(3), (4), (9)).

ARTICLE V — SPECIAL INSTRUCTIONS

On the following lines I may limit, extend, delete, or modify the powers granted to my agent (Tenn. Code Ann. § 34-6-108(b)).

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

ARTICLE VI — OTHER PROVISIONS

Fiduciary duty. My agent is in a fiduciary relationship with me to the extent my agent acts under this document and must adequately account to me, and to any legal representative appointed for me, for actions taken under it (Tenn. Code Ann. § 34-6-107). Acts of my agent under this durable power of attorney during any period of my disability or incapacity bind me and my successors in interest as if I were competent and not disabled (Tenn. Code Ann. § 34-6-103).

Compensation. My agent is entitled to reimbursement for reasonable costs and expenses actually incurred on my behalf, and to reasonable compensation for services actually performed as my agent.

_______ (Initial only if desired) My agent shall serve without compensation. (Reimbursement of expenses still applies.)

Delegation. My agent may hire and pay professionals and service providers under the powers granted in Article III. In addition:

_______ (Initial only if desired) My agent may delegate discretionary authority granted under this power of attorney to one or more persons my agent selects.

Nomination of conservator (optional). If a court proceeding is ever commenced to appoint a conservator, guardian of my estate, or other fiduciary for me, I nominate the following person for consideration by the court: ________________________________________________. The court must make its appointment in accordance with my most recent nomination except for good cause or disqualification (Tenn. Code Ann. § 34-6-104). If a conservator, guardian of the estate, or other fiduciary is appointed for me, my agent will be accountable to that fiduciary as well as to me, and the fiduciary will have the same power to revoke or amend this power of attorney that I would have if I were not disabled or incapacitated (Tenn. Code Ann. § 34-6-104).

Revocation. I may revoke this power of attorney at any time while I am competent by a signed writing delivered to my agent and to any person relying on this power of attorney. If this power of attorney has been registered with a county register of deeds, its revocation should also be registered (Tenn. Code Ann. § 66-24-101(a)). This power of attorney terminates at my death.

_______ (Initial only if desired) I revoke every general financial power of attorney I previously signed. This does not revoke any health care power of attorney or advance directive.

Reliance by third parties; proof of continuation. Any person may rely on this power of attorney in good faith. An affidavit by my agent, executed under Tenn. Code Ann. § 34-6-105(c), stating that my agent does not have actual knowledge of the termination of this power of attorney by revocation or by my death, is conclusive proof of its nonrevocation or nontermination as to acts undertaken in good-faith reliance, and is recordable when authenticated for record. A form of that affidavit is included with this document. A photocopy or electronic copy of this document may be relied on to the same extent as the original, except that an authenticated original may be required for registration with a county register of deeds.

Governing law. This power of attorney is governed by and shall be construed under the laws of the State of Tennessee. I intend it to be valid in every jurisdiction, but if any provision is held invalid elsewhere, the remainder continues in effect (severability).

ARTICLE VII — EXECUTION

I am fully informed as to all the contents of this power of attorney and understand the full import of this grant of powers to my agent.

Signed this _______ day of ____________________, 20_____.

_____________________________________________

(Signature of Principal)

_____________________________________________

(Printed Name and Address of Principal)

Signing note for Tennessee. This power of attorney is valid between you and your agent when it is in writing and signed by you — Tennessee law does not require a notary or witnesses for its validity (Tenn. Code Ann. § 34-6-102). However, to REGISTER this document with a county register of deeds — which is required before your agent signs a deed or other recordable instrument — your signature must be acknowledged before a notary public or other authorized officer, OR proved by at least two subscribing witnesses (Tenn. Code Ann. §§ 66-22-101, 66-24-101). Banks and title companies customarily require notarization as well. The acknowledgment certificate below is provided for that purpose; if you use two subscribing witnesses instead, they should sign a statement that they witnessed your signature, and their signatures should be proved as provided by law.

CERTIFICATE OF ACKNOWLEDGMENT (TENNESSEE)

State of Tennessee

County of ____________________

Personally appeared before me, ________________________________________ [name of officer], ________________________________________ [official capacity of officer], ________________________________________ [name of principal], with whom I am personally acquainted (or proved to me on the basis of satisfactory evidence), and who acknowledged that such person executed the within instrument for the purposes therein contained (Tenn. Code Ann. §§ 66-22-107, 66-22-114).

The principal personally appeared before me (check one): _______ physically; _______ by interactive two-way audio and video communication meeting the requirements of the Online Notary Public Act (Tenn. Code Ann. § 66-22-101(c)).

Witness my hand, at office, this _______ day of ____________________, 20_____.

(Seal, if any)

_____________________________________________

(Signature of officer)

My commission expires: ____________________

PREPARATION STATEMENT

This document was prepared by the following individual:

________________________________________________ [Typed or printed name]

________________________________________________ [Address]

________________________________________________ [Signature]

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AGENT'S ACKNOWLEDGMENT (OPTIONAL)

Signing this acknowledgment is NOT required for this power of attorney to be effective. It is provided so your agent can confirm, for banks and others, that the agent accepts the role and understands the duties Tennessee law imposes.

I, ________________________________________________ [name of agent], have read the attached power of attorney and am the person identified as the agent for the principal. I accept the appointment. I understand that to the extent I act under the power of attorney I am in a fiduciary relationship with the principal, and that I have a duty to adequately account to the principal, and to any legal representative of the principal, for actions I take under it (Tenn. Code Ann. § 34-6-107). I agree to act loyally for the principal's benefit, to keep the principal's property separate from my own, and to act only within the scope of authority granted.

_____________________________________________

(Agent's Signature)

_____________________________________________

(Agent's Printed Name)

_____________________

(Date)

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AGENT'S AFFIDAVIT OF NON-REVOCATION OR NON-TERMINATION

For use after this power of attorney is in effect, when a bank, register of deeds, or other person asks for proof that it is still in force. Under Tenn. Code Ann. § 34-6-105(c), this affidavit is conclusive proof of the nonrevocation or nontermination of the power of attorney as to acts undertaken in good-faith reliance on it. When authenticated for record, it is recordable with the county register of deeds.

State of Tennessee

County of ____________________

I, ________________________________________________ [name of agent], being duly sworn, state:

1. I am the agent (attorney in fact) designated in the attached Tennessee General Durable Power of Attorney executed by ________________________________________________ [name of principal].

2. That power of attorney has become effective: the principal's disability or incapacity has been determined in the manner specified in Article II of that document, and the written certification or determination is attached to or accompanies this affidavit.

3. At the time of the exercise of the power described, I do not have actual knowledge of the termination of the power of attorney by revocation or by the death of the principal.

_____________________________________________

(Agent's Signature)

Sworn to (or affirmed) and subscribed before me by ________________________________ [name of agent] on ____________________ [date].

(Seal, if any)

_____________________________________________

(Signature of notarial officer)

My commission expires: ____________________

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EXHIBIT A — CERTIFICATION OF DISABILITY OR INCAPACITY

This certification activates the attached Tennessee General Durable Power of Attorney. It must be completed by the licensed physician, or by the individual named in Article II of that document, who examined or evaluated the principal. Persons may rely in good faith on a certification that is regular on its face.

I, ________________________________________________, state:

_______ I am a physician licensed to practice in ____________________ [state], and I examined ________________________________________________ [name of principal] on ____________________ [date].

_______ I am the individual named in Article II of the attached power of attorney to make this determination.

On the basis of that examination or evaluation, I certify that the principal is disabled or incapacitated as defined in Article II of the attached power of attorney — that is, the principal is unable to manage the principal's property or financial affairs effectively.

_____________________________________________

(Signature)

_____________________________________________

(Printed name)

_____________________________________________

(Address and telephone)

_____________________

(Date)