The Vermont Statutes Online

Title 14 : Decedents Estates and Fiduciary Relations

Chapter 127 : Vermont Uniform Power of Attorney Act

Subchapter 003 : Statutory Forms

• 4052. Statutory short form power of attorney for real estate transactions

  (a) A document substantially in the following form may be used to create a statutory form power of attorney for a real estate transaction that has the meaning and effect prescribed by this chapter.

  VERMONT STATUTORY FORM POWER OF ATTORNEY IMPORTANT INFORMATION

  This power of attorney authorizes another person (your agent) to take actions for you (the principal) in connection with a real estate transaction (sale, purchase, mortgage, or gift). Your agent will be able to make decisions and act with respect to a specific parcel of land whether or not you are able to act for yourself. The meaning of authority over subjects listed on this form is explained in the Vermont Uniform Power of Attorney Act, 14 V.S.A. chapter 127.

  DESIGNATION OF AGENT

  I/we _______________________________and _______________________________

  (Name(s) of Principal) appoint the following person as my (our) agent:

  Name of Agent: _________________________________________

  Name of Alternate Agent: _________________________________________

  Address of Property that is the subject of this power of attorney

  (Street): _________________________________________, (Municipality)

  ___________________________________________, Vermont.

  Transaction for which the power of attorney is given:

  [ ] Sale

  [ ] Purchase or Acquisition

  [ ] Mortgage

  [ ] Finance and/or Mortgage

  [ ] Gift

  GRANT OF AUTHORITY

  I/we grant my (our) agent and any alternate agent authority named in this power of attorney to act for me/us with respect to a real estate transaction involving the property with the address stated above, including, but not limited to, the powers described in 14 V.S.A. 4034(2), (3), and (4) as provided in the Vermont Uniform Power of Attorney Act, 14 V.S.A. chapter 127.

  POWER TO DELEGATE

  [ ] If this box is checked, each agent appointed in this power of attorney may delegate the authority to act to another person. Any delegation shall be in writing and executed in the same manner as this power of attorney.

  TERM

  This power of attorney commences when fully executed and continues until the real estate transaction for which it was given is complete.

  SELF HEALING

  [ ] If this box is checked, the agent named in this power of attorney may convey the subject real estate with or without consideration to the agent, individually, in trust, or to one or more persons with the agent.

  CHOICE OF LAW

  This power of attorney and the effect hereof shall be determined by the application of Vermont law and the Vermont Uniform Power of Attorney Act.

  SIGNATURE AND ACKNOWLEDGMENT

  _______________________________________________________________________

  Your Name Printed

  _______________________________________________________________________

  Your Address

  Your Telephone Number_________________________________________________________

  State of_________________________________________

  County of_________________________________________

  This document was acknowledged before me on _______________________________(Date)

  by _______________________________________________________________________

  (Name of Principal)

  __________________________________________________________________(Seal, if any)

  Signature of Notary_________________________________________

  My Commission expires:_________________________________________

  (b) A power of attorney in the form above confers on the agent the powers provided in subdivisions 4034(2), (3), and (4) of this chapter. (Added 2023, No. 60, 1, eff. July 1, 2023.)