EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0092*
HOUSE BILL 92
N2 2lr0391
HB 870/21 – JUD (PRE–FILED)
By: Delegate Hill
Requested: August 18, 2021
Introduced and read first time: January 12, 2022
Assigned to: Judiciary
A BILL ENTITLED
AN ACT concerning 1
Maryland General and Limited Power of Attorney Act – Assistance With 2
Governmental Benefits and Programs 3
FOR the purpose of altering certain statutory forms for a power of attorney to include 4
certain provisions relating to the authority of an agent to perform certain acts 5
relating to eligibility and qualifications for certain governmental benefits or 6
programs; altering a certain provision in a certain statutory form for a limited power 7
of attorney relating to the authority of an agent to make a gift of part or all of a 8
principal’s property or to take certain actions with respect to certain trusts under 9
certain circumstances; and generally relating to powers of attorney. 10
BY repealing and reenacting, with amendments, 11
Article – Estates and Trusts 12
Section 17–202 and 17–203 13
Annotated Code of Maryland 14
(2017 Replacement Volume and 2021 Supplement) 15
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 16
That the Laws of Maryland read as follows: 17
Article – Estates and Trusts 18
17–202. 19
“MARYLAND STATUTORY FORM 20
PERSONAL FINANCIAL POWER OF ATTORNEY 21
IMPORTANT INFORMATION AND WARNING 22
2 HOUSE BILL 92
You should be very careful in deciding whether or not to sign this document. The powers 1
granted by you (the principal) in this document are broad and sweeping. This power of 2
attorney authorizes another person (your agent) to make decisions concerning your 3
property for you (the principal). Your agent will be able to make decisions and act with 4
respect to your property (including your money) whether or not you are able to act for 5
yourself. 6
You should select someone you trust to serve as your agent. Unless you specify otherwise, 7
generally the agent’s authority will continue until you die or revoke the power of attorney 8
or the agent resigns or is unable to act for you. 9
You need not grant all of the powers listed below. If you choose to grant less than all of the 10
listed powers, you may instead use a Maryland Statutory Form Limited Power of Attorney 11
and mark on that Maryland Statutory Form Limited Power of Attorney which powers you 12
intend to delegate to your attorney–in–fact (the Agent) and which you do not want the 13
Agent to exercise. 14
This power of attorney becomes effective immediately unless you state otherwise in the 15
Special Instructions. 16
You should obtain competent legal advice before you sign this power of attorney if you have 17
any questions about the document or the authority you are granting to your agent. 18
DESIGNATION OF AGENT 19
This section of the form provides for designation of one agent. 20
If you wish to name coagents, skip this section and use the next section (“Designation of 21
Coagents”). 22
I, ___________________________________________________________________________, 23
(Name of Principal) 24
Name the following person as my agent: 25
Name of Agent: _______________________________________________________________ 26
Agent’s Address: ______________________________________________________________ 27
Agent’s Telephone Number: ___________________________________________________ 28
DESIGNATION OF COAGENTS (OPTIONAL) 29
This section of the form provides for designation of two or more coagents. Coagents are 30
required to act together unanimously unless you otherwise provide in this form. 31
HOUSE BILL 92 3
I, ___________________________________________________________________________, 1
(Name of Principal) 2
Name the following persons as coagents: _______________________________________ 3
Name of Coagent: ____________________________________________________________ 4
Coagent’s Address: ___________________________________________________________ 5
Coagent’s Telephone Number: _________________________________________________ 6
Name of Coagent: ____________________________________________________________ 7
Coagent’s Address: ___________________________________________________________ 8
Coagent’s Telephone Number: _________________________________________________ 9
Special Instructions Regarding Coagents: _______________________________________ 10
___________________________________________________________________________________ 11
___________________________________________________________________________________ 12
____________________________________________________________________ 13
DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL) 14
If my agent is unable or unwilling to act for me, I name as my successor agent: 15
Name of Successor Agent: _____________________________________________________ 16
Successor Agent’s 17
Address: _____________________________________________________________________ 18
Successor Agent’s 19
Telephone Number: ___________________________________________________________ 20
If my successor agent is unable or unwilling to act for me, I name as my second successor 21
agent: 22
Name of Second 23
Successor Agent: _____________________________________________________________ 24
Second Successor 25
Agent’s Address: ______________________________________________________________ 26
Second Successor Agent’s 27
Telephone Number: ___________________________________________________________ 28
4 HOUSE BILL 92
GRANT OF GENERAL AUTHORITY 1
I (“the principal”) grant my agent and any successor agent, with respect to each subject 2
listed below, the authority to do all acts that I could do to: 3
(1) Contract with another person, on terms agreeable to the agent, to 4
accomplish a purpose of a transaction and perform, rescind, cancel, terminate, reform, 5
restate, release, or modify the contract or another contract made by or on behalf of the 6
principal; 7
(2) Execute, acknowledge, seal, deliver, file, or record any instrument or 8
communication the agent considers desirable to accomplish a purpose of a transaction; 9
(3) Seek on the principal’s behalf the assistance of a court or other 10
governmental agency to carry out an act authorized in this power of attorney; 11
(4) Initiate, participate in, submit to alternative dispute resolution, settle, 12
oppose, or propose or accept a compromise with respect to a claim existing in favor of or 13
against the principal or intervene in litigation relating to the claim; 14
(5) Engage, compensate, and discharge an attorney, accountant, 15
discretionary investment manager, expert witness, or other advisor; 16
(6) Prepare, execute, and file a record, report, or other document to 17
safeguard or promote the principal’s interest under a statute or regulation and 18
communicate with representatives or employees of a government or governmental 19
subdivision, agency, or instrumentality, on behalf of the principal; and 20
(7) Do lawful acts with respect to the subject and all property related to the 21
subject. 22
SUBJECTS AND AUTHORITY 23
My agent’s authority shall include the authority to act as stated below with regard to each 24
of the following subjects: 25
Real property – With respect to this subject, I authorize my agent to: demand, buy, sell, 26
convey, lease, receive, accept as a gift or as security for an extension of credit, or otherwise 27
acquire or reject an interest in real property or a right incident to real property; pledge or 28
mortgage an interest in real property or right incident to real property as security to borrow 29
money or pay, renew, or extend the time of payment of a debt of the principal or a debt 30
guaranteed by the principal, including a reverse mortgage; release, assign, satisfy, or 31
enforce by litigation or otherwise a mortgage, deed of trust, conditional sale contract, 32
encumbrance, lien, or other claim to real property that exists or is asserted; and manage or 33
conserve an interest in real property or a right incident to real property owned or claimed 34
to be owned by the principal, including: (1) insuring against liability or casualty or other 35
loss; (2) obtaining or regaining possession of or protecting the interest or right by litigation 36 HOUSE BILL 92 5
or otherwise; (3) paying, assessing, compromising, or contesting taxes or assessments or 1
applying for and receiving refunds in connection with them; and (4) purchasing supplies, 2
hiring assistance or labor, and making repairs or alterations to the real property. 3
Stocks and bonds – With respect to this subject, I authorize my agent to: buy, sell, and 4
exchange stocks and bonds; establish, continue, modify, or terminate an account with 5
respect to stocks and bonds; pledge stocks and bonds as security to borrow, pay, renew, or 6
extend the time of payment of a debt of the principal; receive certificates and other 7
evidences of ownership with respect to stocks and bonds; exercise voting rights with respect 8
to stocks and bonds in person or by proxy, enter into voting trusts, and consent to 9
limitations on the right to vote. 10
Banks and other financial institutions – With respect to this subject, I authorize my agent 11
to: continue, modify, transact all business in connection with, and terminate an account or 12
other banking arrangement made by or on behalf of the principal; establish, modify, 13
transact all business in connection with, and terminate an account or other banking 14
arrangement with a bank, trust company, savings and loan association, credit union, thrift 15
company, brokerage firm, or other financial institution selected by the agent; contract for 16
services available from a financial institution, including renting a safe deposit box or space 17
in a vault; deposit by check, money order, electronic funds transfer, or otherwise with, or 18
leave in the custody of, a financial institution money or property of the principal; withdraw, 19
by check, money order, electronic funds transfer, or otherwise, money or property of the 20
principal deposited with or left in the custody of a financial institution; receive statements 21
of account, vouchers, notices, and similar documents from a financial institution and act 22
with respect to them; enter a safe deposit box or vault and withdraw or add to the contents; 23
borrow money and pledge as security personal property of the principal necessary to borrow 24
money or pay, renew, or extend the time of payment of a debt of the principal or a debt 25
guaranteed by the principal; make, assign, draw, endorse, discount, guarantee, and 26
negotiate promissory notes, checks, drafts, and other negotiable or nonnegotiable paper of 27
the principal or payable to the principal or the principal’s order, transfer money, receive 28
the cash or other proceeds of those transactions; and apply for, receive, and use credit cards 29
and debit cards, electronic transaction authorizations, and traveler’s checks from a 30
financial institution. 31
Insurance and annuities – With respect to this subject, I authorize my agent to: continue, 32
pay the premium or make a contribution on, modify, exchange, rescind, release, or 33
terminate a contract procured by or on behalf of the principal that insures or provides an 34
annuity to either the principal or another person, whether or not the principal is a 35
beneficiary under the contract; procure new, different, and additional contracts of 36
insurance and annuities for the principal and select the amount, type of insurance or 37
annuity, and mode of payment; pay the premium or make a contribution on, modify, 38
exchange, rescind, release, or terminate a contract of insurance or annuity procured by the 39
agent; apply for and receive a loan secured by a contract of insurance or annuity; surrender 40
and receive the cash surrender value on a contract of insurance or annuity; exercise an 41
election; exercise investment powers available under a contract of insurance or annuity; 42
change the manner of paying premiums on a contract of insurance or annuity; change or 43
convert the type of insurance or annuity with respect to which the principal has or claims 44 6 HOUSE BILL 92
to have authority described in this section; apply for and procure a benefit or assistance 1
under a statute or regulation to guarantee or pay premiums of a contract of insurance on 2
the life of the principal; collect, sell, assign, hypothecate, borrow against, or pledge the 3
interest of the principal in a contract of insurance or annuity; select the form and timing of 4
the payment of proceeds from a contract of insurance or annuity; pay, from proceeds or 5
otherwise, compromise or contest, and apply for refunds in connection with a tax or 6
assessment levied by a taxing authority with respect to a contract of insurance or annuity 7
or the proceeds or liability from the contract of insurance or annuity accruing by reason of 8
the tax or assessment. 9
Claims and litigation – With respect to this subject, I authorize my agent to: assert and 10
maintain before a court or administrative agency a claim, claim for relief, cause of action, 11
counterclaim, offset, recoupment, or defense, including an action to recover property or 12
other thing of value, recover damages sustained by the principal, eliminate or modify tax 13
liability, or seek an injunction, specific performance, or other relief; act for the principal 14
with respect to bankruptcy or insolvency, whether voluntary or involuntary, concerning the 15
principal or some other person, or with respect to a reorganization, receivership, or 16
application for the appointment of a receiver or trustee that affects an interest of the 17
principal in property or other thing of value; pay a judgment, award, or order against the 18
principal or a settlement made in connection with a claim or litigation; and receive money 19
or other thing of value paid in settlement of or as proceeds of a claim or litigation. 20
Benefits from governmental programs or civil or military service (including any benefit, 21
program, or assistance provided under a statute or regulation including Social Security, 22
Medicare, and Medicaid) – With respect to this subject, I authorize my agent to: execute 23
vouchers in the name of the principal for allowances and reimbursements payable by the 24
United States or a foreign government or by a state or subdivision of a state to the principal; 25
PERFORM THE ACTS NEC ESSARY TO ENABLE THE PRINCIPAL TO QUALIFY FOR A 26
BENEFIT OR PROGRAM , INCLUDING OBTAINING PERSONAL AND FINANCI AL 27
RECORDS AND , TO THE EXTENT AUTHOR IZED IN THE SPECIAL INSTRUCTIONS 28
BELOW, TO TRANSFER OR GIFT THE PRINCIPAL ’S PROPERTY; enroll in, apply for, 29
select, reject, change, amend, or discontinue, on the principal’s behalf, a benefit or program; 30
prepare, file, and maintain a claim of the principal for a benefit or assistance, financial or 31
otherwise, to which the principal may be entitled under a statute or regulation; initiate, 32
participate in, submit to alternative dispute resolution, settle, oppose, or propose or accept 33
a compromise with respect to litigation concerning a benefit or assistance the principal may 34
be entitled to receive under a statute or regulation; and receive the financial proceeds of a 35
claim described above and conserve, invest, disburse, or use for a lawful purpose anything 36
so received. 37
Retirement plans (including a plan or account created by an employer, the principal, or 38
another individual to provide retirement benefits or deferred compensation of which the 39
principal is a participant, beneficiary, or owner, including a plan or account under the 40
following sections of the Internal Revenue Code: (1) an individual retirement account under 41
Internal Revenue Code Section 408, 26 U.S.C. § 408; (2) a Roth individual retirement 42
account under Internal Revenue Code Section 408A, 26 U.S.C. § 408A; (3) a deemed 43
individual retirement account under Internal Revenue Code Section 408(q), 26 U.S.C. § 44 HOUSE BILL 92 7
408(q); (4) an annuity or mutual fund custodial account under Internal Revenue Code 1
Section 403(b), 26 U.S.C. § 403(b); (5) a pension, profit–sharing, stock bonus, or other 2
retirement plan qualified under Internal Revenue Code Section 401(a), 26 U.S.C. § 401(a); 3
(6) a plan under Internal Revenue Code Section 457(b), 26 U.S.C. § 457(b); and (7) a 4
nonqualified deferred compensation plan under Internal Revenue Code Section 409A, 26 5
U.S.C. § 409A) – With respect to this subject, I authorize my agent to: select the form and 6
timing of payments under a retirement plan and withdraw benefits from a plan; make a 7
rollover, including a direct trustee–to–trustee rollover, of benefits from one retirement plan 8
to another; establish a retirement plan in the principal’s name; make contributions to a 9
retirement plan; exercise investment powers available under a retirement plan; borrow 10
from, sell assets to, or purchase assets from a retirement plan. I recognize that granting 11
my agent the authority to create or change a beneficiary designation for a retirement plan 12
may affect the benefits that I may receive if that authority is exercised. If I grant my agent 13
the authority to designate the agent, the agent’s spouse, or a dependent of the agent as a 14
beneficiary of a retirement plan, the grant may constitute a taxable gift by me and may 15
make the property subject to that authority taxable as a part of the agent’s estate. 16
Therefore, if I wish to authorize my agent to create or change a beneficiary designation for 17
any retirement plan, and in particular if I wish to authorize the agent to designate as my 18
beneficiary the agent, the agent’s spouse, or a dependent of the agent, I will explicitly state 19
this authority in the Special Instructions section that follows or in a separate power of 20
attorney. 21
Taxes – With respect to this subject, I authorize my agent to: prepare, sign, and file federal, 22
state, local, and foreign income, gift, payroll, property, federal insurance contributions act, 23
and other tax returns, claims for refunds, requests for extension of time, petitions regarding 24
tax matters, and other tax–related documents, including receipts, offers, waivers, consents, 25
including consents and agreements under Internal Revenue Code Section 2032(A), 26 26
U.S.C. § 2032(A), closing agreements, and other powers of attorney required by the Internal 27
Revenue Service or other taxing authority with respect to a tax year on which the statute 28
of limitations has not run and the following 25 tax years; pay taxes due, collect refunds, 29
post bonds, receive confidential information, and contest deficiencies determined by the 30
Internal Revenue Service or other taxing authority; exercise elections available to the 31
principal under federal, state, local, or foreign tax law; and act for the principal in all tax 32
matters for all periods before the Internal Revenue Service, or other taxing authority. 33
Digital assets – With respect to this subject, in accordance with the Maryland Fiduciary 34
Access to Digital Assets Act, my agent shall have authority over and the right to access: (1) 35
the content of any of my electronic communications; (2) any catalogue of electronic 36
communications sent or received by me; and (3) any other digital asset in which I have a 37
right or interest. 38
SPECIAL INSTRUCTIONS (OPTIONAL) 39
YOU MAY GIVE SPECIAL INSTRUCTIONS ON THE FOLL OWING LINES: 40
___________________________________________________________________________________ 41
___________________________________________________________________________________ 42 8 HOUSE BILL 92
___________________________________________________________________________________ 1
___________________________________________________________________________________ 2
___________________________________________________________________________________ 3
___________________________________________________________________________________ 4
___________________________________________________________________________________ 5
___________________________________________ 6
EFFECTIVE DATE 7
This power of attorney is effective immediately unless I have stated otherwise in the Special 8
Instructions. 9
TERMINATION DATE (OPTIONAL) 10
This power of attorney shall terminate on ______________________________, 20____. 11
(Use a specific calendar date) 12
NOMINATION OF GUARDIAN (OPTIONAL) 13
If it becomes necessary for a court to appoint a guardian of my property or guardian of my 14
person, I nominate the following person(s) for appointment: 15
Name of nominee for guardian of my property: __________________________________ 16
Nominee’s address: ___________________________________________________________ 17
Nominee’s telephone number: _________________________________________________ 18
Name of nominee for guardian of my person: ____________________________________ 19
Nominee’s address: ___________________________________________________________ 20
Nominee’s telephone number: _________________________________________________ 21
DESIGNATION OF AGENT TO MAKE ELECTION TO TAKE ELECTIVE SHARE 22
(OPTIONAL) 23
If I am incapacitated within the meaning of § 17–101 of the Estates and Trusts Article, I 24
designate the following person as my agent for purposes of making the election to take an 25
elective share of an estate subject to election under § 3–403 of the Estates and Trusts 26
Article: 27
Name of designated agent: _____________________________________________________ 28
Designated agent’s address: ____________________________________________________ 29
Designated agent’s telephone number: __________________________________________ 30
SIGNATURE AND ACKNOWLEDGMENT 31
________________________________________ __________________________ 32
Your Signature Date 33
______________________________________________________________________________ 34 HOUSE BILL 92 9
Your Name Printed 1
___________________________________________________________________________________ 2
_________________________________________________________________________ 3
Your Address 4
______________________________________________________________________________ 5
Your Telephone Number 6
STATE OF MARYLAND 7
(COUNTY) OF _______________________________________________________________ 8
This document was acknowledged before me on 9
__________________________ 10
(Date) 11
By ______________________________________ to be his/her act. 12
(Name of Principal) 13
____________________________________________ (SEAL, IF ANY) 14
Signature of Notary 15
My commission expires: _____________________ 16
WITNESS ATTESTATION 17
The foregoing power of attorney was, on the date written above, published and declared by 18
____________________________________________ 19
(Name of Principal) 20
in our presence to be his/her power of attorney. We, in his/her presence and at his/her 21
request, and in the presence of each other, have attested to the same and have signed our 22
names as attesting witnesses. 23
____________________________________________ 24
Witness #1 Signature 25
____________________________________________ 26
Witness #1 Name Printed 27
____________________________________________ 28
____________________________________________ 29
Witness #1 Address 30
____________________________________________ 31
Witness #1 Telephone Number 32
____________________________________________ 33
Witness #2 Signature 34 10 HOUSE BILL 92
____________________________________________ 1
Witness #2 Name Printed 2
____________________________________________ 3
____________________________________________ 4
Witness #2 Address 5
____________________________________________ 6
Witness #2 Telephone Number” 7
17–203. 8
“MARYLAND STATUTORY FORM LIMITED POWER OF ATTORNEY 9
PLEASE READ CAREFULLY 10
This power of attorney authorizes another person (your agent) to make decisions concerning 11
your property for you (the principal). You need not give to your agent all the authorities 12
listed below and may give the agent only those limited powers that you specifically indicate. 13
This power of attorney gives your agent the right to make limited decisions for you. You 14
should very carefully weigh your decision as to what powers you give your agent. Your 15
agent will be able to make decisions and act with respect to your property (including your 16
money) whether or not you are able to act for yourself. 17
If you choose to make a grant of limited authority, you should check the boxes that identify 18
the specific authorization you choose to give your agent. 19
This power of attorney does not authorize the agent to make health care decisions for you. 20
You should select someone you trust to serve as your agent. Unless you specify otherwise, 21
generally the agent’s authority will continue until you die or revoke the power of attorney 22
or the agent resigns or is unable to act for you. 23
Your agent is not entitled to compensation unless you indicate otherwise in the special 24
instructions of this power of attorney. If you indicate that your agent is to receive 25
compensation, your agent is entitled to reasonable compensation or compensation as 26
specified in the Special Instructions. 27
This form provides for designation of one agent. If you wish to name more than one agent 28
you may name a coagent in the Special Instructions. Coagents are required to act together 29
unanimously unless you specify otherwise in the Special Instructions. 30
If your agent is unavailable or unwilling to act for you, your power of attorney will end 31
unless you have named a successor agent. You may also name a second successor agent. 32
This power of attorney becomes effective immediately unless you state otherwise in the 33
Special Instructions. 34
If you have questions about the power of attorney or the authority you are granting to your 35 HOUSE BILL 92 11
agent, you should seek legal advice before signing this form. 1
DESIGNATION OF AGENT 2
This section of the form provides for designation of one agent. 3
If you wish to name coagents, skip this section and use the next section (“Designation of 4
Coagents”). 5
I, ___________________________________________________, name the following person 6
(Name of Principal) 7
as my agent: 8
Name of 9
Agent: _______________________________________________________________________ 10
Agent’s 11
Address: _____________________________________________________________________ 12
Agent’s Telephone 13
Number: _____________________________________________________________________ 14
DESIGNATION OF COAGENTS (OPTIONAL) 15
This section of the form provides for designation of two or more coagents. Coagents are 16
required to act together unanimously unless you otherwise provide in this form. 17
I, ___________________________________________________________________________, 18
(Name of Principal) 19
Name the following persons as coagents: 20
Name of Coagent: ____________________________________________________________ 21
Coagent’s Address: ___________________________________________________________ 22
Coagent’s Telephone Number: _________________________________________________ 23
Name of Coagent: ____________________________________________________________ 24
Coagent’s Address: ___________________________________________________________ 25
Coagent’s Telephone Number: _________________________________________________ 26
Special Instructions Regarding Coagents: _______________________________________ 27
___________________________________________________________________________________ 28
___________________________________________________________________________________ 29
____________________________________________________________________ 30 12 HOUSE BILL 92
DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL) 1
If my agent is unable or unwilling to act for me, I name as my successor agent: 2
Name of Successor Agent: _____________________________________________________ 3
Successor Agent’s 4
Address: _____________________________________________________________________ 5
Successor Agent’s Telephone Number: __________________________________________ 6
If my successor agent is unable or unwilling to act for me, I name as my second successor 7
agent: 8
Name of Second Successor 9
Agent: _______________________________________________________________________ 10
Second Successor Agent’s 11
Address: _____________________________________________________________________ 12
Second Successor Agent’s Telephone Number: ___________________________________ 13
GRANT OF GENERAL AUTHORITY 14
I (“the principal”) grant my agent and any successor agent, with respect to each subject 15
that I choose below, the authority to do all acts that I could do to: 16
(1) Demand, receive, and obtain by litigation or otherwise, money or 17
another thing of value to which the principal is, may become, or claims to be entitled, and 18
conserve, invest, disburse, or use anything so received or obtained for the purposes 19
intended; 20
(2) Contract with another person, on terms agreeable to the agent, to 21
accomplish a purpose of a transaction and perform, rescind, cancel, terminate, reform, 22
restate, release, or modify the contract or another contract made by or on behalf of the 23
principal; 24
(3) Execute, acknowledge, seal, deliver, file, or record any instrument or 25
communication the agent considers desirable to accomplish a purpose of a transaction, 26
including creating a schedule contemporaneously or at a later time listing some or all of the 27
principal’s property and attaching the schedule to this power of attorney; 28
(4) Initiate, participate in, submit to alternative dispute resolution, settle, 29
oppose, or propose or accept a compromise with respect to a claim existing in favor of or 30
against the principal or intervene in litigation relating to the claim; 31
(5) Seek on the principal’s behalf the assistance of a court or other 32
governmental agency to carry out an act authorized in this power of attorney; 33
(6) Engage, compensate, and discharge an attorney, accountant, 34 HOUSE BILL 92 13
discretionary investment manager, expert witness, or other advisor; 1
(7) Prepare, execute, and file a record, report, or other document to 2
safeguard or promote the principal’s interest under a statute or regulation; 3
(8) Communicate with representatives or employees of a government or 4
governmental subdivision, agency, or instrumentality, on behalf of the principal; 5
(9) Access communications intended for, and communicate on behalf of the 6
principal, whether by mail, electronic transmission, telephone, or other means; and 7
(10) Do lawful acts with respect to the subject and all property related to the 8
subject. 9
(INITIAL each authority in any subject you want to include in the agent’s general 10
authority. Cross through each authority in any subject that you want to exclude. If you 11
wish to grant general authority over an entire subject, you may initial “All of the above” 12
instead of initialing each authority.) 13
SUBJECTS AND AUTHORITY 14
A. Real Property – With respect to this category, I authorize my agent to: 15
(___) Demand, buy, lease, receive, accept as a gift or as security for an 16
extension of credit, or otherwise acquire or reject an interest in real property or a right 17
incident to real property 18
(___) Sell, exchange, convey with or without covenants, representations, or 19
warranties, quitclaim, release, surrender, retain title for security, encumber, partition, 20
consent to partitioning, subject to an easement or covenant, subdivide, apply for zoning or 21
other governmental permits, plat or consent to platting, develop, grant an option 22
concerning, lease, sublease, contribute to an entity in exchange for an interest in that 23
entity, or otherwise grant or dispose of an interest in real property or a right incident to 24
real property 25
(___) Pledge or mortgage an interest in real property or right incident to real 26
property as security to borrow money or pay, renew, or extend the time of payment of a 27
debt of the principal or a debt guaranteed by the principal, including a reverse mortgage 28
(___) Release, assign, satisfy, or enforce by litigation or otherwise a 29
mortgage, deed of trust, conditional sale contract, encumbrance, lien, or other claim to real 30
property that exists or is asserted 31
(___) Manage or conserve an interest in real property or a right incident to 32
real property owned or claimed to be owned by the principal, including: 33
(1) Insuring against liability or casualty or other loss; 34 14 HOUSE BILL 92
(2) Obtaining or regaining possession of or protecting the interest or right 1
by litigation or otherwise; 2
(3) Paying, assessing, compromising, or contesting taxes or assessments or 3
applying for and receiving refunds in connection with them; and 4
(4) Purchasing supplies, hiring assistance or labor, and making repairs or 5
alterations to the real property 6
(___) Use, develop, alter, replace, remove, erect, or install structures or other 7
improvements on real property in or incident to which the principal has, or claims to have, 8
an interest or right 9
(___) Participate in a reorganization with respect to real property or an entity 10
that owns an interest in or a right incident to real property and receive, hold, and act with 11
respect to stocks and bonds or other property received in a plan of reorganization, including: 12
(1) Selling or otherwise disposing of the stocks and bonds or other property; 13
(2) Exercising or selling an option, a right of conversion, or a similar right 14
with respect to the stocks and bonds or other property; and 15
(3) Exercising voting rights in person or by proxy 16
(___) Change the form of title of an interest in or a right incident to real 17
property 18
(___) Dedicate to public use, with or without consideration, easements or 19
other real property in which the principal has, or claims to have, an interest 20
(___) All of the above 21
B. Tangible Personal Property – With respect to this subject, I authorize my 22
agent to: 23
(___) Demand, buy, receive, accept as a gift or as security for an extension of 24
credit, or otherwise acquire or reject ownership or possession of tangible personal property 25
or an interest in tangible personal property 26
(___) Sell, exchange, convey with or without covenants, representations, or 27
warranties, quitclaim, release, surrender, create a security interest in, grant options 28
concerning, lease, sublease, or otherwise dispose of tangible personal property or an 29
interest in tangible personal property 30
(___) Grant a security interest in tangible personal property or an interest in 31
tangible personal property as security to borrow money or pay, renew, or extend the time 32 HOUSE BILL 92 15
of payment of a debt of the principal or a debt guaranteed by the principal 1
(___) Release, assign, satisfy, or enforce by litigation or otherwise, a security 2
interest, lien, or other claim on behalf of the principal, with respect to tangible personal 3
property or an interest in tangible personal property 4
(___) Manage or conserve tangible personal property or an interest in 5
tangible personal property on behalf of the principal, including: 6
(1) Insuring against liability or casualty or other loss; 7
(2) Obtaining or regaining possession of or protecting the property or 8
interest, by litigation or otherwise; 9
(3) Paying, assessing, compromising, or contesting taxes or assessments or 10
applying for and receiving refunds in connection with taxes or assessments; 11
(4) Moving the property from place to place; 12
(5) Storing the property for hire or on a gratuitous bailment; and 13
(6) Using and making repairs, alterations, or improvements to the property 14
(___) Change the form of title of an interest in tangible personal property 15
(___) All of the above 16
C. Stocks and Bonds – With respect to this subject, I authorize my agent to: 17
(___) Buy, sell, and exchange stocks and bonds 18
(___) Establish, continue, modify, or terminate an account with respect to 19
stocks and bonds 20
(___) Pledge stocks and bonds as security to borrow, pay, renew, or extend 21
the time of payment of a debt of the principal 22
(___) Receive certificates and other evidences of ownership with respect to 23
stocks and bonds 24
(___) Exercise voting rights with respect to stocks and bonds in person or by 25
proxy, enter into voting trusts, and consent to limitations on the right to vote 26
(___) All of the above 27
D. Commodities – With respect to this subject, I authorize my agent to: 28
16 HOUSE BILL 92
(___) Buy, sell, exchange, assign, settle, and exercise commodity futures 1
contracts and call or put options on stocks or stock indexes traded on a regulated option 2
exchange 3
(___) Establish, continue, modify, and terminate option accounts 4
(___) All of the above 5
E. Banks and Other Financial Institutions – With respect to this subject, I 6
authorize my agent to: 7
(___) Continue, modify, transact all business in connection with, and 8
terminate an account or other banking arrangement made by or on behalf of the principal 9
(___) Establish, modify, transact all business in connection with, and 10
terminate an account or other banking arrangement with a bank, trust company, savings 11
and loan association, credit union, thrift company, brokerage firm, or other financial 12
institution selected by the agent 13
(___) Contract for services available from a financial institution, including 14
renting a safe deposit box or space in a vault 15
(___) Deposit by check, money order, electronic funds transfer, or otherwise 16
with, or leave in the custody of, a financial institution money or property of the principal 17
(___) Withdraw, by check, money order, electronic funds transfer, or 18
otherwise, money or property of the principal deposited with or left in the custody of a 19
financial institution 20
(___) Receive statements of account, vouchers, notices, and similar 21
documents from a financial institution and act with respect to them 22
(___) Enter a safe deposit box or vault and withdraw or add to the contents 23
(___) Borrow money and pledge as security personal property of the principal 24
necessary to borrow money or pay, renew, or extend the time of payment of a debt of the 25
principal or a debt guaranteed by the principal 26
(___) Make, assign, draw, endorse, discount, guarantee, and negotiate 27
promissory notes, checks, drafts, and other negotiable or nonnegotiable paper of the 28
principal or payable to the principal or the principal’s order, transfer money, receive the 29
cash or other proceeds of those transactions, and accept a draft drawn by a person on the 30
principal and pay the draft when due 31
(___) Receive for the principal and act on a sight draft, warehouse receipt, 32
other document of title whether tangible or electronic, or other negotiable or nonnegotiable 33
instrument 34 HOUSE BILL 92 17
(___) Apply for, receive, and use letters of credit, credit cards and debit cards, 1
electronic transaction authorizations, and traveler’s checks from a financial institution and 2
give an indemnity or other agreement in connection with letters of credit 3
(___) Consent to an extension of the time of payment with respect to 4
commercial paper or a financial transaction with a financial institution 5
(___) All of the above 6
F. Operation of an Entity or a Business – With respect to this subject, I authorize 7
my agent to: 8
(___) Operate, buy, sell, enlarge, reduce, or terminate an ownership interest 9
(___) Perform a duty or discharge a liability and exercise in person or by 10
proxy a right, power, privilege, or an option that the principal has, may have, or claims to 11
have 12
(___) Enforce the terms of an ownership agreement 13
(___) Initiate, participate in, submit to alternative dispute resolution, settle, 14
oppose, or propose or accept a compromise with respect to litigation to which the principal 15
is a party because of an ownership interest 16
(___) Exercise in person or by proxy, or enforce by litigation or otherwise, a 17
right, power, privilege, or an option the principal has or claims to have as the holder of 18
stocks and bonds 19
(___) Initiate, participate in, submit to alternative dispute resolution, settle, 20
oppose, or propose or accept a compromise with respect to litigation to which the principal 21
is a party concerning stocks and bonds 22
(___) With respect to an entity or business owned solely by the principal: 23
(1) Continue, modify, renegotiate, extend, and terminate a contract made 24
by or on behalf of the principal with respect to the entity or business before execution of 25
this power of attorney; 26
(2) Determine: 27
(i) The location of the operation of the entity or business; 28
(ii) The nature and extent of the business of the entity or business; 29
(iii) The methods of manufacturing, selling, merchandising, 30
financing, accounting, and advertising employed in the operation of the entity or business; 31 18 HOUSE BILL 92
(iv) The amount and types of insurance carried by the entity or 1
business; and 2
(v) The mode of engaging, compensating, and dealing with the 3
employees and accountants, attorneys, or other advisors of the entity or business; 4
(3) Change the name or form of organization under which the entity or 5
business is operated and enter into an ownership agreement with other persons to take 6
over all or part of the operation of the entity or business; and 7
(4) Demand and receive money due or claimed by the principal or on the 8
principal’s behalf in the operation of the entity or business and control and disburse the 9
money in the operation of the entity or business 10
(___) Put additional capital into an entity or a business in which the principal 11
has an interest 12
(___) Join in a plan of reorganization, consolidation, conversion, 13
domestication, or merger of the entity or business 14
(___) Sell or liquidate all or part of an entity or business 15
(___) Establish the value of an entity or a business under a buyout agreement 16
to which the principal is a party 17
(___) Prepare, sign, file, and deliver reports, compilations of information, 18
returns, or other papers with respect to an entity or business and make related payments 19
(___) Pay, compromise, or contest taxes, assessments, fines, or penalties and 20
perform other acts to protect the principal from illegal or unnecessary taxation, 21
assessments, fines, or penalties, with respect to an entity or a business, including attempts 22
to recover, as permitted by law, money paid before or after the execution of this power of 23
attorney 24
(___) All of the above 25
G. Insurance and Annuities – With respect to this subject, I authorize my agent 26
to: 27
(___) Continue, pay the premium or make a contribution on, modify, 28
exchange, rescind, release, or terminate a contract procured by or on behalf of the principal 29
that insures or provides an annuity to either the principal or another person, whether or 30
not the principal is a beneficiary under the contract 31
(___) Procure new, different, and additional contracts of insurance and 32
annuities for the principal and the principal’s spouse, children, and other dependents, and 33 HOUSE BILL 92 19
select the amount, type of insurance or annuity, and mode of payment 1
(___) Pay the premium or make a contribution on, modify, exchange, rescind, 2
release, or terminate a contract of insurance or annuity procured by the agent 3
(___) Apply for and receive a loan secured by a contract of insurance or 4
annuity 5
(___) Surrender and receive the cash surrender value on a contract of 6
insurance or annuity 7
(___) Exercise an election 8
(___) Exercise investment powers available under a contract of insurance or 9
annuity 10
(___) Change the manner of paying premiums on a contract of insurance or 11
annuity 12
(___) Change or convert the type of insurance or annuity with respect to 13
which the principal has or claims to have authority described in this section 14
(___) Apply for and procure a benefit or assistance under a statute or 15
regulation to guarantee or pay premiums of a contract of insurance on the life of the 16
principal 17
(___) Collect, sell, assign, hypothecate, borrow against, or pledge the interest 18
of the principal in a contract of insurance or annuity 19
(___) Select the form and timing of the payment of proceeds from a contract 20
of insurance or annuity 21
(___) Pay, from proceeds or otherwise, compromise or contest, and apply for 22
refunds in connection with a tax or assessment levied by a taxing authority with respect to 23
a contract of insurance or annuity or the proceeds or liability from the contract of insurance 24
or annuity accruing by reason of the tax or assessment 25
(___) All of the above 26
H. Estates, Trusts, and Other Beneficial Interests (including trusts, probate 27
estates, guardianships, conservatorships, escrows, or custodianships or funds from which 28
the principal is, may become, or claims to be entitled to a share or payment) – With respect 29
to this subject, I authorize my agent to: 30
(___) Accept, receive, receipt for, sell, assign, pledge, or exchange a share in 31
or payment from the fund described above 32
20 HOUSE BILL 92
(___) Demand or obtain money or another thing of value to which the 1
principal is, may become, or claims to be entitled by reason of the fund described above, by 2
litigation or otherwise 3
(___) Exercise for the benefit of the principal a presently exercisable general 4
power of appointment held by the principal 5
(___) Initiate, participate in, submit to alternative dispute resolution, settle, 6
oppose, or propose or accept a compromise with respect to litigation to ascertain the 7
meaning, validity, or effect of a deed, will, declaration of trust, or other instrument or 8
transaction affecting the interest of the principal 9
(___) Initiate, participate in, submit to alternative dispute resolution, settle, 10
oppose, or propose or accept a compromise with respect to litigation to remove, substitute, 11
or surcharge a fiduciary 12
(___) Conserve, invest, disburse, or use anything received for an authorized 13
purpose 14
(___) Transfer an interest of the principal in real property, stocks and bonds, 15
accounts with financial institutions or securities intermediaries, insurance, annuities, and 16
other property to the trustee of a revocable trust created by the principal as settlor 17
(___) Reject, renounce, disclaim, release, or consent to a reduction in or 18
modification of a share in or payment from the fund described above 19
(___) Elect to take an elective share of an estate subject to election under § 20
3–403 of the Estates and Trusts Article 21
(___) All of the above 22
I. Claims and Litigation – With respect to this subject, I authorize my agent to: 23
(___) Assert and maintain before a court or administrative agency a claim, 24
claim for relief, cause of action, counterclaim, offset, recoupment, or defense, including an 25
action to recover property or other thing of value, recover damages sustained by the 26
principal, eliminate or modify tax liability, or seek an injunction, specific performance, or 27
other relief 28
(___) Bring an action to determine adverse claims or intervene or otherwise 29
participate in litigation 30
(___) Seek an attachment, garnishment, order of arrest, or other preliminary, 31
provisional, or intermediate relief and use an available procedure to effect or satisfy a 32
judgment, order, or decree 33
(___) Make or accept a tender, offer of judgment, or admission of facts, submit 34 HOUSE BILL 92 21
a controversy on an agreed statement of facts, consent to examination, and bind the 1
principal in litigation 2
(___) Submit to alternative dispute resolution, settle, and propose or accept 3
a compromise 4
(___) Waive the issuance and service of process on the principal, accept 5
service of process, appear for the principal, designate persons on which process directed to 6
the principal may be served, execute and file or deliver stipulations on the principal’s 7
behalf, verify pleadings, seek appellate review, procure and give surety and indemnity 8
bonds, contract and pay for the preparation and printing of records and briefs, receive, 9
execute, and file or deliver a consent, waiver, release, confession of judgment, satisfaction 10
of judgment, notice, agreement, or other instrument in connection with the prosecution, 11
settlement, or defense of a claim or litigation 12
(___) Act for the principal with respect to bankruptcy or insolvency, whether 13
voluntary or involuntary, concerning the principal or some other person, or with respect to 14
a reorganization, receivership, or application for the appointment of a receiver or trustee 15
that affects an interest of the principal in property or other thing of value 16
(___) Pay a judgment, award, or order against the principal or a settlement 17
made in connection with a claim or litigation 18
(___) Receive money or other thing of value paid in settlement of or as 19
proceeds of a claim or litigation 20
(___) All of the above 21
J. Personal and Family Maintenance – With respect to this subject, I authorize 22
my agent to: 23
(___) Perform the acts necessary to maintain the customary standard of 24
living of the principal, the principal’s spouse, and the following individuals, whether living 25
when this power of attorney is executed or later born: 26
(1) The principal’s children; 27
(2) Other individuals legally entitled to be supported by the 28
principal; and 29
(3) The individuals whom the principal has customarily supported 30
or indicated the intent to support; 31
(___) Make periodic payments of child support and other family maintenance 32
required by a court or governmental agency or an agreement to which the principal is a 33
party 34
22 HOUSE BILL 92
(___) Provide living quarters for the individuals described above by: 1
(1) Purchase, lease, or other contract; or 2
(2) Paying the operating costs, including interest, amortization 3
payments, repairs, improvements, and taxes, for premises owned by the principal or 4
occupied by those individuals 5
(___) Provide normal domestic help, usual vacations and travel expenses, and 6
funds for shelter, clothing, food, appropriate education, including postsecondary and 7
vocational education, and other current living costs for the individuals described above 8
(___) Pay expenses for necessary health care and custodial care on behalf of 9
the individuals described above 10
(___) Act as the principal’s personal representative in accordance with the 11
Health Insurance Portability and Accountability Act, §§ 1171 through 1179 of the Social 12
Security Act, 42 U.S.C. § 1320d, and applicable regulations in making decisions related to 13
the past, present, or future payment for the provision of health care consented to by the 14
principal or anyone authorized under the law of this State to consent to health care on 15
behalf of the principal 16
(___) Continue provisions made by the principal for automobiles or other 17
means of transportation, including registering, licensing, insuring, and replacing the 18
means of transportation, for the individuals described above 19
(___) Maintain credit and debit accounts for the convenience of the 20
individuals described above and open new accounts 21
(___) Continue payments incidental to the membership or affiliation of the 22
principal in a religious institution, club, society, order, or other organization or to continue 23
contributions to those organizations 24
(NOTE: Authority with respect to personal and family maintenance is neither 25
dependent on, nor limited by, authority that an agent may or may not have with respect to 26
gifts under this power of attorney.) 27
(___) All of the above 28
K. Benefits from Governmental Programs or Civil or Military Service (including 29
any benefit, program, or assistance provided under a statute or regulation including Social 30
Security, Medicare, and Medicaid) – With respect to this subject, I authorize my agent to: 31
(___) Execute vouchers in the name of the principal for allowances and 32
reimbursements payable by the United States or a foreign government or by a state or 33
subdivision of a state to the principal, including allowances and reimbursements for 34
transportation of the individuals described in “J. Personal and Family Maintenance” above, 35 HOUSE BILL 92 23
and for shipment of the household effects of those individuals 1
(___) Take possession and order the removal and shipment of property of the 2
principal from a post, warehouse, depot, dock, or other place of storage or safekeeping, 3
either governmental or private, and execute and deliver a release, voucher, receipt, bill of 4
lading, shipping ticket, certificate, or other instrument for that purpose 5
(___) PERFORM THE ACTS NECE SSARY TO ENABLE THE PRINCIPAL TO 6
QUALIFY FOR A BENEFIT OR PRO GRAM, INCLUDING OBTAINING PERSONAL AND 7
FINANCIAL RECORDS AN D, TO THE EXTENT SPECIF ICALLY AUTHORIZED BELOW , TO 8
TRANSFER OR GIFT THE PRINCIPAL’S PROPERTY 9
(___) Enroll in, apply for, select, reject, change, amend, or discontinue, on the 10
principal’s behalf, a benefit or program 11
(___) Prepare, file, and maintain a claim of the principal for a benefit or 12
assistance, financial or otherwise, to which the principal may be entitled under a statute 13
or regulation 14
(___) Initiate, participate in, submit to alternative dispute resolution, settle, 15
oppose, or propose or accept a compromise with respect to litigation concerning a benefit or 16
assistance the principal may be entitled to receive under a statute or regulation 17
(___) Receive the financial proceeds of a claim described above and conserve, 18
invest, disburse, or use for a lawful purpose anything so received 19
(___) All of the above 20
L. Retirement Plans (including a plan or account created by an employer, the 21
principal, or another individual to provide retirement benefits or deferred compensation of 22
which the principal is a participant, beneficiary, or owner, including a plan or account 23
under the following sections of the Internal Revenue Code: 24
(1) An individual retirement account under Internal Revenue Code Section 25
408, 26 U.S.C. § 408; 26
(2) A Roth individual retirement account under Internal Revenue Code 27
Section 408A, 26 U.S.C. § 408A; 28
(3) A deemed individual retirement account under Internal Revenue Code 29
Section 408(q), 26 U.S.C. § 408(q); 30
(4) An annuity or mutual fund custodial account under Internal Revenue 31
Code Section 403(b), 26 U.S.C. § 403(b); 32
(5) A pension, profit–sharing, stock bonus, or other retirement plan 33
qualified under Internal Revenue Code Section 401(a), 26 U.S.C. § 401(a); 34 24 HOUSE BILL 92
(6) A plan under Internal Revenue Code Section 457(b), 26 U.S.C. § 457(b); 1
and 2
(7) A nonqualified deferred compensation plan under Internal Revenue 3
Code Section 409A, 26 U.S.C. § 409A) – With respect to this subject, I authorize my agent 4
to: 5
(___) Select the form and timing of payments under a retirement plan and 6
withdraw benefits from a plan 7
(___) Make a rollover, including a direct trustee–to–trustee rollover, of 8
benefits from one retirement plan to another 9
(___) Establish a retirement plan in the principal’s name 10
(___) Make contributions to a retirement plan 11
(___) Exercise investment powers available under a retirement plan 12
(___) Borrow from, sell assets to, or purchase assets from a retirement plan 13
(___) All of the above 14
M. Taxes – With respect to this subject, I authorize my agent to: 15
(___) Prepare, sign, and file federal, state, local, and foreign income, gift, 16
payroll, property, Federal Insurance Contributions Act, and other tax returns, claims for 17
refunds, requests for extension of time, petitions regarding tax matters, and other 18
tax–related documents, including receipts, offers, waivers, consents, including consents 19
and agreements under Internal Revenue Code Section 2032A, 26 U.S.C. § 2032A, closing 20
agreements, and other powers of attorney required by the Internal Revenue Service or other 21
taxing authority with respect to a tax year on which the statute of limitations has not run 22
and the following 25 tax years 23
(___) Pay taxes due, collect refunds, post bonds, receive confidential 24
information, and contest deficiencies determined by the Internal Revenue Service or other 25
taxing authority 26
(___) Exercise elections available to the principal under federal, state, local, 27
or foreign tax law 28
(___) Act for the principal in all tax matters for all periods before the Internal 29
Revenue Service, or other taxing authority 30
(___) All of the above 31
HOUSE BILL 92 25
N. Gifts [(including gifts to] AND TRANSFERS – WITH RESPECT TO THIS 1
SUBJECT, I AUTHORIZE MY AGENT T O: 2
(___) MAKE A GIFT OR TRANSF ER TO A PERSON, OR CREATE AND FUND 3
FOR THE BENEFIT OF A PERSON, INCLUDING THE PRINCI PAL, a trust, an account under 4
the Uniform Transfers to Minors Act, a tuition savings account or prepaid tuition plan as 5
defined under Internal Revenue Code Section 529, 26 U.S.C. § 529, [and] an ABLE account 6
as defined under Internal Revenue Code Section 529A, 26 U.S.C. § 529A[) – With respect 7
to this subject, I authorize my agent to: 8
(___) Make outright to, or for the benefit of, a person, a gift], OR A SPECIAL 9
NEEDS TRUST OR ANY T RUST AUTHORIZED UNDE R § 1917 OF THE FEDERAL SOCIAL 10
SECURITY ACT, of part or all of the principal’s property, including by the exercise of a 11
presently exercisable general power of appointment held by the principal, in an amount for 12
each donee not to exceed the annual dollar limits of the federal gift tax exclusion under 13
Internal Revenue Code Section 2503(b), 26 U.S.C. § 2503(b), without regard to whether the 14
federal gift tax exclusion applies to the gift, or if the principal’s spouse agrees to consent to 15
a split gift pursuant to Internal Revenue Code Section 2513, 26 U.S.C. § 2513, in an amount 16
for each donee not to exceed twice the annual federal gift tax exclusion limit 17
(___) Consent, pursuant to Internal Revenue Code Section 2513, 26 U.S.C. § 18
2513, to the splitting of a gift made by the principal’s spouse in an amount for each donee 19
not to exceed the aggregate annual gift tax exclusions for both spouses 20
(NOTE: An agent may only make a gift of the principal’s property as the agent 21
determines is consistent with the principal’s objectives if actually known by the agent and, 22
if unknown, as the agent determines is consistent with the principal’s best interest based 23
on all relevant factors, including: 24
(1) The value and nature of the principal’s property; 25
(2) The principal’s foreseeable obligations and need for maintenance; 26
(3) Minimization of taxes, including income, estate, inheritance, 27
generation–skipping transfer, and gift taxes; 28
(4) Eligibility for a benefit, a program, or assistance under a statute or 29
regulation; and 30
(5) The principal’s personal history of making or joining in making gifts.) 31
(___) All of the above 32
GRANT OF SPECIFIC AUTHORITY (OPTIONAL) 33
[My agent MAY NOT] IN ADDITION, MY AGENT MAY do any of the following specific acts 34 26 HOUSE BILL 92
for me [UNLESS] ONLY IF I have INITIALED the specific authority listed below: 1
(Caution: Granting any of the following will give your agent the authority to take actions 2
that could significantly reduce your property or change how your property is distributed at 3
your death. In addition, granting your agent the authority to make gifts to, or to designate 4
as the beneficiary of any retirement plan, the agent, the agent’s spouse, or a dependent of 5
the agent may constitute a taxable gift by you and may make the property subject to that 6
authority taxable as part of the agent’s estate. INITIAL ONLY the specific authority you 7
WANT to give your agent.) 8
(___) TAKE ANY OF THE ACTIO NS I HAVE AUTHORIZED IN S ECTION N OF THIS 9
POWER OF ATTORNEY WI THOUT RESTRICTION ON THE AMOUNT OF THE GI FT OR 10
TRANSFER 11
(___) TAKE ANY OF THE ACTIO NS I HAVE AUTHORIZE D IN SECTION N OF THIS 12
POWER OF ATTORNEY IN FAVOR OF MY AGENT 13
(___) Create AND FUND an inter vivos trust, [or amend, revoke, or terminate an 14
existing inter vivos trust if the trust expressly authorizes that action by the agent] 15
INCLUDING A SPECIAL NEEDS TRUST , ANY TRUST AUTHORIZED UNDER § 1917 OF 16
THE FEDERAL SOCIAL SECURITY ACT, OR A THIRD–PARTY SPECIAL NEEDS TRUST, 17
OR ESTABLISH AND FUN D AN ABLE ACCOUNT AS DEFINED U NDER § 529A OF THE 18
INTERNAL REVENUE CODE, FOR THE BENEFIT OF T HE PRINCIPAL OR THE 19
PRINCIPAL’S FAMILY, HEIRS AT LAW, OR DESCENDANTS , OR ANY OTHER PERSON 20
DESIGNATED BY THE PR INCIPAL AS A BENEFIC IARY UNDER AN EXISTI NG WILL, 21
TRUST, OR OTHER INSTRUMENT 22
(___) AMEND, REVOKE, OR TERMINATE AN EXIS TING INTER VIVOS TRU ST IF 23
THE TRUST EXPRESSLY AUTH ORIZES THAT ACTION B Y THE AGENT 24
(___) Make a gift, subject to any special instructions in this power of attorney, 25
INCLUDING A GIFT OF THE PRINCIPAL ’S ASSETS TO ASSIST T HE PRINCIPAL IN 26
MEETING THE ELIGIBIL ITY REQUIREMENTS AND QUALIFYING FOR A BENEFIT OR 27
PROGRAM 28
(___) Create or change rights of survivorship 29
(___) Create or change a beneficiary designation, subject to any special instructions 30
in this power of attorney; and, if I wish to authorize my agent to designate the agent, the 31
agent’s spouse, or a dependent of the agent as a beneficiary, I will explicitly state this 32
authority within the special instructions of this power of attorney or in a separate power of 33
attorney 34
(___) Authorize another person to exercise the authority granted under this power 35
of attorney 36 HOUSE BILL 92 27
(___) Waive the principal’s right to be a beneficiary of a joint and survivor annuity, 1
including a survivor benefit under a retirement plan 2
(___) Exercise fiduciary powers that the principal has authority to delegate 3
(___) Disclaim or refuse an interest in property, including a power of appointment 4
(___) In accordance with the Maryland Fiduciary Access to Digital Assets Act, 5
access and take control of (1) the content of any of my electronic communications, (2) any 6
catalogue of electronic communications sent or received by me, and (3) any other digital 7
asset in which I have a right or interest 8
(___) Demand the delivery of the principal’s will from the custodian of the will and, 9
on delivery of the principal’s will, take custody of the will subject to the requirements of 10
Title 4, Subtitle 2 of the Estates and Trusts Article 11
LIMITATION ON AGENT’S AUTHORITY 12
An agent that is not my ancestor, spouse, or descendant MAY NOT use my property to 13
benefit the agent or a person to whom the agent owes an obligation of support unless I have 14
included that authority in the Special Instructions. 15
SPECIAL INSTRUCTIONS (OPTIONAL) 16
You may give special instructions on the following lines: 17
___________________________________________________________________________________ 18
___________________________________________________________________________________ 19
___________________________________________________________________________________ 20
___________________________________________________________________________________ 21
___________________________________________________________________________________ 22
___________________________________________________________________________________ 23
________________________________________________ 24
EFFECTIVE DATE 25
This power of attorney is effective immediately unless I have stated otherwise in the Special 26
Instructions. 27
TERMINATION DATE (OPTIONAL) 28
This power of attorney shall terminate on _______________________________, 20______. 29
(Use a specific calendar date) 30
NOMINATION OF GUARDIAN (OPTIONAL) 31
28 HOUSE BILL 92
If it becomes necessary for a court to appoint a guardian of my property or guardian of my 1
person, I nominate the following person(s) for appointment: 2
Name of Nominee for guardian of my property: 3
_____________________________________________________________________________ 4
Nominee’s Address: __________________________________________________________ 5
Nominee’s Telephone Number: ________________________________________________ 6
Name of Nominee for guardian of my person: 7
______________________________________________________________________________ 8
Nominee’s Address: ___________________________________________________________ 9
Nominee’s Telephone Number: ________________________________________________ 10
SIGNATURE AND ACKNOWLEDGMENT 11
_____________________________________________ __________________________ 12
Your Signature Date 13
______________________________________________________________________________ 14
Your Name Printed 15
___________________________________________________________________________________ 16
_________________________________________________________________________ 17
Your Address 18
______________________________________________________________________________ 19
Your Telephone Number 20
STATE OF MARYLAND 21
(COUNTY) OF _______________________________________________________________ 22
This document was acknowledged before me on 23
______________________________________________________________________________, 24
(Date) 25
by ___________________________________________________________________________. 26
(Name of Principal) 27
__________________________________________________________________ (Seal, if any) 28
Signature of Notary 29
My commission expires: _______________________________________________________ 30
WITNESS ATTESTATION 31
The foregoing power of attorney was, on the date written above, published and declared by 32
______________________________________________________________________________ 33
(Name of Principal) 34 HOUSE BILL 92 29
in our presence to be his/her power of attorney. We, in his/her presence and at his/her 1
request, and in the presence of each other, have attested to the same and have signed our 2
names as attesting witnesses. 3
____________________________________________ 4
Witness #1 Signature 5
____________________________________________ 6
Witness #1 Name Printed 7
____________________________________________ 8
____________________________________________ 9
Witness #1 Address 10
____________________________________________ 11
Witness #1 Telephone Number 12
____________________________________________ 13
Witness #2 Signature 14
____________________________________________ 15
Witness #2 Name Printed 16
____________________________________________ 17
____________________________________________ 18
Witness #2 Address 19
____________________________________________ 20
Witness #2 Telephone Number 21
This document prepared by: 22
___________________________________________________________________________________ 23
_________________________________________________________________________ 24
IMPORTANT INFORMATION FOR AGENT 25
Agent’s Duties 26
When you accept the authority granted under this power of attorney, a special legal 27
relationship is created between you and the principal. This relationship imposes on you 28
legal duties that continue until you resign or the power of attorney is terminated or revoked. 29
You must: 30
(1) Do what you know the principal reasonably expects you to do with the 31
principal’s property or, if you do not know the principal’s expectations, act in the principal’s 32
best interest; 33
(2) Act with care, competence, and diligence for the best interest of the principal; 34
(3) Do nothing beyond the authority granted in this power of attorney; and 35 30 HOUSE BILL 92
(4) Disclose your identity as an agent whenever you act for the principal by 1
writing or printing the name of the principal and signing your own name as “agent” in the 2
following manner: 3
__________________________________ ______________________________________ 4
(Principal’s Name) by (Your Signature) as Agent 5
Unless the Special Instructions in this power of attorney state otherwise, you must also: 6
(1) Act loyally for the principal’s benefit; 7
(2) Avoid conflicts that would impair your ability to act in the principal’s best 8
interest; 9
(3) Keep a record of all receipts, disbursements, and transactions made on behalf 10
of the principal; 11
(4) Cooperate with any person that has authority to make health care decisions 12
for the principal to do what you know the principal reasonably expects or, if you do not 13
know the principal’s expectations, to act in the principal’s best interest; and 14
(5) Attempt to preserve the principal’s estate plan if you know the plan and 15
preserving the plan is consistent with the principal’s best interest. 16
Termination of Agent’s Authority 17
You must stop acting on behalf of the principal if you learn of any event that terminates 18
this power of attorney or your authority under this power of attorney. Events that 19
terminate a power of attorney or your authority to act under a power of attorney include: 20
(1) Death of the principal; 21
(2) The principal’s revocation of the power of attorney or your authority; 22
(3) The occurrence of a termination event stated in the power of attorney; 23
(4) The purpose of the power of attorney is fully accomplished; or 24
(5) If you are married to the principal, a legal action is filed with a court to end 25
your marriage, or for your legal separation, unless the Special Instructions in this power of 26
attorney state that such an action will not terminate your authority. 27
Liability of Agent 28
The meaning of the authority granted to you is defined in the Maryland Power of Attorney 29
Act, Title 17 of the Estates and Trusts Article. If you violate the Maryland Power of 30 HOUSE BILL 92 31
Attorney Act, Title 17 of the Estates and Trusts Article, or act outside the authority 1
granted, you may be liable for any damages caused by your violation. 2
If there is anything about this document or your duties that you do not understand, you 3
should seek legal advice.” 4
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 5
October 1, 2022. 6