Power of Attorney for Retirement Accounts

Principal Information

Full Name:
Address:
Phone Number:

Attorney-in-Fact Information

Full Name:
Address:
Phone Number:

Retirement Account Information

Account Provider:
Account Number:
Type of Account(s):

Powers Granted

The Principal grants the Attorney-in-Fact the power to manage, access, withdraw, transfer, and otherwise handle the above-listed retirement account(s), including but not limited to communicating with the financial institution and making decisions related to distributions, account management, and beneficiary changes as permitted by law.

Effective Date and Duration

Effective Date:
Expiration Date (if any):

This Power of Attorney remains in effect unless revoked in writing by the Principal or upon the expiration date stated above, if any.

Signatures

Principal Signature:
Date:
Attorney-in-Fact Signature:
Date:

Notarization (if required)

Notary Public Signature:
Date:
Commission Expiration: