Lasting Power of Attorney Application Form
This is the person completing this application. If you are applying for a friend or a relative, they are the Donor.
This is the person(s) you choose to make decisions on your behalf. You should choose people that you can trust and you know well. Examples of people you may choose are; your spouse, partner, friends or adult children. You can appoint up to four Attorneys. But you may consider that more Attorneys may make it more difficult to agree on decisions.
You need someone to confirm that you are making the Lasting Power of Attorney (LPA) of your own free will – no one is forcing you to do this. They are also confirming that you know what you are doing in putting the LPA in place. This person must be either one of the following:
- Someone with relevant professional skills – for example a Doctor or a Lawyer
- A person you have known for at least two years – for example a colleague or a friend
Complete the following information :
Home Visit, Virtual and Telephone Appointments available where applicable in :
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