David Thomas

Solicitor, Conveyancer & Notary

3, Sussex Terrace, Hawthorn, South Australia 5062
Telephone: (+ 61 8) 8172 1222
Facsimile: (+ 61 8) 8127 9553
Contact


INSTRUCTIONS FOR ENDURING POWER OF ATTORNEY
(only for residents of South Australia)


You can use this form to give me instructions for the preparation of a South Australian Enduring Power of Attorney.

The special feature of an enduring power of attorney is that it "endures" and remains effective when the grantor has lost his legal capacity, i.e., soundness of mind, memory and understanding. This can be particularly useful for victims of accidents, stroke, dementia and the like. However, this positive feature gives emphasis to the need to exercise great care in selecting the attorney, who must be absolutely trustworthy and dependable.

This form can be used to give me instructions for a single Power of Attorney or for "mutual" or "mirror image" Powers of Attorney, i.e., where spouses appoint each other (with or without additional persons) as their attorneys.

If I need any more information, I will contact you. Please provide as many contact details as you can.

Your e-mail address
This field is mandatory, otherwise submission of the form will fail
Your name
This field is mandatory, otherwise submission of the form will fail
YOU
(the person giving the instructions)
Full Name(s) (including surname or family name in BLOCKS)
Residential Address
Contact Address
Contact Telephone
(day and evening)
Contact Fax
Contact Email
Preferred means
INSTRUCTIONS
These instructions are for:
If for a relative, state your relationship to the grantor
If for a relative or friend, confirm that you are authorised to provide these instructions: Yes, I am authorised by the grantor(s)
The authority is in writing
The authority is verbal
Date of the authority:
GRANTOR
(the person granting the power of attorney)
Full Name(s) (including surname or family name in BLOCKS)
Full Address
Occupation(s) or description(s)
ATTORNEY 1
(the first person whom you wish to appoint as your attorney)
Full Name (including surname or family name in BLOCKS)
Full Address
Occupation or description
Relationship (if any) to grantor
ATTORNEY 2
(the second person (if any) whom you wish to appoint as your attorney)
Full Name (including surname or family name in BLOCKS)
Full Address
Occupation or description
Relationship (if any) to grantor
ATTORNEY 3
(the third person (if any) whom you wish to appoint as your attorney)
Full Name (including surname or family name in BLOCKS)
Full Address
Occupation or description
Relationship (if any) to grantor
EXERCISE OF POWER
If you appoint more than one attorney, you must state how your attorneys are to exercise their powers Jointly (all together). This is not recommended.
Severally (any one of them).
A minimum of (state number):
Successively, e.g., if Attorney 1 cannot act for any reason, then Attorney 2 can.
EXCLUSIONS
You can exclude certain powers. These are some exclusions you may wish to consider. If you do NOT want your attorneys to have any of these powers, please tick the relevant box. Power to mortgage or encumber any of your assets.
Power to execute in your name any guarantee of a third person's legal obligation.
Power to give away any of your assets.
Other - please specify:
COMMENCEMENT
When do you want the Power of Attorney to become operative? Immediately
On a certain date - please specify:
On your loss of legal capacity
On the occurrence of some other event - please specify:
CESSATION
When do you want the operation of the Power of Attorney to cease? No cessation date (your death will automatically cancel the Power of Attorney)
On a certain date - please specify:
On the occurrence of some event - please specify:
REGISTRATION
Do you want the Power of Attorney to be deposited in the Lands Titles Office? This is necessary if the attorney will be dealing with any land in which you have an interest.
CUSTODY
Where do you want the original Power of Attorney to be held?
If "Other", please specify:
EXECUTIONThe Grantor must sign the Power of Attorney in the presence of a person authorised by law in South Australia to take affidavits. This means a Commissioner for Taking Affidavits in the Supreme Court of South Australia (usually a solicitor); a Justice of The Peace for South Australia; a proclaimed manager; or a proclaimed member of the police force.

Each Attorney must sign the statement of acceptance at the foot of the Power of Attorney, but the signature need not be witnessed.

If these requirements are not satisfied, the Power of Attorney will not endure.
FEES Single Power of Attorney: $121-00 (including GST)

Two mutual Powers of Attorney: $198-00 (including GST)

Additional cost for LTO registration (per Power of Attorney): $160-00 (including GST)

Please send your payment as soon as you have received confirmation from me that I have accepted your instructions. Upon receipt of your payment, I will send the document(s) to the Grantor with instructions for execution.


Click on this button to clear all fields and re-enter data:
Click on this button to send your instructions to me:
THANK YOU FOR YOUR INSTRUCTIONS!

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