Durable Power Of Attorney

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Please fill the form out below and hit submit to send it to Express Non Lawyer for review.

DURABLE POWER OF ATTORNEY QUESTIONNAIRE

Client Information

Your Contact Email Address: *
Name of person giving authority: *
Best Contact Phone Number: *
Complete Address: *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Date Of Birth: *
We ONLY need the Last 4 digits of SS# *

Trusted Person #1

Name of the Trusted Person to receive authority: *
How is this person related to person listed in Client Information *
Complete Address: *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Date Of Birth: *
We ONLY need the Last 4 digits of SS# *

Trusted Person #2

Name of the Trusted Person to receive authority:
How is this person related to person listed in Client Information
Complete Address:
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Date Of Birth:
We ONLY need the Last 4 digits of SS#
RELEASE OF LIABILITY *
Please read the information below and by clicking on EACH CHECK BOX below acts as you read and agree to the terms below. I have been informed by the Staff of Express L C L Services, Inc. d/b/a Express Non Lawyer that:They ARE NOT ATTORNEYS, & they CANNOT GIVE LEGAL ADVICE.They are only assisting me in the proper preparation of these documents so that I can represent myself in this matter without an attorney.They have further informed me that legal representation by an attorney would advise me of all legal rights that I may have arising out of this action.The legal documents prepared by Express L C L Services, Inc. d/b/a Express Non Lawyer,have been prepared in accordance with the information provided by me in my desire to represent myself in this transaction.I declare:That the information provided by me is true and complete to the best of my knowledge and belief;That I agree to review all documents prepared and my signature is acknowledgment of my approval of all documents;That I hereby release Express L C L Services, Inc. d/b/a Express Non Lawyer, from any liability arising out of the services performed for me by them as the result of my failure to provide the information requested or to thoroughly review all documents. I further declare that I am signing this document without undue influence, threat or pressure from any person or entity involved in the outcome of this transactionI understand that any and all payments made to Express L C L Services, Inc. d/b/a Express Non Lawyer, for the preparation of any documents are non-refundable and that I have been informed that I must pick up my documents within 90 days of completion or the documents maybe destroyed and/or I may incur additional fees as determined applicable by the Staff of Express L C L Services, Inc. d/b/a Express Non Lawyer.
By Entering The Date & Name below, I hereby agree to the terms listed in the RELEASE OF LIABILITY.
Your First & Last Name *
Today's Date *

Are You A Human?

Please enter these two digits *Example: 12
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Express NonLawyer

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