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Power of Attorney Intake Form

Thank you for selecting Open Door Law Corporation to potentially assist you with a Power of Attorney. Powers of Attorney are highly effective documents that are used by one party to assist another with financial matters. Please complete our Power of Attorney Intake Form as completely as possible as the information provided will be used to check for conflicts and comply with the Law Society of British Columbia’s identification requirements. By completing this form in advance, we can spend more time focusing on the Power of Attorney and related issues. Submission of this form will help us assess your matter and whether we can help you. it should not be inferred that a lawyer client relationship is formed until we confirm this with you. Please note that this form assumes that British Columbia law applies to you. We reserve the right to request additional information from you either before or during our meeting.

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If you would rather complete this form on paper, we also offer a PDF version that you can print, then mail or fax to us. (Details within)

    Fields marked with * are required

    A. Personal Information of the Donor

    Your Full Legal Name:


    Relationship status:
    SingleMarriedCommon Law

    Does your partner also require a power of attorney?
    YesNo

    Partner Full Legal Name:


    B. Information about Your Attorney

    Do you have an alternate person you are appointing as your power of attorney?
    YesNo

    What is the working relationship between your primary and alternate attorney?
    Each of them can act separatelyThey must act together

    C. Additional Information

    Have you given a power of attorney to anyone else that remains valid?
    YesNo

    Are we revoking the existing power of attorney?
    YesNo

    Do you wish your power of attorney to continue if you lose capacity (endured power of attorney)?
    YesNo

    Do you wish your attorney to have the ability to appoint a replacement attorney?
    YesNo

    Do you own real property/real estate?
    YesNo

    Can your attorney use the power of attorney to transfer property from you to himself or herself?
    YesNo

    Can your attorney use the power of attorney to provide gifts to a charity(ies)?
    YesNo

    Can your attorney use the power of attorney to delegate authority to retain the services of a qualified person to assist the Attorney?
    YesNo

    When do you wish the Power of Attorney to be effective?
    ImmediatelyOnly when one (1) doctor declare you are incapable of managing your affairsOnly to be used upon specific condition

    Is your attorney to be compensated for his/her time and effort on your behalf?
    No compensation except for out-of-pocket expensesOther

    Additional Comments (if any):


    Required Consent and Agreement *

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      Required Consent and Agreement *