Please enable JavaScript in your browser to complete this form.A Lasting Power of Attorney is to protect your interests during your lifetime and is the only way to ensure that the people you trust are in a position to deal with your property, financial affairs and health & welfare where you are unable to do so, for example, due to a serious accident or an illness that affects your mental capacity, like dementia. There are two types of Lasting Powers of Attorney: Health and welfare Lasting Power of Attorney: this gives your attorney power to make decision such as medical care, accommodation, daily routine and giving or refusing consent to life-sustaining treatments. Property and financial affairs Lasting Power of Attorney: this gives your attorney power to manage bank accounts, deal with benefits, savings and investments, pensions, pay bills or buy and/or sell property. You can only make an Lasting Power of Attorney when you have the mental capacity to do so. We can guide you through the process to help you prepare a Lasting Power of Attorney that reflects your wishes. Please fill out our online form below. If you need assistance or have any questions, please contact us. Lasting Power of Attorney for Property & Financial Affairs Section 1 - The DonorTitle *MrMrsMissMsMxSirDrLadyLordName *FirstLastAny other names you're known byoptional - e.g. your maiden nameDate of birth *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeEmailSection 2 - The Attorneys Your attorneys will be the people you choose to make decisions on your behalf. They should be people that you know and trust well. You need at least one attorney, but you can have more.Title *MrMrsMissMsMxSirDrLadyLordName *FirstLastAny other names you're known byoptional - e.g. your maiden nameDate of birth *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeEmailAdd another attorneyYesTitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAny other names you're known byoptional - e.g. your maiden nameDate of birthDD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeAdd another attorneyYesTitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAny other names you're known byoptional - e.g. your maiden nameDate of birthDD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeAdd another attorneyYesTitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAny other names you're known byoptional - e.g. your maiden nameDate of birthDD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeSection 3 - How should your attorneys make decisions? You need to choose whether your attorneys can make decisions on their own or must agree some or all decisions unanimously. Whatever you choose, they must always act in your best interests.I only appointed one attorneyYesNoHow do you want your attorneys to work together? (tick one only)Jointly and severally Attorneys can make decisions on their own or together. Most people choose this option because it’s the most practical. Attorneys can get together to make important decisions if they wish, but can make simple or urgent decisions on their own. It’s up to the attorneys to choose when they act together or alone. It also means that if one of the attorneys dies or can no longer act, your LPA will still work.If one attorney makes a decision, it has the same effect as if all the attorneys made that decision.Jointly Attorneys must agree unanimously on every decision, however big or small. Remember, some simple decisions could be delayed because it takes time to get the attorneys together. If your attorneys can’t agree a decision, then they can only make that decision by going to court.Be careful – if one attorney dies or can no longer act, all your attorneys become unable to act. This is because the law says a group appointed ‘jointly’ is a single unit. Your LPA will stop working unless you appoint at least one replacement attorney (in section 4).Jointly for some decisions, jointly and severally for other decisions Attorneys must agree unanimously on some decisions, but can make others on their own. If you choose this option, you must list the decisions your attorneys should make jointly and agree unanimously on Continuation sheet 2. The wording you use is important. There are examples in the Guide, part A3.Be careful – if one attorney dies or can no longer act, none of your attorneys will be able to make any of the decisions you’ve said should be made jointly. Your LPA will stop working for those decisions unless you appoint at least one replacement attorney (in section 4). Your original attorneys will still be able to make any of the other decisions alongside your replacement attorneysDecisions to be made jointly (please list)Section 4 - Replacement Attorneys This section is optional, but we recommend you consider it. Replacement attorneys are a backup in case one of your original attorneys can’t make decisions for you any more. To appoint a trust corporation, fill in the first attorney space below and tick the box in that section. Reasons replacement attorneys step in – if one of your original attorneys dies, loses capacity, no longer wants to be your attorney, becomes bankrupt or subject to a debt relief order or is no longer legally your husband, wife or civil partner. Restrictions – replacement attorneys must be at least 18 years old and have mental capacity to make decisions. They must not be bankrupt or subject to a debt relief order.TitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeThis attorney is a trust corporationYesNoAnother replacementYesTitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeAnother replacementYesTitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeAnother replacementYesTitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeSection 5 - When can your attorneys make decisions? When can your attorneys make decisions?As soon as my LPA has been registered (and also when I don’t have mental capacity). Most people choose this option because it is the most practical. While you still have mental capacity, your attorneys can only act with your consent. If you later lose capacity, they can continue to act on your behalf for all decisions covered by this LPA. This option is useful if you are able to make your own decisions but there’s another reason you want your attorneys to help you – for example, if you’re away on holiday, or if you have a physical condition that makes it difficult to visit the bank, talk on the phone or sign documents.Only when I don’t have mental capacity. Be careful – this can make your LPA a lot less useful. Your attorneys might be asked to prove you do not have mental capacity each time they try to use this LPA.Section 6 - People to notify when the LPA is registered. This section is optional You can let people know that you’re going to register your LPA. They can raise any concerns they have about the LPA – for example, if there was any pressure or fraud in making it.When the LPA is registered, the person applying to register (you or one of your attorneys) must send a notice to each ‘person to notify’. You can’t put your attorneys or replacement attorneys here. People to notify can object to the LPA, but only for certain reasons (listed in the notification form LP3). After that, they are no longer involved in the LPA. Choose people who care about your best interests and who would be willing to speak up if they were concerned.TitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeI want to appoint another person to notify (maximum 5)YesTitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeI want to appoint another person to notify (maximum 5)YesTitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeI want to appoint another person to notify (maximum 5)YesTitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeI want to appoint another person to notify (maximum 5)YesTitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeSection 7 - Preferences and instructions This section is optionalYou can tell your attorneys how you’d prefer them to make decisions, or give them specific instructions which they must follow when making decisions. Most people leave this page blank – you can just talk to your attorneys so they understand how you want them to make decisions for you. Preferences Your attorneys don’t have to follow your preferences but they should keep them in mind.Preferences – use words like ‘prefer’ and ‘would like’Section 8 - Certificate Provider The certificate provider will discuss the lasting power of attorney with the donor to ensure that the donor understands what they are doing and that nobody is forcing them to do it. The certificate provider should be either: a) Someone who has known the donor personally for at least 2 years, such as a friend, neighbour, colleague, or former colleague; or b) Someone with relevant professional skills, such as the donor’s GP, a healthcare professional or a solicitor TitleMrMrsMissMsMxSirDrLadyLordNameFirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeWhat Happens Next? Following submission of your Lasting Power of Attorney for Property & Financial Affairs questionnaire, a member of the DJS Law Solicitors’ team will contact you and shall provide you with our Letter of Engagement that will contain a quotation, together with our Terms of Business. A signed Letter of Engagement is required to be returned before we commence any work on your Lasting Power of Attorney. EmailSubmit