Power of Attorney Questionnaire - Garrison Wills & Trusts

What is a Lasting Power of Attorney (LPA)?

An LPA allows you to appoint trusted people to make decisions on your behalf if you lose mental capacity.

Two types available:

• Property & Financial Affairs LPA - Manages your money, property, and bills

• Health & Welfare LPA - Makes decisions about your medical treatment and care

Type of LPA Required

Which LPA(s) do you need? *

Property & Financial Affairs LPA (£420) Health & Welfare LPA (£420)

Most people need both. Price is per LPA type.

Your Details (The Donor)

Full Legal Name *

Date of Birth *

Full Address *

Email Address *

Phone Number *

Previous Names (if any) Including maiden names or any names you've been known by

Your Attorneys

Attorneys are the people you trust to make decisions on your behalf. You can appoint 1 or more attorneys.

First Attorney - Full Name *

First Attorney - Full Address *

First Attorney - Date of Birth *

Relationship to You *

Second Attorney - Full Name

Second Attorney - Full Address

Second Attorney - Date of Birth

Relationship to You

Additional Attorneys

How should your attorneys make decisions? *

Jointly (all must agree) Jointly & Severally (can act together or separately)

If you have only one attorney, this doesn't apply

Replacement Attorneys (Optional)

Replacement attorneys can step in if an original attorney can no longer act.

First Replacement Attorney - Full Name

First Replacement Attorney - Full Address

First Replacement Attorney - Date of Birth

Relationship to You

People to Notify (Optional)

You can name up to 5 people who should be told when you apply to register your LPA.

People to Notify (Name & Address)

Certificate Provider

A certificate provider confirms you understand the LPA and are making it of your own free will. This must be someone who has known you for at least 2 years OR a professional (e.g., solicitor, doctor).

Do you have a certificate provider? *

Yes (please provide details below) No (we can arrange this for you)

Certificate Provider Details

Preferences & Instructions

Preferences (for Health & Welfare LPA)

Instructions (Optional)

Are there any restrictions on what your attorneys can do?

Additional Information

When do you need your LPA?

Preferred Contact Method

Additional Notes or Questions

Lasting Power of Attorney Questionnaire