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Employment Power of Attorney

A Power of Attorney is a legal document that gives someone you trust the legal authority to act for you in the financial, property, or legal matters you choose. The Power of Attorney is frequently used to help in the event of your illness or disability or in legal transactions where you cannot be present to sign necessary legal documents.

Preview your document instantly online after answering the questions below.

THE PRINCIPAL
Full Name:
Address:
City:
State:
Zip:
AGENT
Full Name:
Address:
City:
State:
Zip:
Would you like to add a second Agent? Yes No
ALTERNATE AGENT
If you think your agent might not be available at any future time, you may name a second person as an alternate agent. Your alternate agent will be called if your agent is unwilling or unable to serve.
Would you like to include an alternate agent? Yes No
POWERS TO BE GRANTED
TAX
The filling of reports , payment of contributions, Cost Statements (quarterly), (Limited) Tax Rate Notices (annually), and any legal documents, i.e. assessments, garnishments, etc., or obtaining other account information as is permissible, (employer reporting data, tax rate information and liability dates).
Yes No
BENEFITS
Requests for separation, 1st notice of payment of benefits for charge purposes, (Limited) employer�s protest of benefit claims and information relative thereto.
Yes No
TAX AND BENEFITS
As described above in the first and second blocks. (Unlimited)
Yes No
TAX REPORTS ONLY
The filing of quarterly reports and payment of contributions only. (Limited)
Yes No
Specify your own powers Yes No
DURABLE OR NON-DURABLE
Answering Yes will make this a Durable power of attorney; answering No will make it Non-Durable
A Durable power of attorney continues to be effective even when the principal becomes incapacitated.
A Non-durable power of attorney terminates upon the principal's incapacity or death.
Do you want this Power of Attorney to be effective even if the Principal becomes incapacitated? Yes No
Please specify the end date of the Power of Attorney:
SIGNING AND WITNESSESS
Would you like to have the document signed in front of a Notary Public? No Yes
How many witnesses would you like to sign the document? None One Two
Agreement Signing Date:
Use the area below to enter any other details that you would like:
(Leave blank if not needed)

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