Address
Country
---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArctic OceanArubaAshmore and Cartier IslandsAtlantic OceanAustraliaAustriaAzerbaijanBahamasBahrainBaker IslandBangladeshBarbadosBassas da IndiaBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandClipperton IslandCocos IslandsColombiaComorosCook IslandsCoral Sea IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDemocratic Republic of the CongoDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaEuropa IslandFalkland Islands (Islas Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGambiaGaza StripGeorgiaGermanyGhanaGibraltarGlorioso IslandsGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHowland IslandHungaryIcelandIndiaIndian OceanIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJan MayenJapanJarvis IslandJerseyJohnston AtollJordanJuan de Nova IslandKazakhstanKenyaKingman ReefKiribatiKerguelen ArchipelagoKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMidway IslandsMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNavassa IslandNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth SeaNorthern Mariana IslandsNorwayOmanPacific OceanPakistanPalauPalmyra AtollPanamaPapua New GuineaParacel IslandsParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunionRepublic of the CongoRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSpainSpratly IslandsSri LankaSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTromelin IslandTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUSAUruguayUzbekistanVanuatuVenezuelaViet NamVirgin IslandsWake IslandWallis and FutunaWest BankWestern SaharaYemenYugoslaviaZambiaZimbabwe
Relationship Status
SingleMarriedEngagedDeFactoDivorcedSame SexRegistered Same Sex
Have you previously made an EPOA?
YesNo
Have you previously made a Will?
Do you wish to appoint more than one attorney?
How many Power of Attorney do you wish to make?
12345
Full Address of Attorney
Is your attorney your paid carer or healthcare provider?
Please ReviewYou cannot appoint this person as your attorney, please nominate another person
Is your attorney bankrupt or taking advantage of the laws of bankruptcy?
Full Address of Attorney 2
Is this attorney your paid carer or healthcare provider?
Is this attorney bankrupt or taking advantage of the laws of bankruptcy?
Full Address of Attorney 3
Full Address of Attorney 4
Full Address of Attorney 5
Do you want your attorney to make decisions for:
Financial MattersPersonal / Health MattersFinancial Matters & Personal / Health Matters
Do you wish to set any specific terms for your wishes?
For financial matters, when would you like the power to begin?
ImmediatelyOn my losing capacityA specific dateA specific occasion
If you are appointing more than one attorney, how are they to act?
Severally (Any of them may decide)As a majorityJointly (Unanimously)Successively
Majority - If more than three
Simple MajorityTwo third majority
Do you require your EPOA to be registered?
Instructions
I acknowledge that I have been offered an Estate Planning Service by Hatzis Lawyers and have chosen not to take advantage of same but rather have instructed Hatzis Lawyers to draw my Power of Attorney strictly as per my wishes and directions contained herein.
I/We require Legal Advice and Assistance and I/we hereby authorise and request you to act on my/our behalf as solicitors in this matter and I/we hereby undertake to be responsible for your proper fees in relation thereto as advised by you. In respect of any moneys that you may hold in your Trust Account on my/our behalf,
I/we authorise you to utilise such moneys for your professional costs, statutory duties and charges and other proper outlays expended on my/our behalf in this matter or any other matter in which instructions may have been given by me to you.
TERMS OF TRADING
I/We acknowledge and agree to the firm's terms of trading as follows:-
Payment of all costs and outlays for the preparation of your Power of Attorney is required at your appointment when you sign your Power of Attorney. Payment of any other fees and charges applicable are required within 7 days from the date of account unless prior arrangements in writing are made; Accounts are sent monthly or at various stages unless agreed otherwise; No work will be carried out after 30 days if any account is unpaid; All outlays are to be paid upon request throughout my matter; No carrying of accounts without prior approval in writing from the firm; No work will be commenced without my written authority.
Tick the box below to Accept and Press the Submit Button to submit this form.
By checking this box I hereby accept the terms and conditions listed above.
Verification
To use CAPTCHA, you need Really Simple CAPTCHA plugin installed.
Please feel free to call our law firm on 1300 HATZIS or email info@hatzis.com.au for any enquiries.