Valley Docs & Paralegal Services, LLC
Information Forms - Powers of 
Attorney (POA) Information



Testator - Male creator of document
- Female creator of document
Agent or Attorney-In-Fact- Appointed by testatrix or testator to make decisions on his or her behalf
AlternateSecond choice if first appointee is unable to fulfillobligations

General Information

1)    Your name:               

2)    Your email address:  

Powers of Attorney (POA) Questionnaire

1)    Current Resident Address:


Current Resident Phone Number:


3)    Fill in the Following Table:




 Social Security Numbers

 Date of Birth
 Agent or Attorney-In-
 Fact for POAs (A-I-F) 
 City & State for Agent 
 Successor Agent or 
 (A-I-F) for POAs (Name)
 City & State for
 Successor or (A-I-F)
 Autopsy - Yes or No     Yes       No     Yes       No

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