Intake

Request a free consultation

A short, confidential intake. The first 30-minute consultation is complimentary.

Full name *

Email *

Phone

Town / city

Practice area *

Urgency

Subject *

Describe your matter *

Durable Power of Attorney

A few more details

Anything you don't know yet, leave blank — we'll fill it in together.

Principal — full legal name

The person making the DPOA

Principal address

Principal SSN (last 4 only)

When should the DPOA become effective?

If springing — who determines incapacity? (1 or 2 doctors; who chooses)

Attorney-in-Fact (AIF) — full name

AIF address

AIF phones (home / work / cell)

Alternate AIF — full name

Alternate AIF address

Alternate AIF phones (home / work / cell)

Powers to grant (check all that apply, or 'all')

Limit real estate powers? (e.g. cannot sell home)

Authorize gifts to the AIF? If yes, any dollar limit?

Gifts to others — anyone, or only named people? Any dollar limit?

Must AIF report to a third party? (name, address, frequency)

May AIF delegate powers? If yes, any limits?

May AIF benefit personally from transactions on principal's behalf?

Must AIF keep principal's assets separate?

AIF compensation? (none / specific amount / reasonable amount at AIF discretion)

Additional notes or special instructions

Opposing party (if any)

Preferred contact

I consent to being contacted by Robert Osol's office regarding this matter. I understand submitting this form does not create an attorney-client relationship.

Confidential. Stored securely.