TLH TRH

Please note that on 1 October 2007 James Quinn & Co merged with Dougherty & Associates and is now trading as Dougherty Quinn Limited.

Please visit us at our new website www.dq.im

Enduring Power of Attorney Questionnaire

PLEASE COMPLETE THIS FORM and click on "PROCEED" at the end of this page, when you have completed the form.

1. The Donor:
1a.* Your Full Name
1b.* Your Full Address
1c.* Your Date of Birth
1d.* Your telephone number
1e. Your email address
 
 
2. Details of the Attorney(s) to be appointed:
2a.* First Attorney's full name and address
2b. Second Attorney's full name and address (if appropriate)
NB If you want to appoint more than two Attorneys, please fill in the "Any other details" box at the end of this form.
 
 
3. Joint Attorneys:
NB To complete this question please refer to section entitled "The Attorney".
If you are appointing more than one Attorney:
3a. Do you want the Attorneys to act jointly?
3b. Do you want your Attorneys to act jointly and severally?
 
 
4. Powers of the Attorneys:
NB To complete this question please refer to section entitled "The Attorney".
4a.* Do you want your Attorney(s) to have general authority to act on your behalf?
4b.* Do you want your Attorney(s) to be able to deal with all of your property and affairs?
4c.* Do you want any restrictions or conditions to be placed on your Attorney(s) ability to act for you?
If yes, please specify
 
 
5.* When do you want the Enduring Power of Attorney to commence:
5a.
Some other time:
 
 
6. If you are completing this questionnaire on behalf of someone else:
6a. Please confirm your full name, address and relationship to the Donor.
6b. Please confirm whether the Donor is aware that you are completing this form on their behalf
6c. If not, why not?
 
 
7. Please confirm that the Donor is fully capable of understanding the powers that they are delegating to the Attorney:
 
 
8. Any other details:

All information submitted to us via this web site is subject to the duty of confidentiality between advocates and their clients. However, if you would prefer not to submit information to us over the internet, please contact us using the contact details at the bottom of this page.