Power of Attorney Instruction Form

Transcription

1 Legacy Planning Power of Attorney Instruction Form England & Wales Applicant 1 & Applicant 2 names: Your appointment is with: On: Who attended the appointment? Applicant 1 Applicant 2 Important information Please read the Power of Attorney Guide (England and Wales) and the Legal Documents and Estate Administration Tariff of Charges before completing this form. Providing the information on this form does not mean that you have a Lasting Power of Attorney (LPA). Redstone Wills Ltd will draft an LPA for you and will use the details that you supply on this form. Please complete the details below as fully as you can as they will provide helpful information and make the process of preparing your LPA as straightforward as possible. If you need help with anything please call Skipton Building Society on Please specify whether these instructions relate to a: Property and Financial Affairs LPA Single Mirror and/or Any other person Health & Welfare LPA Single If you and your spouse/civil partner have similar ( mirror ) requirements you may both complete this form. LPA documents will be created for each of you. Do you wish to include Registration with the Office of Public Guardian (OPG)? Yes No Please explain reasons why LPA is required. If you intend to replace an existing LPA, it will need to be revised. Mirror 2. Where do you consider yourself to reside permanently? England or Wales Scotland We need to take account of the laws of the country where you reside permanently, we can write LPAs for people who reside permanently in England, Wales or Scotland. If you consider yourself to reside permanently in Scotland, please use the Scottish Instruction Forms as different rules apply. If you have foreign property or assets, you should seek advice in the country where the asset is held to establish if you need a POA in that jurisdiction. 3. Your details (Applicant 1) ID and address verification will be required. Please provide proof of ID e.g. passport, driving licence and proof of address e.g. utility bills (we may use electronic address verification). : (Mr/Mrs/Ms/Miss/Other) Full Postal : : Full Forenames: Home Tel No : : Daytime Tel No : Town and Country of Birth: Mobile Tel No :

2 Spouse/Civil partner s details (Applicant 2) If you are a new customer of the Society ID verification will be required. We will usually use electronic verification or you can provide proof of ID e.g. passport, driving licence and proof of address e.g. utility bills. : (Mr/Mrs/Ms/Miss/Other) Full Postal : : Full Forenames: Home Tel No : : Daytime Tel No : Town and Country of Birth: Mobile Tel No : Please complete so Skipton Trustees Limited and/or Redstone can contact you, if needed, about preparing your LPA. 4. Details of your Attorney(s) You can appoint more than one Attorney. Where this application is for both Property and Financial affairs and Health and Welfare LPA, the Attorneys noted below will be treated as having both powers. If you wish to appoint different Attorneys for Property and Financial affairs and Health and Welfare LPA, set it out in the box below. Additional notes: If applicant one s spouse/civil partner is to be an Attorney tick here If applicant two s spouse/civil partner is to be an Attorney tick here For Mirror instructions, the Attorneys below will apply for both applicants. If you wish to appoint different Attorneys, please specify. Attorney 1 Attorney 2 Relationship to Applicant 1 Relationship to Applicant 2 Attorney 3 Relationship to Applicant 1 Relationship to Applicant 2 Attorney 4 Relationship to Applicant 1 Relationship to Applicant 2 Relationship to Applicant 1 Relationship to Applicant 2

3 5. If you have appointed more than one Attorney, how do you want them to act? Jointly: This means that the Attorneys must make all decisions together. Remember, if one Attorney is unavailable or unable to act, it means other Attorneys cannot make decisions. Applicant 1 Applicant 2 Jointly and severally: This means that Attorneys can make decisions together and separately. This might be useful, for example, if one Attorney is not available to make a decision at a certain time. If one Attorney cannot act the remaining Attorney is able to continue to make decisions. Jointly for some decisions, and jointly and severally for other decisions: This means that your Attorneys must make certain decisions together and may make certain decisions separately. You will need to set out below how you want this to work in practice. Take care to be clear how you intend powers to be appointed. Complex arrangements may be unworkable. You may also provide guidance to your attorney(s). See section 12. Applicant 1, only complete this box if you have ticked the last box above. Please tell us in the space below which decisions your Attorneys must make jointly and which decisions may be made jointly and severally. Applicant 2, only complete this box if you have ticked the last box above. Please tell us in the space below which decisions your Attorneys must make jointly and which decisions may be made jointly and severally. 6. Do you wish to appoint any replacement Attorney(s)? It is wise to appoint a replacement Attorney(s) to ensure the POA can continue in the event an original Attorney is no longer able to act. For Mirror instructions, the replacement Attorney(s) below will apply for both applicants. If you wish to appoint different Attorneys, please specify. Replacement Attorney 1 Replacement Attorney 2 Relationship to Applicant 1 Relationship to Applicant 2 Relationship to Applicant 1 Relationship to Applicant 2

4 7. Do you wish to give any specific instructions to your Attorney(s)/replacement Attorney(s)? Applicant 1 Applicant 2 8. When will powers take effect? An LPA can only be used once it has been registered with the Office of the Public Guardian. Health and Welfare Powers: These will only take effect when you no longer have capacity. This is effective with the issuing of a doctor s certificate, unless you stipulate otherwise how incapacity will be determined. Property and Financial Powers: These powers can take effect immediately or you may stipulate that they become effective only on loss of mental capacity. Applicant 1 Applicant 2 Tick here if your Property and Financial powers should take effect immediately once it has been registered Tick here if your Property and Financial powers should take effect only when you lack capacity. This will be determined by a doctor who will confirm in writing that you no longer have capacity 9. Health and Welfare LPA only: about life-sustaining treatment Enabling your Attorneys to make decisions about your care Life-sustaining treatment means any treatment that a doctor considers necessary to keep you alive. Whether or not a treatment is life-sustaining will depend on the specific situation. Some treatments will be life-sustaining in some situations but not in others. The decisions you authorise your Attorneys to make for you in this Lasting Power of Attorney take the place of any advance decision you have already made on the same subject. You must be clear whether or not you want to give your Attorneys this authority. This is very important so please be clear about the choice you are making. You might want to discuss this first with your Attorneys or doctors and health professionals. You must choose either Option A OR Option B: Your Attorneys can only make decisions about life-sustaining treatment if you choose Option A. If you choose Option B, your doctors will take into account, where it is practicable and appropriate, the views of your Attorneys and people who are interested in your welfare, as well as any written statement you may have made. Applicant 1 Option A I want to give my Attorneys authority to give or refuse consent to life-sustaining treatment on my behalf. Option B I do not want to give my Attorneys authority to give or refuse consent to life-sustaining treatment on my behalf. Applicant 2 Option A I want to give my Attorneys authority to give or refuse consent to life-sustaining treatment on my behalf. Option B I do not want to give my Attorneys authority to give or refuse consent to life-sustaining treatment on my behalf.

5 10. People to be told For your protection, you can choose up to five people to be told when your Lasting Power of Attorney is being registered. This gives people who know you well an opportunity to raise any concerns or objections before this Lasting Power of Attorney is registered and can be used. You do not have to choose anyone. The people to be told cannot be your Attorney or replacement named in sections 4 & 6. Applicant 1 First person to be told Second person to be told Relationship Relationship Applicant 2 (if different) First person to be told Second person to be told Relationship Relationship Please use the Additional Information (Section 12) to add further people to be told.

6 11. Certificate Provider A Certificate Provider is someone who you choose, who can confirm that you; understand your LPA; have not been put under pressure to make it and; that it has not been completed fraudulently. These points above are an important safety aspect of your LPA. Who can be a Certificate Provider? Someone who; is aged over 18; has known you for at least two years; or has relevant skill or knowledge to be able to form a professional judgement about your understanding. If you choose someone with relevant professional skills, they must be one of the following; a registered healthcare professional (your doctor for example); a solicitor, barrister, or advocate; a registered social worker; an Independent Mental Capacity Advocate (IMCA); someone who considers that they have the relevant professional skills and can specify what they are. Please note that some professionals may make a charge for completing this Certificate. Who cannot be a Certificate Provider? an Attorney or replacement Attorney named in this LPA or any other LPA or Enduring Power of Attorney for the donor; a family member related to the donor or any of their Attorneys or replacements; a business partner or paid employee of the donor or any of their Attorneys or replacements; the owner, director, manager or employee of a care home that the donor lives in, or a member of their family; a director or employee of a trust corporation appointed as an Attorney or replacement Attorney in this LPA; employees of Skipton Building Society or any company in the Skipton Building Society group of companies. As family members cannot be a Certificate Provider, it is advisable not to use anybody who has a family connection of any kind. Details of Certificate Provider Applicant 1 Certificate Provider Applicant 2 Certificate Provider (if different) Professional capacity (if applicable) How long have they known you? In what capacity are they known to Applicant 1? Professional capacity (if applicable) How long have they known you? In what capacity are they known to Applicant 2?

7 12. Guidance and preferences Any guidance you add may help your Attorneys to identify your views though you do not have to add any. Your Attorneys do not have to follow your guidance but it will help them to understand your wishes when they make decisions for you. For example, do you wish your Attorney(s) to consult your family and medical professionals when making decisions about life sustaining treatment? Does this guidance apply to Applicant 1 and/or Applicant 2. Please make sure you specify to whom guidance applies. 13. Additional information Please compile any additional information relevant to your LPA requirements: Provide details if you are in receipt of means-tested benefits or your income is less than 12,000. This may reduce the OPG registration fee applicable. Redstone Wills Ltd will contact you in this event.

8 14. Storing your LPA If anything happens to your LPA, or if your Attorney(s) don t know where to find it, you might as well not have written one. You need to decide how to look after your LPA, then let your Attorney(s) know where it is. Never keep your LPA in a safety deposit box; the deposit box cannot be opened until the firm holding the box is satisfied that the Attorney(s) have right of access which can prove to be extremely difficult when someone becomes incapacitated. Another service you may require Please see our Legal Documents and Estate Administration Tariff of Charges for the details of the fees for these legal services. Please tick if you would like to take advantage of our Legal Documents Care Package. (A secure storage facility for your Skipton or Redstone Will and other legal documents, please ask for details) Method of payment Please tick your preferred payment method. Redstone Wills Limited administer the payment on behalf of Skipton Trustees Limited. You may include the registration fee to the Office of the Public Guardian. Or By Cheque please make your cheque payable to Redstone Wills Limited and hand in to your Skipton adviser. By Credit/Debit Card - payment by telephone directly to Redstone Wills Limited will be arranged in branch.

9 Customer agreement It is important that before you sign you read through your requirements above, it is important that you believe they correctly represent your intentions. This forms part of the record that shows the reasons why you have made the decision you have, should anyone wish to challenge your LPA and if not correct, will affect the terms of the LPA, which may not be as you want it. Your personal data I agree to the processing of my personal data for the purposes of opening and administering my Power of Attorney, contacting me where necessary, (this may be by letter, telephone, SMS text or secure messaging or to the address I provide), fraud prevention and detection, legal and regulatory compliance, market research, statistical analysis and, after I no longer require the services associated with a Power of Attorney, for statutory, regulatory, accounting, auditing or other lawful requirements. Information may be passed to the Society s agents and third party processors if this is necessary for any of these purposes. Data may be transferred to any country, including countries outside the European Economic Area, for any of these purposes and for systems administration. Keeping you up to date about products and services Skipton Building Society would occasionally like to provide you with details of products, services and other promotions which may be of interest to you. This may be by telephone, post or . By giving your personal details, you are consenting to receiving such communications. If there is a contact method you DO NOT want us to use for this, please indicate your objection by ticking one or more of the boxes below: Applicant 1 Applicant 2 Telephone Telephone Post Post We may share your information with other companies within the Skipton Building Society group of companies and our third party providers (lists of which are available on request) in order that they can occasionally provide you with details of their products and services. If you would prefer not to receive such communications, please tick this box: We will remind you of your right to alter your marketing preferences from time to time, or you may change them at any time by writing to the Marketing Department, The Bailey, Skipton, North Yorkshire, BD23 1DN, or if you are a Skipton Online customer, by logging in and going to My Account. Applicant 1 Full Name Date Signature Applicant 2 Full Name Date Signature

10 The Customer Journey for your LPA Identify suitable Attorney(s) and substitute(s) Are they over 18, willing and able? Consider their ability in the longer term. Do you wish to allow particular powers, limits or guidance? Complete the Instruction Form You can complete at home or your local branch will be happy to help. We will then arrange instructions to be submitted to Redstone. Redstone Wills draft the LPA Redstone may contact you to clarify any requirements. Drafting normally takes 10 working days unless more information is needed. The LPA is returned to the branch for checking You will be invited in to the branch so that you can go through the LPA document. The LPA is ready for signing Your LPA document is signed by you, the Certificate Provider, Attorney(s) and witnesses. Ready to register the LPA with the OPG? We can submit your LPA for registration with the OPG on your behalf The LPA cannot be used until it is registered. The OPG registration fee will be payable. Normally, the OPG takes a minimum of 8 weeks to confirm registration. The original LPA will be returned to your branch for collection. Document is stored until needed Make sure your Attorney(s) are aware. You can use our Legal Documents Care Package for safe, secure storage.

11 For Office Use Only Customer No 1 Marketing Campaign Code DEV01/Will No. Self-generated Recommendation Spouse/Partner Referral Staff Customer No 2 ID Verified? BAR and Focus notes updated? DEV01/Will No. Branch Staff Name Referral passed to SFS? SFS adviser name Staff Number

12 Principal Office, The Bailey, Skipton, North Yorkshire BD23 1DN. Skipton Building Society is a member of the Building Societies Association and Financial Ombudsman Service. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and Prudential Regulation Authority under registration number for accepting deposits, advising on and arranging mortgages and providing Restricted financial advice. Skipton Power of Attorney Service is provided by Skipton Trustees Limited. Principal Office: The Bailey, Skipton, North Yorkshire BD23 1DN. Telephone Registered in England no Skipton Power of Attorney Writing is a service administered by Redstone Wills Limited, Windmill Road, St Leonards-on- Sea, East Sussex TN38 9BY. Company no Skipton Estate and Trust Administration Service is administered by Pearson Jones Plc (1825) of Clayton Wood Close, West Park Ring Road, Leeds LS16 6QE. Skipton Building Society and Redstone Wills Limited are both members of The Society Of Will Writers And Estate Planning Practitioners and they both abide by their Code of Practice, copies of which can be found on the Society Of Will Writers website or by writing to them at Chancery House, Whisby Way, Lincoln LN6 3LQ. Red Arc Assured Ltd is a company registered in England and Wales with company number Red Arc Assured Ltd is registered for VAT, number The registered office is: 11 Strand, London, WC2N 5HR. Please note that Power of Attorney writing is not regulated by the Financial Conduct Authority; see terms and conditions for full details. Stock Code: _22/12/16