Kansas Limited Power of Attorney Form


A Kansas limited power of attorney entrusts a competent person, named the agent, to efficiently and effectively manage a principal’s responsibilities for a temporary period. The form does not bind the agent to the principal indefinitely, making it a convenient choice for someone who needs one (1) or a few tasks completed.

For instance, a principal could assign an agent to cash a check at the credit union. After the agent performs the duty, the limited power of attorney ends, and the individual no longer has control.

Both parties must include the following information in the form:

  • The principal’s name;
  • The agent’s name and address;
  • Requested task(s);
  • Start and end date(s);
  • Date of signing;
  • Principal and agent printed names and signatures; and
  • Notary public information.

Signing requirements (§ 58-652(a)(3)): Requires notarization.

How to Write

Download: PDF, WORD, RTF

Step 1 – Name Principal + Agent

Enter the name of the principal and their current address (i.e. street, city/town, state). On the next line, write the full name of the appointed agent and the city/town and state in which they reside.

Step 2 – Assign Task(s)

Include the exact responsibilities that are being given to the agent. This section must be specific to ensure that boundaries are set and the agent understands their role. While it is an optional part of the form, the principal can enter the start and end date of the form on the line after the words “effective on.”

Step 3 – Sign

The principal and agent must sign the document in order for it to become official. Each party has specific responsibilities when filling out this section.

The principal is required to include:

  • Full signature
  • Printed name
  • Date of signing
  • The location where they signed.

The agent must provide the following:

  • Official signature
  • Printed name (first + last name)
  • Signing date
  • Current address
  • Telephone number
  • Name of the town in which they signed.

Step 4 – Notarize

Kansas requires notarization for limited power of attorney forms, as well as two (2) witnesses. Once the notary public watches both parties sign, they will digitally or physically stamp the form. Additionally, they must include their full name, signature, the signing date, and the expiration date of their commission.