[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-276449-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-276449-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","power-of-attorney-application-and-retainer-agreement-university-of-hawaii-elder-law-program-uhelp","POWER OF ATTORNEY APPLICATION AND RETAINER AGREEMENT - University of Hawaii Elder Law Program (UHELP)","","POWER OF ATTORNEY APPLICATION AND RETAINER AGREEMENT for the University of Hawaii Elder Law Program (UHELP), including the Elder Law Clinic. The form collects applicant identity and contact details, evaluates whether the applicant has memory or decision-making concerns, and records information about any existing power of attorney. It captures proposed agent and successor agent details and defines the requested power type (general, special/limited, durable or not durable, commencement/termination). It also explains the application review process, interview scheduling, drafting steps, signing and notarization, key warnings, and the applicant’s acknowledgments and signatures.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/power-of-attorney-application-and-retainer-agreement-university-of-hawaii-elder-law-program-uhelp/276449/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/power-of-attorney-application-and-retainer-agreement-university-of-hawaii-elder-law-program-uhelp/276449.png","ImageObject",442,249,{"name":42,"@type":43},"Blitz","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-23","2026-09-15",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What information does the Power of Attorney application collect from the applicant?","Question",{"text":63,"@type":64},"It collects the applicant’s full name, birth date, address and contact information, whether they are a veteran, and whether they have experienced or been diagnosed with memory or decision-making problems, including a physician’s name if applicable.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How does the form describe the proposed agent and successor agent?",{"text":68,"@type":64},"It requires the name of the proposed agent and their relationship to the applicant, along with address, telephone, and email. It also asks for a proposed successor agent’s name, relationship, and contact/address details.",{"name":70,"@type":61,"acceptedAnswer":71},"What steps follow after submitting the application to UHELP or the Elder Law Clinic?",{"text":72,"@type":64},"The application is reviewed for acceptance. If approved, UHELP schedules interviews/meetings with an attorney or clinic students, then drafts the power of attorney for review. After a final draft, the applicant appoints a time to review, sign, and have the document notarized.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},276449,1789493252,{"code":4,"msg":82,"data":83},"success",[84,88,93,98,103,108,112,117,122],{"id":55,"doc_module":22,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Presentations",90,"presentations",{"id":89,"doc_module":22,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},12,"Resumes",80,"resumes",{"id":94,"doc_module":22,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},14,"Invoices",70,"invoices",{"id":99,"doc_module":22,"doc_module_name":25,"category_name":100,"show_sort_weight":101,"slug":102},15,"Posters",60,"posters",{"id":104,"doc_module":22,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},16,"Social Media",50,"social-media",{"id":109,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":110,"slug":111},17,40,"forms",{"id":113,"doc_module":22,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},18,"Letters",30,"letters",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},21,"Paper Templates",5,"papers-templates",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":4,"slug":125},158,"General","general-158",{"code":4,"msg":82,"data":127},{"doc_id":79,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":109,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":30,"language":135,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":12,"update_tm":80,"read_time":22},24464137899374,"https://us-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","POWER OF ATTORNEY APPLICATION  \nAND RETAINER AGREEMENT  \nUNIVERSITY OF HAWAII ELDER LAW PROGRAM (UHELP)  \nINCLUDING ELDER LAW CLINIC  \nNote: This is an Application Form and is not a Power of Attorney  \nAlso Note: This Power of Attorney Does Not Authorize the Agent to Make Health Care Decisions For You (Health Care Powers May Be Authorized Through Durable Powers of Attorney for Health Care Included  \nin Advance Health Care Directives available at UHELP)  \nPlease fill out information, sign and return application to:  \nUniversity of Hawaii Elder Law Program (UHELP) William S. Richardson School of Law 2515 Dole Street  \nHonolulu, Hawaii 96822  \nTel: (808) 956-6544  \n1. Full Name of Applicant (person seeking to be the principal, the person granting power):  \n\n| (Last) Birth date:   | /   | /   | (First)\u003Cbr>(Month/Day/Year) | (Middle) |\n| --- | --- | --- | --- | --- |\n| (Address) |  |  |  |  |\n| (City) (State) (Zip code)\u003Cbr>(Home phone) (Cell phone) (E-mail)\u003Cbr>Are you a veteran?  Yes  No\u003Cbr>2. Have you experienced or been diagnosed with memory or decision-making problems (e.g. from\u003Cbr>Alzheimer’s Disease, dementia, stroke, etc,?  Yes  No If yes, please explain and provide Physician’s name: |  |  |  |  |\n\nPOWER OF ATTORNEY APPLICATION AND RETAINER AGREEMENT -PAGE 1 OF 3  \n3. Do you currently have a power of attorney?  Yes  No  \n4. Name of Proposed Agent—person to whom you are granting power:  \n  Relation to you:    \n\n| (Proposed Agent’s Address)\u003Cbr>(Telephone) (E-mail) | (City) (State) (Zip code) |\n| --- | --- |\n| 5. Name of Proposed Successor Agent: | Relation to you:   |\n|  |  |\n\n(Proposed Successor Agent’s Address) (City) (State) (Zip code)  \n(Telephone) (E-mail)  \n6. Type of Power of Attorney Requested:  \n General—Full Personal, Legal and Financial Powers  \n Special or Limited. If Special or Limited describe powers to be granted:  \nDurable—durable means that the power granted is effective during periods of incompetency or incapacity of the principal. (This is the default rule for the statutory form. See information on reverse side.)  \n Not Durable—power is discontinued upon principal’s incapacity.  \n Commencement/Termination of Power:  effective immediately  effective only upon incapacity  Or other effective date, termination date, condition or situation, and describe:  \nAny Special Instructions to be included? (Use additional sheets of paper if necessary.)   \n7. Do you wish to nominate your agent as guardian/conservator if it becomes necessary?  Yes  No  \n8. Do you have income over $75,000 per year or assets over $100,000 or own or have an interest in real property (such as a home or condominium):  Yes  No  \n9. Do you have a personal/family attorney?  Yes  No  \nPOWER OF ATTORNEY APPLICATION AND RETAINER AGREEMENT -PAGE 2 OF 3  \nAPPLICATION PROCESS  \nYour application will be reviewed for acceptance by UHELP or by the Elder Law Clinic. After your application is received and if it is approved by our attorney, we will schedule you for one or more interviews/meetings with an attorney or with our Elder Law Clinic students. If your application is accepted we will draft a power of attorney for your review. Once there is a final draft, you will then make an appointment to review the power of attorney and to have it signed and notarized.  \nPLEASE READ THE FOLLOWING INFORMATION AND WARNINGS BEFORE SIGNING  \nPowers of Attorney are important legal documents that can affect the management of your personal affairs. You should make sure that you know and trust the individual to whom you are granting power as your agent. It is sometimes wise to limit the powers granted and the duration of powers of attorney. You should contact a private practice attorney if you have income over $75,000 per year or you have assets over $100,000 or if you own or have an interest in real property (such as a home or condominium or land) .  \nThere can be grave consequences to you and your finances through the misuse of a power of attorney by your agent. So choose yo","cbCailuIabQMNFt8","https://ap.wps.com/l/cbCailuIabQMNFt8","pdf",156620,"English","# Power of Attorney Application and Retainer Agreement - University of Hawaii Elder Law Program (UHELP)\n## Applicant Information\n## Proposed Agents and Power Type\n## Application Process and Warnings","[{\"question\":\"What information does the Power of Attorney application collect from the applicant?\",\"answer\":\"It collects the applicant’s full name, birth date, address and contact information, whether they are a veteran, and whether they have experienced or been diagnosed with memory or decision-making problems, including a physician’s name if applicable.\"},{\"question\":\"How does the form describe the proposed agent and successor agent?\",\"answer\":\"It requires the name of the proposed agent and their relationship to the applicant, along with address, telephone, and email. It also asks for a proposed successor agent’s name, relationship, and contact/address details.\"},{\"question\":\"What steps follow after submitting the application to UHELP or the Elder Law Clinic?\",\"answer\":\"The application is reviewed for acceptance. If approved, UHELP schedules interviews/meetings with an attorney or clinic students, then drafts the power of attorney for review. After a final draft, the applicant appoints a time to review, sign, and have the document notarized.\"}]","POWER OF ATTORNEY APPLICATION AND RETAINER AGREEMENT - University of Hawaii Elder Law Program (UHELP) | PDF"]