This section establishes the foundational identity and verification data for both the account holder granting authority and the designated attorney-in-fact receiving delegated powers. Complete all fields with current, legally recognized documentation.
Account Holder Full Legal Name (as appears on government-issued identification)
Account Holder Date of Birth
Account Holder Primary Residential Address
Account Holder Citizenship(s)
Account Holder Tax Identification Number(s)
Primary Account Number(s) Subject to this POA
Brief Description of Account Holder's Source of Wealth and Primary Business Activities
Upload Certified Copy of Account Holder's Government-Issued Photo Identification (Passport, National ID)
Upload Recent Proof of Address for Account Holder (dated within last 3 months)
Designated Attorney-in-Fact Profile
Attorney-in-Fact Full Legal Name
Attorney-in-Fact Date of Birth
Attorney-in-Fact Primary Residential Address
Attorney-in-Fact Citizenship(s)
Attorney-in-Fact Tax Identification Number(s)
Relationship of Attorney-in-Fact to Account Holder
Immediate Family Member (Spouse, Child, Parent)
Extended Family Member (Sibling, Niece/Nephew, Cousin)
Professional Advisor (Attorney, Accountant, Trust Officer)
Business Partner or Corporate Officer
Fiduciary or Trustee
Other Professional Representative
Detailed Explanation of Relationship and Reason for POA Designation
Attorney-in-Fact Professional Qualifications or Licensing (if applicable)
Upload Certified Copy of Attorney-in-Fact's Government-Issued Photo Identification
Upload Recent Proof of Address for Attorney-in-Fact (dated within last 3 months)
Attorney-in-Fact Primary Contact Telephone Number
Attorney-in-Fact Secondary Contact Telephone Number
Attorney-in-Fact Secure Email Address
This section meticulously defines the legal scope, temporal boundaries, and specific authorities granted under the Power of Attorney instrument. Precise documentation here prevents unauthorized actions and ensures regulatory compliance.
Type of Power of Attorney Instrument
Durable General Power of Attorney (effective immediately, survives incapacity)
Springing Power of Attorney (effective upon specific triggering event)
Limited or Special Power of Attorney (restricted to specific acts)
Contingent Power of Attorney (effective upon future occurrence)
Medical or Healthcare Power of Attorney (non-financial authority)
POA Execution Date and Time (as stated in original instrument)
POA Effective Date (if different from execution date)
POA Expiration Date (if applicable)
Is this a Springing POA requiring verification of a specific triggering event?
Describe the specific triggering event and provide evidence of its occurrence (medical certification, incapacity determination, etc.)
Upload Original or Court-Certified Copy of the Complete Power of Attorney Instrument
Upload Any Amendments, Codicils, or Restatements to the POA
Specific Grant of Authority - Rate each category based on the POA document
Authority Matrix: Please indicate the level of authority granted for each financial domain
No Authority | Limited Authority (capped amounts/restricted types) | General Authority (standard operations) | Plenary Authority (unrestricted discretion) | Sole Authority (exclusive decision-making) | |
|---|---|---|---|---|---|
Investment Decision-Making (buy/sell securities, portfolio rebalancing) | |||||
Banking Transactions (wire transfers, check issuance, account closures) | |||||
Real Estate Transactions (property sale, purchase, mortgage execution) | |||||
Tax Matters (filing returns, engaging with tax authorities, payments) | |||||
Estate Planning Implementation (trust creation, beneficiary changes) | |||||
Business Entity Management (corporate decisions, partnership authority) | |||||
Personal Expenditure Authorization (living expenses, luxury purchases) | |||||
Digital Asset Management (cryptocurrency, online accounts) | |||||
Legal Proceedings (initiate/settle litigation, engage attorneys) |
Maximum Single Transaction Limit Authorized Without Additional Oversight
Maximum Aggregate Monthly Transaction Limit
Explicitly Prohibited Actions or Restrictions (select all that apply per POA terms)
No authority to make gifts exceeding annual exclusion limits
Cannot change beneficiary designations on insurance/retirement accounts
Prohibited from self-dealing or personal benefit transactions
Cannot pledge assets as collateral for third-party debts
No authority to amend or revoke trusts
Cannot delegate authority to sub-agents
Restricted from making speculative high-risk investments
Prohibited from relocating account holder's primary residence
Cannot engage in related-party transactions without independent approval
No authority to execute estate tax planning strategies
Does the POA require co-signature or secondary approval for certain transactions?
Specify which transaction types require co-signature and identify the required co-signatory
Has the Account Holder provided written instructions for investment philosophy or restrictions?
Upload Investment Policy Statement or Written Investment Guidelines
Special Conditions or Qualifying Language Contained in POA
Has this POA been revoked or superseded by a more recent instrument?
Upload Revocation Document or Superseding POA
This section documents comprehensive fraud prevention measures and independent verification protocols to confirm the authenticity of the POA execution and the continuing consent of the Account Holder. All verification steps must be completed before POA activation.
Primary Method of Out-of-Band Verification with Account Holder
Secure video conference with biometric liveness detection
In-person verification at financial institution branch
Independent attorney or notary certification with witness
Third-party identity verification service (Jumio, Onfido, etc.)
Certified mail with secure callback protocol
Embassy or consulate official verification
Date and Time of Primary Verification Event
Name and Credentials of Verification Officer/Professional Conducting Verification
Was the Account Holder's identity confirmed through government ID validation and biometric comparison?
Specify biometric methods used and validation results
Did you conduct a challenge question protocol with the Account Holder?
List challenge questions asked and summary of responses (do not record actual answers)
Was the Account Holder's mental capacity and absence of duress assessed during verification?
Describe capacity assessment methodology and observations
Were any third-party witnesses present during POA execution or verification?
Identify witnesses and their relationship to the parties
Have you detected any behavioral red flags or anomalies during the verification process?
Select all red flags observed
Unusual urgency or pressure to expedite POA activation
Inconsistent explanations for need of POA
Account Holder seemed unfamiliar with Attorney-in-Fact
Discrepancies in documentation or timeline
Attempts to avoid direct verification with Account Holder
Attorney-in-Fact overly dominant in communications
Inconsistent signatures or document alterations
Use of newly created email addresses or phone numbers
Requests for immediate large transfers upon activation
Was a secondary out-of-band verification conducted via independent communication channel?
Describe secondary verification method and confirmation received
Upload Video Recording or Notarized Affidavit of Verification Event
Has the Account Holder's digital footprint and device been verified for authenticity?
Provide digital verification details (IP geolocation, device fingerprint, etc.)
Overall Confidence Level in Identity Verification and Authenticity of POA Execution
Low Confidence - Requires Enhanced Due Diligence
Moderate Confidence - Some Concerns Noted
High Confidence - Standard Verification Met
Very High Confidence - Multiple Verification Layers Passed
Absolute Confidence - Zero Anomalies Detected
This section documents comprehensive AML compliance screening, Politically Exposed Person (PEP) status determination, and risk assessment for both the Account Holder and Attorney-in-Fact. All screening must be completed using current watchlist databases and adverse media sources.
Has the Account Holder been screened against global sanctions, watchlists, and PEP databases within the last 30 days?
Date of Most Recent Screening
Account Holder PEP Classification
Not a PEP - No public function or immediate family connection
Foreign PEP - Holds prominent public office in foreign jurisdiction
Domestic PEP - Holds prominent public office in home jurisdiction
International Organization PEP - Senior official at international body
Family Member of PEP - Immediate family (spouse, child, parent)
Close Associate of PEP - Known close business associate or advisor
Is the Account Holder subject to Enhanced Due Diligence (EDD) due to PEP status or high-risk jurisdiction?
Describe EDD measures completed and risk mitigation controls implemented
Has the Attorney-in-Fact been screened against global sanctions, watchlists, and PEP databases?
Date of Attorney-in-Fact Screening
Attorney-in-Fact PEP Classification
Not a PEP
Foreign PEP
Domestic PEP
International Organization PEP
Family Member of PEP
Close Associate of PEP
Have adverse media or negative news alerts been identified for either party?
Summarize adverse media findings and compliance assessment
Upload Comprehensive AML Screening Report for Account Holder
Upload Comprehensive AML Screening Report for Attorney-in-Fact
Has the source of funds for the account been verified and documented within the last 12 months?
Upload Source of Funds Documentation (Audited financials, sale agreements, inheritance documentation)
Does the account structure involve complex beneficial ownership layers (trusts, shell companies, nominees)?
Describe beneficial ownership structure and attach organizational chart
Upload Beneficial Ownership Declaration and Supporting Documentation
Are there any jurisdiction-specific AML requirements applicable to this POA arrangement?
Specify jurisdictional requirements and compliance status
Transaction Monitoring Parameters for POA-Initiated Activity
Transaction Type | Standard Threshold | Enhanced Threshold (if PEP/EDD) | Requires Pre-Approval? | Approval Authority | ||
|---|---|---|---|---|---|---|
A | B | C | D | E | ||
1 | Domestic Wire Transfer | $100,000.00 | $25,000.00 | Yes | Wealth Management Director | |
2 | International Wire Transfer | $50,000.00 | $10,000.00 | Yes | Compliance Committee | |
3 | Securities Purchase | $250,000.00 | $50,000.00 | N/A | ||
4 | Real Estate Transaction | $1.00 | $1.00 | Yes | Legal Counsel & Wealth Director | |
5 | Cash Withdrawal | $25,000.00 | $5,000.00 | Yes | Senior Relationship Manager | |
6 | ||||||
7 | ||||||
8 | ||||||
9 | ||||||
10 |
Overall AML Risk Rating for this POA Mandate (1 = Low Risk, 5 = High Risk)
This final section requires formal approval from Legal Counsel and Wealth Management Director, confirming that all verification steps have been satisfactorily completed, risks have been assessed and mitigated, and the POA may be activated for operational use. This represents the final gate before third-party authority becomes effective.
Has Internal Legal Counsel or External Legal Advisor reviewed the POA instrument for legal sufficiency and enforceability?
Summarize legal review findings and any qualifications or concerns identified
Upload Legal Counsel Review Memorandum or Opinion Letter
Has the POA been validated for compliance with applicable succession laws and potential conflicts with existing trust instruments?
Describe any trust/POA coordination measures implemented
Has the Wealth Management Risk Committee reviewed and approved this third-party mandate?
Risk Committee Approval Reference Number
Risk Committee Approval Date
Upload Risk Committee Meeting Minutes or Approval Resolution
Does the Wealth Management Director accept full responsibility and accountability for this POA activation?
Wealth Management Director Statement of Acceptance and Risk Acknowledgment
Wealth Management Director Digital Signature
Wealth Management Director Full Name and Title
Wealth Management Director Sign-Off Timestamp
Has Chief Compliance Officer (CCO) or designated AML Officer provided final compliance clearance?
Chief Compliance Officer Digital Signature
Chief Compliance Officer Full Name and Title
Compliance Clearance Timestamp
Are there any conditions precedent or post-activation monitoring requirements imposed by approving authorities?
List all conditions and monitoring requirements
POA Activation Effective Date and Time
Audit Trail Documentation
Form Completed By (Relationship Manager Name and Employee ID)
Form Completion Timestamp
I certify that all information provided in this intake form is accurate, complete, and based on verified documentation
Relationship Manager Digital Signature
Upload Complete Documentation Package (All files consolidated into single zip archive)
To configure an element, select it on the form.