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Lasting power of attorney forms: what they ask and a worksheet to prepare

A lasting power of attorney (LPA) lets you choose people to make decisions for you if you lose mental capacity. In England and Wales it is made on official forms and registered with the Office of the Public Guardian. This free worksheet helps you prepare every answer first.

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LPA worksheet example, filled in with sample data
Example filled in with sample data

The full LPA worksheet

LASTING POWER OF ATTORNEY · PREPARATION WORKSHEET

Use it to prepare your answers before filling in the official forms

This worksheet is not a lasting power of attorney. It helps you gather the decisions and details the official forms ask for. Fill it in, talk it through with the people you choose, then complete the official LPA online or on paper.

1. Type of LPA

[ ] Property and financial affairs [ ] Health and welfare [ ] Both (two separate LPAs)

2. You, the donor

Full name: [name] · Other names used: [names] · Date of birth: [date] · Address: [address and postcode] · Email: [email]

3. Your attorneys

Attorney 1: [full name, date of birth, address, relationship to you]

Attorney 2: [full name, date of birth, address, relationship to you]

Each attorney must be 18 or over. For property and financial affairs, an attorney cannot be bankrupt or subject to a debt relief order.

4. How your attorneys make decisions

[ ] Jointly and severally (together or on their own) [ ] Jointly (all must agree) [ ] Jointly for some decisions, jointly and severally for others: [list]

5. Replacement attorneys

Replacement 1: [full name, date of birth, address] · When they step in: [if any attorney can no longer act / other]

6. When the LPA can be used

Property and financial affairs: [ ] as soon as it is registered, with my consent [ ] only when I lack mental capacity

Health and welfare: it can only be used when you lack capacity to make the decision. Life-sustaining treatment: [ ] my attorneys can decide [ ] my attorneys cannot decide

7. People to notify

Up to five people who will be told when the LPA is registered: [names and addresses]

8. Preferences and instructions

Preferences (wishes your attorneys should consider): [for example, I would like to stay in my home as long as possible]

Instructions (rules your attorneys must follow): [for example, my attorneys must not sell my house]

9. Certificate provider

Someone who has known you well for at least two years, or a professional such as a doctor or solicitor, who confirms you understand the LPA and are not under pressure: [name, address]

10. Witnesses

Witness for your signature: [name, address] · Witnesses for the attorneys: [names, addresses]

11. Registration

Who will apply to register: [you / your attorneys] · Fee: £92 unless you qualify for a reduction or exemption · Where the original will be kept: [place]

PREPARED BY

Name: [full name]

Date: [date]

What the template includes

  • Choice between property and financial affairs and health and welfare
  • Your details as the donor
  • Your attorneys and the rules for who can act
  • How attorneys decide: jointly, jointly and severally, or mixed
  • Replacement attorneys
  • When the LPA can be used, including life-sustaining treatment
  • People to notify
  • Preferences and instructions in your own words
  • Certificate provider and witnesses
  • Who registers and the fee

What you fill in

FieldExample
TypeProperty and financial affairs
DonorPatricia Hughes, born 3 March 1952
AttorneysClaire Hughes and Mark Hughes, her children
How they decideJointly and severally
ReplacementSusan Reid, her sister
When it can be usedAs soon as it is registered, with her consent
Certificate providerHer solicitor, Anita Desai

How it gets signed

This form is signed on paper under the Mental Capacity Act 2005, by you, your attorneys, your certificate provider and the witnesses. Fill in the worksheet here and download it in Word, ready to copy into the official forms.

Once the LPA is registered, your attorneys can use certified copies with banks and care providers.

What the law says

The gov.uk guide to making, registering or ending an LPA explains the process. You must be 18 or over and have mental capacity when you make it. The LPA is legally binding only in England and Wales.

You can make an LPA online or on paper forms, but either way the forms are printed and signed. You then register it with the Office of the Public Guardian. Registration costs £92 unless you get a reduction or exemption and takes 8 to 10 weeks if there are no mistakes.

Scotland and Northern Ireland have their own powers of attorney. If you live in the US, see the durable power of attorney form.

The two types of LPA

TypeWhat attorneys can decideWhen it can be used
Property and financial affairsBank accounts, bills, benefits, selling a homeOnce registered, with your consent, or only when you lack capacity
Health and welfareDaily care, medical treatment, moving into a care homeOnly when you lack capacity to decide

Many people make both. Each one is a separate form with its own registration fee.

How to use this worksheet

  1. 1Download the worksheet in Word and fill in each section.
  2. 2Talk to your attorneys and replacements. Make sure they agree to act.
  3. 3Choose a certificate provider and witnesses who meet the rules.
  4. 4Make the LPA online or on the official paper forms, copying your answers.
  5. 5Print, sign and have everyone sign in the right order.
  6. 6Send the forms to notify people, then register the LPA.

Choosing attorneys

Pick people you trust who manage their own affairs well. They can be relatives, friends or a professional. They do not need to live in the UK.

Jointly and severally gives flexibility, since any attorney can act alone. Jointly means every decision needs all of them, which is safer but slower.

Preferences and instructions

Preferences are wishes your attorneys should take into account. Instructions are rules they must follow. Keep instructions few and clear, because an unworkable instruction can delay registration.

Mistakes that delay registration

  • Signing in the wrong order. You sign first, then the certificate provider, then the attorneys.
  • Changing the form by hand. Corrections can make an LPA invalid.
  • Missing witnesses. Each signature needs the right witness.
  • Waiting too long. An LPA must be made while you still have capacity.

Talking to your attorneys

An LPA works best when your attorneys know your wishes before they need to act. Share the finished worksheet with them.

Tell them where the original LPA will be kept and who your bank, doctor and care contacts are. Update the worksheet if your wishes change.

After registration

The Office of the Public Guardian returns the registered LPA. Make certified copies for banks and care providers. Your attorneys can also use the online service to share access to the LPA.

If an attorney changes address or name, tell the Office of the Public Guardian. Do not write changes on the LPA itself.

Checklist before you start the official form

  1. 1You chose the type of LPA, or both.
  2. 2Your attorneys and replacements agreed to act.
  3. 3You decided how attorneys make decisions.
  4. 4You wrote your preferences and instructions.
  5. 5You have a certificate provider and witnesses ready.
  6. 6You know who will pay the fee and register.

With the worksheet complete, the official form takes much less time and fewer corrections.

If you live abroad

You do not need to live in the UK or be a British citizen to make an LPA. It still covers only decisions and assets in England and Wales. For property in other countries, ask about the local form of power of attorney.

Before you sign

Other templates

Frequently asked questions

Is this worksheet a valid LPA?

No. It prepares your answers. The LPA itself is the official form, signed and registered with the Office of the Public Guardian.

How much does it cost to register an LPA?

The application fee is £92 per LPA, unless you qualify for a reduction or exemption.

How long does registration take?

About 8 to 10 weeks if there are no mistakes in the application.

Does an LPA work in Scotland?

No. An LPA is legally binding only in England and Wales. Scotland and Northern Ireland have their own powers of attorney.

Can I download the worksheet in Word?

Yes. “Download in Word” gives you the worksheet with no email and no account.

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