Kentucky Limited Power of Attorney Form

A Kentucky limited power of attorney (POA) lets a person, the principal, name an agent (also called an attorney-in-fact) to act for them only on the matters the document lists. You can limit it to one task or to a set period. This page gives you a free Kentucky limited power of attorney form to create online or download as a PDF, and explains how to fill it out, sign it and end it.

Last Updated: October 2026. This guide is reviewed and updated regularly to reflect current Kentucky law. If you notice an error or outdated information, please contact us.

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Kentucky Limited Power of Attorney Form Details

This table summarizes the FormsPal Kentucky limited power of attorney form. It shows the document name, the other name it goes by, the Kentucky statutes behind the signing and ending rules, how long the form takes to fill out and the format you can download.

Document NameKentucky Limited Power of Attorney Form
Other NameKentucky Special Power of Attorney
Relevant LawsKy. Rev. Stat. § 457.050, § 457.090, § 457.100, § 457.130 and § 457.420
Avg. Time to Fill Out8 minutes
# of Fillable Fields32
Available FormatsAdobe PDF

Kentucky Limited Power of Attorney Requirements

A Kentucky limited POA is signed by the principal, or by another individual who signs the principal's name at the principal's direction and in the principal's conscious presence. The principal's signature is presumed genuine if the principal acknowledges it before a notary public or another individual authorized by law to take acknowledgments.[1]

  • If another individual signs for the principal, the reason for signing that way must be stated in the power of attorney.[1]
  • A power of attorney is effective when executed, unless the principal provides that it becomes effective at a future date or upon a future event or contingency.[2]
  • A document substantially in the form the Kentucky statute sets out may be used to create a statutory form power of attorney, with the meaning and effect the statute gives it.[5]

The form on this page lets you choose either start. You can make the power effective immediately or on a later day you write in.

How to Fill Out the Kentucky Limited Power of Attorney Form

The FormsPal Kentucky limited power of attorney form has 32 fillable fields on three pages. You enter the principal and the agent, list the purposes, choose when the power starts and ends, sign, and complete the notary acknowledgment. If you download the PDF, you can fill it in with our PDF editor.

The screenshots under each step show the FormsPal Kentucky limited power of attorney template filled with sample entries in blue, so you can see where each answer goes. The names, addresses, dates and amounts are examples only.

  1. Principal and agent. On page 1, write your name and address in the first blanks. Then enter your agent's name and address. The form calls the agent the attorney-in-fact.
    Kentucky limited power of attorney: KENTUCKY LIMITED POWER OF ATTORNEY, filled with sample entries
    Step 1: sample entries, not a real document.
  2. Limited purposes. On page 1, list what the agent may do on the five purpose lines, one purpose per line. The special instructions under the lines say the powers are limited to these purposes, so be specific.
    Kentucky limited power of attorney: purpose(s), filled with sample entries
    Step 2: sample entries, not a real document.
  3. Effective date. On page 1, initial one option. Choose effective immediately, or effective on a set day and write that day in the blanks.
    Kentucky limited power of attorney: EFFECTIVE DATE, filled with sample entries
    Step 3: sample entries, not a real document.
  4. Termination date, first option. Still on page 1, initial the first option if you want the power to end when you sign a written revocation. The list of options continues on page 2.
    Kentucky limited power of attorney: TERMINATION DATE, filled with sample entries
    Step 4: sample entries, not a real document.
  5. Termination options and successor agent. On page 2, initial one of the remaining options. You can end the power on a date you write in, or when you are determined to be incapacitated. Then enter your agent's name and the name and address of an alternate agent in the successor paragraph.
    Kentucky limited power of attorney: A WRITTEN REVOCATION, filled with sample entries
    Step 5: sample entries, not a real document.
  6. Date and signature. At the foot of page 2, fill in the day, month and year after "Signed this." Sign on the signature line and print your name below it.
    Kentucky limited power of attorney: Day, Month and more, filled with sample entries
    Step 6: sample entries, not a real document.
  7. Acknowledgment: county, date, officer. Page 3 is the acknowledgment, completed with a notary public or another officer. The officer enters the county, the date, their own name and title, and your name.
    Kentucky limited power of attorney: STATE OF KENTUCKY, filled with sample entries
    Step 7: sample entries, not a real document.
  8. Officer's signature and seal. The officer signs on the signature line that follows the officer certification and adds the seal.
    Kentucky limited power of attorney: Signature, filled with sample entries
    Step 8: sample entries, not a real document.
Write each purpose on its own line and be specific. In practice, an agent can only be expected to act within the purposes you list, so a vague entry leaves room for disagreement later.

How to Sign and Use the Kentucky Limited Power of Attorney

To put a Kentucky POA in place, sign it and take it to a notary public to acknowledge your signature. An acknowledged signature is presumed genuine.[1] Then give your agent a copy and store the original safely.

  1. Sign the document. Sign on the signature line on page 2 and print your name. The requirements section above explains when another individual may sign for you.
  2. Have a notary acknowledge your signature. Many notaries ask for a government-issued photo ID, so bring one. The notary completes the acknowledgment on page 3.
  3. Give your agent a copy. Your agent is the attorney-in-fact. Unless the POA says otherwise, a person accepts appointment as an agent by exercising authority or performing duties as an agent, or by any other assertion or conduct indicating acceptance.[4] The form has no separate acceptance section for the agent to sign.
  4. Keep the original safe. Store the signed original where you can find it, and give copies to your agent and to any bank or other party your agent will deal with.

If you need a different kind of document, browse our Kentucky power of attorney forms.

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When a Kentucky Limited Power of Attorney Ends

A Kentucky limited POA ends when one of the events below happens, such as the principal's death, a revocation by the principal, or an end date or purpose written into the document. The agent's authority ends when the principal revokes that authority or when the power of attorney itself ends.[3]

  • The principal dies.
  • The principal revokes the power of attorney. If the power of attorney was filed, the principal revokes it in accordance with KRS 382.370.
  • The power of attorney specifically states a purpose, and that purpose is accomplished.
  • The power of attorney provides that it terminates, for example on a date you write into it.
  • A court appoints a limited conservator, conservator, limited guardian, or guardian of the principal's estate or another fiduciary charged with managing some or all of the principal's property, unless the court specifically provides that the power of attorney stays in effect.
If you revoke the power of attorney, tell your agent and every party that holds a copy. Under Kentucky law, ending the power of attorney is not effective as to an agent or other person who acts in good faith under it without actual knowledge that it ended.[3]

Frequently Asked Questions

These answers cover the questions people ask most often about how a Kentucky limited power of attorney ends or changes. Each answer comes from the Kentucky statutes listed in the Sources section, so check the cited section if your situation is unusual.

Does my limited power of attorney end if I become incapacitated?

It does if the power of attorney is not durable. The principal's incapacity does not revoke or terminate it as to an agent or other person who, without actual knowledge of the incapacity, acts in good faith under it.[3]

Does a divorce filing end my spouse's authority as my agent?

Yes, unless the power of attorney provides otherwise. The agent's authority terminates when an action is filed for the dissolution or annulment of the agent's marriage to the principal, or for their legal separation.[3]

What happens if my agent dies or resigns?

The agent's authority terminates if any of these happens:

  • The agent dies.
  • The agent becomes incapacitated.
  • The agent resigns.

The power of attorney itself terminates then if it does not provide for another agent to act.[3]

Does signing a new power of attorney cancel an earlier one?

Not automatically. Signing a new power of attorney does not revoke one you signed before, unless the new one provides that the previous power of attorney is revoked or that all other powers of attorney are revoked.[3]

General information, not legal or tax advice.

Sources

Unless noted otherwise, the sources below are from the Ky. Rev. Stat.

  1. Ky. Rev. Stat. § 457.050.
  2. Ky. Rev. Stat. § 457.090(1).
  3. Ky. Rev. Stat. § 457.100.
  4. Ky. Rev. Stat. § 457.130.
  5. Ky. Rev. Stat. § 457.420.
Published: Aug 15, 2024
Mara Erlach
Mara Erlach
Writer & Attorney
Mara has been practicing estate planning and trust law in California since 2003, taking pride in helping clients of all backgrounds and asset profiles form a complete and customized estate plan. Her specialties are: estate planning, wills and trusts, trust and probate administration.