How to Fill Out a Kansas Power of Attorney (POA) Form

To fill out a Kansas power of attorney form, download the free statutory template from the Kansas Judicial Council, enter the principal’s and agent’s full legal names and addresses, select which powers you want the agent to hold (expressly listing any gift-making, anatomical gift, or electronic communications authority), decide whether the document takes effect immediately or only on your incapacity, and then sign in front of a notary — plus two qualifying witnesses if you are using the healthcare form without notarization. Kansas has two separate forms, one for finances and one for medical decisions, so if you want both kinds of coverage you need to complete each one.

Pick the Right Form

The Kansas Judicial Council publishes the official templates for free. Three are available: a General Durable Power of Attorney (dated 12-2025), a Durable Power of Attorney for Healthcare Decisions (dated 12-2025), and a Certification by Attorney in Fact (dated 9-2023).¹ The Kansas courts’ self-help site links to the same forms under Probate & Elder Law.²

The financial form, authorized under K.S.A. 58-652, lets your agent handle money, property, and business matters. The healthcare form, governed by K.S.A. 58-625 through 58-632, covers medical decisions only. They are separate documents with different signing rules, so complete each one you need.

Both forms are durable by default, meaning the agent’s authority continues if you become incapacitated. To qualify as durable, the document must be labeled “durable power of attorney” and must say the agent’s authority will not end if the principal becomes disabled.³ The Judicial Council templates already contain that language.

Fill In the Parties

Start with the principal — that’s you, the person creating the document. Enter your full legal name and current address. Then name your agent (also called your attorney-in-fact): their full legal name and address. Choose someone you trust completely, because the authority you grant can be sweeping.

Add a successor agent. The successor steps in if your primary agent dies, becomes incapacitated, or declines to serve. Skipping this field is a common mistake. Without a successor, you would have to execute a brand-new power of attorney if your first choice ever became unavailable, and if you have already lost capacity by then, that is no longer possible.

Choose Which Powers to Grant

Kansas lets you grant “general powers” that cover all lawful subjects, or you can limit the agent to specific categories. Under K.S.A. 58-654, a general grant without limitations lets the agent do anything you could do through a specifically authorized agent.⁴ Common categories on the form include banking and financial transactions, real estate, tax filings, and business operations. Be precise about what you are and are not granting. Vague wording invites pushback from banks and title companies.

Powers That Must Be Spelled Out

Some acts are never implied, no matter how broadly the rest of the form reads. Under K.S.A. 58-654(f), your agent can only perform these if the document expressly says so:⁴

Making gifts of your property
Consenting to an autopsy or making anatomical gifts under Kansas’s Revised Uniform Anatomical Gift Act
Accessing or managing your electronic communications

The gift restriction catches many families off guard. If your agent might need to transfer assets for Medicaid planning or make annual gifts to family, write that authority into the document explicitly. A general-powers clause alone will not cover it.

Filling Out the Healthcare Form

The statutory healthcare form under K.S.A. 58-632 walks you through each section. After the agent’s name and contact information, it lists three categories of authority: consenting to or refusing care and treatment, making arrangements at hospitals and nursing facilities, and accessing your medical records.⁵ A “Limitations of Authority” section lets you prohibit specific procedures. Use it if there are treatments you would never want. A separate section for special instructions is where you can set out preferences on end-of-life care, organ donation, or any treatment you do or do not want.

Decide When It Takes Effect

Both forms let you choose when the agent’s authority starts. An immediate power of attorney is active the moment you sign. A springing power of attorney only activates when a specified event occurs, typically your incapacity as certified by a physician. The healthcare form presents this choice directly: pick “immediately” or “upon the occurrence of my disability or incapacity.”⁵

Springing powers add a layer of protection if you want to keep full control while you are healthy, but they can create delays because the agent has to obtain certification before any institution will cooperate. Immediate powers are faster but require trust from day one.

Sign It Correctly

Financial Form: Notarization

A durable financial power of attorney must be signed by the principal and acknowledged (notarized) under Kansas’s Revised Uniform Law on Notarial Acts.³ If you are physically unable to sign but conscious and mentally competent, another adult may sign your name at your direction, in the presence of a notary public. Kansas does not cap notary fees, but the fee must be disclosed and agreed to before the notarial act.⁶ Without proper notarization, banks and other institutions will refuse the document.

Healthcare Form: Witnesses or Notary

The healthcare form uses a different rule. Under K.S.A. 58-629, you choose one of two options:⁷

Two witnesses, each at least 18. Neither witness can be the agent, related to you by blood, marriage, or adoption, entitled to any part of your estate, or directly financially responsible for your healthcare.
A notary public, with no witnesses required.

One method is enough. Having the healthcare form both witnessed and notarized is not required but can smooth things out if a hospital asks for extra verification.

What to Do After Signing

Record It If Real Estate Is Involved

A Kansas power of attorney is legally valid between you and your agent without recording. But if the agent will sign deeds, mortgages, or other real estate documents on your behalf, record the power of attorney with the Register of Deeds in the county where the property sits. K.S.A. 58-652(c) allows recording in the same manner as a land conveyance.³ Recording fees vary by county. Sedgwick County (Wichita), for example, charges $21 for the first page and $17 for each additional page.⁸ Some Kansas counties will not accept a certified copy for recording, so bring the original. Note that once a power of attorney is recorded, any later revocation must also be recorded to be effective.

Distribute Copies and Keep the Certification Form Handy

Give your agent a signed original or clean copy. Deliver copies to the banks, brokerages, insurers, and healthcare providers who will need to accept it. Keep a copy for yourself in a place your agent can find.

Download the Kansas Judicial Council’s Certification by Attorney in Fact form and keep a few blank copies with your power of attorney.¹ Institutions often ask the agent to sign a certification (under penalty of perjury) that the power of attorney is still in effect before cooperating, and this is the standard form they expect.

Changing or Canceling the Document Later

If you still have mental capacity, you can revoke a power of attorney at any time. Under K.S.A. 58-657, revocation can be oral or written: tell the agent the authority is terminated, or file a written revocation with the Register of Deeds in your county.⁹ If the original was recorded, the revocation must be recorded too. Deliver copies of the revocation to the agent and every institution that holds the original, because until they receive notice they can keep relying on the existing document in good faith. For the healthcare form, signing a new one automatically revokes the previous version under K.S.A. 58-632.⁵

1
Kansas Judicial Council. Power of Attorney
2
Kansas Judicial Branch. Kansas Judicial Branch Self-Help
3
Kansas Office of Revisor of Statutes. Kansas Code 58-652 – Effectiveness of Power of Attorney; Recording; Revocation; Attorney in Fact
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Kansas Office of Revisor of Statutes. Kansas Code 58-654 – General Powers
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Kansas Office of Revisor of Statutes. Kansas Code 58-632 – Form of Durable Power of Attorney
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Kansas Secretary of State. Kansas Notary Handbook
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Kansas Office of Revisor of Statutes. Kansas Code 58-629 – Authority of Agent; Limitations on Agent’s Power; Witnesses and Acknowledgment
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Sedgwick County, Kansas. 2026 Register of Deeds Fees
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Kansas State Legislature. Kansas Code 58-657 – Modification, Termination or Suspension of Power of Attorney