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Data Sheet Lasting Power of Attorney & Living Will

Please complete the following information so that we can prepare your advance directive documents. Mandatory fields are marked with *. Your data will be transmitted in encrypted form and will not be stored on our servers. Your entries are cached in your browser only until submission.

Please note: This form is intended solely to capture some key points. All details – in particular the scope of the power of attorney and the content of the living will – should be discussed personally with the notary on a case-by-case basis.

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Details of the Principal

Personal Details

Salutation *

Title

Nationality *

Nationality (please specify) *

German language skills for the notarisation *

Notary Dr. Baer can also notarise documents in English and Dutch – no interpreter is required for these languages.

First name(s) *

Last name *

Birth name (if different)

Date of birth *

Place of birth

Marital status

Address

Street *

No.

Postcode *

City *

Country (if not Germany)

Contact Details

E-mail *

Phone

Details of the Attorney

Please note: You can specify one primary attorney here and, optionally, one substitute or additional attorney. If you wish to appoint several primary attorneys (e.g. several persons with joint or several authority), please contact us directly – we will then discuss the details with you individually.

Primary Attorney

Salutation *

Title

Relationship to the principal *

First name(s) *

Last name *

Birth name (if different)

Date of birth *

Street *

No.

Postcode *

City *

E-mail

Phone

Substitute or Additional Attorney (optional)

Would you like to appoint a substitute or additional attorney? *

Salutation *

Title

Relationship to the principal *

First name(s) *

Last name *

Birth name (if different)

Date of birth *

Street *

No.

Postcode *

City *

E-mail

Phone

Scope of the Power of Attorney

The scope of the lasting power of attorney can be tailored individually and discussed with the notary in person. As a rule, a general power of attorney is granted, which also includes a power of attorney in personal matters (in particular healthcare, choice of residence and, where applicable, measures involving deprivation of liberty). The power of attorney is usually registered in the Central Register of Lasting Powers of Attorney maintained by the German Federal Chamber of Notaries.

Should certain matters or powers be excluded from the power of attorney? (optional)

Should a living will also be drawn up?

Should a care directive also be drawn up?

Summary and Submission

Additional notes or requests

Preferred means of communication *

Author of this form

Name and e-mail address of the person completing this form – we will send the confirmation of receipt and any follow-up questions to this address.

Name *

E-mail *

I ask the notary to prepare the advance directive documents on the basis of these key points and to discuss the details with me. *

I have read the Privacy Policy and consent to the processing of my data for the preparation of the advance directive documents. *

Please note: Notarial fees are charged for the notarisation in accordance with the German Court and Notary Costs Act (GNotKG). If the notary prepares a draft on instruction, fees may also be charged even if the notarisation does not take place.