Power of Attorney (Scotland) - Template, Sample Form Pro · UK-law
✓ Valid in United Kingdom · drafted to comply with local law
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WELFARE POWER OF ATTORNEY
Granted in accordance with the Adults with Incapacity (Scotland) Act 2000
I, ________, born on ________, of:
________
(the Granter) make this welfare power of attorney (this Power of Attorney) in accordance with the Adults with Incapacity (Scotland) Act 2000 (the Act).
1. APPOINTMENT
1.1. I hereby appoint ________, born on ________, of:
________
to be my welfare attorney in terms of section 16 of the Act and in accordance with the particular powers defined in this Power of Attorney.
1.2. The person named in clause 1.1 shall be referred to in this Power of Attorney as "my Attorney".
1.3. I appoint ________, of ________, to act as my substitute welfare attorney in the event that my Attorney named in clause 1.1 is unable or unwilling to act, declines to act, has resigned, has died or has otherwise ceased to be entitled to act. The substitute Attorney shall, on so acting, have all the powers conferred on my Attorney by this Power of Attorney.
1.4. Where I have appointed more than one Attorney to act jointly, my Attorneys shall act ________ (state "jointly" or "jointly and severally").
2. DECLARATION
I declare and confirm the following:
2.1. I intend this Power of Attorney to be a welfare power of attorney in terms of section 16 of the Act.
2.2. I am habitually resident in Scotland and this Power of Attorney shall be governed by and interpreted in accordance with the law of Scotland, and the courts of Scotland shall have jurisdiction.
2.3. I hereby declare that the welfare powers set out and defined within section 3 (Welfare Powers) shall have effect and may only be exercised by my Attorney in the event that I become incapable, within the meaning of section 1(6) of the Act, of carrying out any of the acts or decisions involved in the Welfare Powers.
2.4. I have considered how my incapacity is to be determined and confirm that it is my wish for my incapacity to be established and certified in writing by ________ (state, for example, "one registered medical practitioner").
2.5. My Attorney shall be authorised to exercise the welfare powers in accordance with section 3 (Welfare Powers) until:
2.5.1. I revoke this Power of Attorney in writing and notify the Office of the Public Guardian in accordance with section 22A of the Act; or
2.5.2. this Power of Attorney is terminated by operation of any provision of the Act or any other lawful reason, including the granting of an intervention or guardianship order to the extent that it conflicts with this Power of Attorney.
2.6. At all times my Attorney shall be subject to the requirements of, and the supervision of the Office of the Public Guardian and the relevant local authority and Mental Welfare Commission for Scotland under, the Act.
2.7. I confirm that, at the date of granting this Power of Attorney, I understand its nature and extent and I am acting of my own free will, without undue influence from any person.
3. WELFARE POWERS
My Attorney shall have the welfare powers set out and defined in this section 3.
3.1. Medical treatment and personal arrangements
3.1.1. My Attorney may make decisions and act on my behalf in respect of any matter relating to my general welfare and care arrangements.
3.1.2. My Attorney may give or withhold consent on my behalf to any medical treatment or health-related treatment, provided that this is not prohibited by the Act or by any provision of the Mental Health (Care and Treatment) (Scotland) Act 2003.
3.1.3. Where there is a difference of opinion between my Attorney and a medical practitioner as to medical treatment, my Attorney acknowledges that the matter shall be determined in accordance with section 50 of the Act.
3.1.4. My Attorney may consent or refuse consent to my participation in medical research, within the parameters of sections 51 and 52 of the Act.
3.1.5. My Attorney may make decisions about my living arrangements and accommodation and may implement any such decision on my behalf.
3.1.6. My Attorney may make decisions in respect of my personal care, including my clothes, personal appearance and diet.
3.2. Confidential information
3.2.2. My Attorney may disclose my Personal Information to any third party where this is reasonably necessary and in my best interests.
3.3. Digital information
3.3.1. My Attorney may monitor and manage any online or email accounts held by me and access any digital information held in relation to me, provided that my Attorney must not post on any online site in my name or hold themselves out as being me.
3.3.2. My Attorney may contact online, internet or email service providers to obtain and manage my login details for any online or email account, and I authorise any such provider to release information to my Attorney.
3.4. Legal action
3.4.1. My Attorney may pursue, defend, settle or compromise any legal action or proceedings relating to my personal welfare on my behalf, including any application to the sheriff under the Act.
3.5. Social, cultural and educational activities
3.5.1. My Attorney may decide which social, cultural or religious meetings or activities I may take part in.
3.5.2. My Attorney may make decisions about my social contacts and may decide with whom I may socialise or associate.
3.5.3. My Attorney may decide which educational or vocational activities I may take part in and may make arrangements for me to attend any such activities.
3.5.4. My Attorney may take me on trips and holidays and may authorise and arrange for others to do so.
4. GENERAL PROVISIONS
4.1. My Attorney shall act at all times in accordance with the principles set out in section 1 of the Act and shall have regard to my present and past wishes and feelings, in so far as these can be ascertained.
4.2. In exercising any power conferred by this Power of Attorney, my Attorney shall take account of the views of any other person whom they consider it reasonable and practicable to consult, including my nearest relative, my primary carer and any guardian or attorney with an interest in my welfare.
4.3. My Attorney shall, in so far as it is reasonable and practicable to do so, encourage me to exercise whatever skills I have concerning my personal welfare and to develop new such skills.
4.4. Any benefit or intervention exercised by my Attorney under this Power of Attorney shall be the least restrictive option in relation to my freedom that is consistent with the purpose of the intervention.
4.5. Where I have appointed more than one Attorney, my Attorneys shall, unless otherwise specified in clause 1.4 of this Power of Attorney, act jointly and severally in the exercise of the Welfare Powers.
4.6. My Attorney shall not be entitled to any remuneration for acting as my Attorney but shall be entitled to be reimbursed for all reasonable outlays properly incurred in the exercise of their functions under this Power of Attorney.
4.8. My Attorney shall keep records of the exercise of their functions under this Power of Attorney and shall produce such records when required to do so by the Office of the Public Guardian or the relevant local authority.
4.9. If any provision of this Power of Attorney is or becomes invalid or unenforceable, the remaining provisions shall continue in full force and effect.
5. EXECUTION
IN WITNESS WHEREOF this Power of Attorney, consisting of this and the preceding pages, together with the statutory certificate annexed in Schedule 1, is executed by me as follows:
SIGNED by the Granter:
______________________________
________
IN THE PRESENCE OF THE FOLLOWING WITNESS:
FULL NAME OF WITNESS:
________
WITNESS SIGNATURE:
______________________________
WITNESS ADDRESS:
________
ON
DATE OF SIGNING:
________
AT
PLACE OF SIGNING:
________
SCHEDULE 1
STATUTORY CERTIFICATE
The statutory certificate required by section 16(3)(c) of the Adults with Incapacity (Scotland) Act 2000 MUST be completed and annexed below before this Power of Attorney can be registered with the Office of the Public Guardian.
I, ________, a ________ (state "practising solicitor", "member of the Faculty of Advocates" or "registered and practising medical practitioner"), of ________, hereby certify that:
(a) I have interviewed the Granter immediately before the Granter subscribed this Power of Attorney;
(b) I am satisfied, either from my own knowledge of the Granter or because I have consulted ________, who has knowledge of the Granter, that at the time this Power of Attorney was granted the Granter understood its nature and extent; and
(c) I have no reason to believe that the Granter was acting under undue influence or that any other factor vitiates the granting of this Power of Attorney.
SIGNED:
______________________________
CERTIFIER NAME: ________
DATE: ________
PLACE: ________
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