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Ontario Limited Continuing Power of Attorney Form


Ontario Limited Continuing Power of Attorney Form
Ontario Limited Continuing Power of Attorney Form
Limited Continuing Power of Attorney
(Made in accordance with the Substitutes Decision Act, 1992)
To: Her Majesty the Queen in right of Ontario, as represented by the Minister of Training, Colleges and Universities
(“the Mini
stry”)
1.
I, _________________________________ appoint:
(print full name of person giving the power of attorney)
____________________________to be my attorney
(print the full name of the person you appoint)
to enter into and endorse, on my behalf, the Certificate of Loan/Grant Approval and Eligibility form relating
to a student loan offered by the Government of Ontario through the Ontario Student Assistance Program.
I confirm that my attorney may do so even if I am mentally incapable.
2. I acknowledge and agree that my attorney, by entering into and endorsing the Certificate of Loan/Grant
Approval and Eligibility form, binds me to all terms, conditions and obligations associated with such form
including all repayment obligations.
3. I confirm that both I and my attorney are at least 18 years old.
4. I understand that this continuing power of attorney will be the only power of attorney accepted by the
Ministry for the purposes of the Ontario Student Assistance Program. The execution of this document,
however, will not revoke any other continuing powers of attorney previously executed by me and I
expressly provide that there may be multiple continuing powers of attorney.
5. Subject to paragraph 6, this continuing power of attorney will come into effect on the date it is signed and
witnessed and will be valid for 1 year.
6. I understand that my attorney may act on my behalf until:
a. this continuing power of attorney expires or the Ministry receives written notice of my death,
bankruptcy, termination by a court order, court appointment of a guardian of my property or
revocation by me of this power of attorney; or
b. the Ministry receives written notice of the resignation, death, bankruptcy or mental incapacity of my
attorney.
Any notice of revocation by me must be in writing, signed, dated and witnessed in the same way as this
continuing power of attorney. All other notices must be in writing, signed and dated. All notices, including
any notice of revocation, must be forwarded to the National Student Loans Service Centre –
Public/Private Institutions Division. Until any notice has been given and acknowledged in writing by the
Ministry all that my attorney will do in accordance with this power of attorney is fully accepted and
confirmed.
7. My attorney is not entitled to compensation for acting pursuant to this continuing power of attorney.
8. Signature of Person giving the Continuing Power of Attorney
Signature: _________________________________________ Date: _______________________
(sign your name in the presence of two witnesses)
Address: ______________________________________________________
(insert your full current address)
9. Witness Signature
Notes:
Both witnesses must be present together when you sign.
Both witnesses must sign their names in your presence and in the presence of each other.
The following people cannot be witnesses: the attorney or his or her spouse or partner; the spouse, partner
or child of the person making the document, or someone that the person treats as his or her child; a person
whose property is under guardianship or who has a guardian of the person; a person under the age of 18.
Witness # 1: Signature: ___________________ Print Name: ___________________
Address: ___________________________________________________________________
____________________________________________ Date: _________________________
Witness # 2: Signature: ___________________ Print Name: ___________________
Address: ___________________________________________________________________
____________________________________________ Date: _________________________
Signature of Attorney
10. _____________________________ Date: _________________________
(sign name of attorney)
N.B. FORWARD THE COMPLETED FORM TO THE NATIONAL STUDENT LOANS SERVICE CENTRE
34-1653
Ontario Limited Continuing Power of Attorney Form