(b) the Powers of Attorney Amendment Regulations 2017[2];
(c) the Powers of Attorney Amendment Regulations 2021[3].
5 Definition
In these Regulations—
the Act means the Powers of Attorney Act 2014.
Part 2—Prescribed forms
6 Enduring power of attorney
(1) For the purposes of section 32 of the Act, the prescribed form is Part 1 of Form 1 of Schedule 1.
(2) For the purposes of section 37 of the Act, the prescribed form of statement of acceptance is Part 2 of Form 1 of Schedule 1.
(3) For the purposes of section 38 of the Act, the prescribed form of statement of acceptance is Part 3 of Form 1 of Schedule 1.
7 Revocation by principal of enduring power of attorney or appointment of attorney/alternative attorney
For the purposes of section 45 of the Act, the prescribed form is Form 2 of Schedule 1.
8 Notification by attorney
For the purposes of section 54(5) of the Act, the prescribed form is Form 3 of Schedule 1.
9 Resignation by attorney or alternative attorney
For the purposes of sections 57 and 60 of the Act, the prescribed form is Form 4 of Schedule 1.
10 Appointment of supportive attorney
(1) For the purposes of section 94 of the Act, the prescribed form is Part 1 of Form 5 of Schedule 1.
(2) For the purposes of section 99 of the Act, the prescribed form of statement of acceptance is Part 2 of Form 5 of Schedule 1.
(3) For the purposes of section 100 of the Act, the prescribed form of statement of acceptance is Part 3 of Form 5 of Schedule 1.
11 Revocation by principal of supportive attorney appointment or appointment of supportive attorney/alternative supportive attorney
For the purposes of section 104 of the Act, the prescribed form is Form 6 of Schedule 1.
12 Resignation by supportive attorney or alternative supportive attorney
For the purposes of section 112 of the Act, the prescribed form is Form 7 of Schedule 1.
Schedule 1—Forms
Form 1
Part 1
ENDURING POWER OF ATTORNEY
Regulation 6
Name of principal:
Address of principal:
APPOINTMENT
I appoint [insert name of one or more persons or position] of [insert address(es) of persons or position]
*to be my attorney
*to be my joint attorneys
*to be my several attorneys
*to be my joint and several attorneys
*to be my majority attorneys
*and I appoint [insert name of one or more persons or position] of [insert address(es) of persons or position] as alternative attorney for [insert name of one attorney]
*and I appoint [insert name of one person or position] of [insert address of person or position] as alternative attorney for [insert names of more than one attorney]
Note: Under section 31(3) of the Powers of Attorney Act 2014, an alternative attorney must act under the enduring power of attorney in the same manner as the attorney for whom the alternative attorney is appointed to act unless you provide otherwise.
AUTHORISATION
I authorise my attorney(s):
*to do anything on my behalf that I can lawfully do by an attorney.
*to do anything on my behalf that I can lawfully do by an attorney for—
[select all that apply and complete as required]
*personal matters only.
*financial matters only.
*the following specified personal matter(s): [list matter(s)]
*the following specified financial matter(s): [list matter(s)]
Note: Personal matter is defined under section 3(1) of the Powers of Attorney Act 2014 to mean any matter, including any legal matter, relating to the principal's personal or lifestyle affairs, but does not include any matter that relates to medical treatment or medical research procedures.
Financial matter is defined under section 3(1) of the Powers of Attorney Act 2014 to mean any matter, including any legal matter, relating to the principal's financial or property affairs.
*EXISTING ENDURING POWER OF ATTORNEY NOT REVOKED
*I specify that the enduring power of attorney made by me on [insert date made if known, or if not known, the name of the attorney(s) appointed and their authorised power(s)] is not revoked by this enduring power of attorney.
*I specify that the following parts of the enduring power of attorney made by me on [insert date made if known, or if not known, the name of the attorney(s) appointed and their authorised power(s)] are not revoked by this enduring power of attorney.
*Note: Under section 55 of the Powers of Attorney Act 2014, an enduring power of attorney is revoked by a later enduring power of attorney of the principal, unless the principal specifies otherwise in the later enduring power of attorney.
Under sections 142, 143, 152 and 153 of the Powers of Attorney Act 2014, an enduring power of attorney is taken to include an existing enduring power of attorney made before 1 September 2015 under the Instruments Act 1958 and an existing appointment of an enduring guardian made before 1 September 2015 under the Guardianship and Administration Act 1986.
COMMENCEMENT
[Principal to complete if all powers under the enduring power of attorney are to commence at the same time]
*All powers under this enduring power of attorney are exercisable:
[then select one of the following options]
*immediately on the making of this enduring power of attorney.
*when I cease to have decision making capacity for the matter(s).
*from the time, in the circumstance or on the occasion specified as follows: [insert time, circumstance or occasion]
OR
[If principal is authorising different commencements for powers for different matters under the enduring power of attorney]:
*The powers under this enduring power of attorney for [insert specified matter(s)] are exercisable:
[then select one of the following options]
*immediately on the making of this enduring power of attorney.
*when I cease to have decision making capacity for the matter(s).
*from the time, in the circumstance or on the occasion specified as follows: [insert time, circumstance, or occasion on which powers are to commence for the matter(s) specified]
[Repeat as required until all matters have a commencement instruction]
*CONDITIONS AND INSTRUCTIONS
The exercise of power under this enduring power of attorney is subject to the following conditions or instructions:
EXECUTION BY PRINCIPAL
Signed: [signature of principal or person signing at the direction of (on behalf of) the principal]
*I sign this enduring power of attorney at the direction of and in the presence of the principal.
*Name of person signing at direction of principal:
*Address of person signing at direction of principal:
Date:
CERTIFICATION OF WITNESSES
Witnessed by:
Name of first witness:
Address of first witness:
Name of second witness:
Address of second witness:
Each witness certifies that:
*the principal appeared to freely and voluntarily sign this instrument in my presence;
OR
*[If witnessing another person signing at the direction of and in the presence of the principal] in my presence, the principal appeared to freely and voluntarily direct the person to sign for the principal and that person signed this instrument in my presence and in the presence of the principal;
AND [to be completed in all cases]
at that time, the principal appeared to me to have decision making capacity in relation to the making of this enduring power of attorney; and
I am not an attorney under this enduring power of attorney; and
I am not a relative of the principal or of an attorney under this enduring power of attorney; and
I am not a care worker or accommodation provider for the principal.
Note: care worker and accommodation provider are defined under section 3(1) of the Powers of Attorney Act 2014.
*[If witnessing another person signing at the direction of and in the presence of the principal] I am not the person who is signing at the direction of the principal.
Is any witness witnessing the signing of this instrument by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014? [tick appropriate box]
Note: under section 5A of the Powers of Attorney Act 2014, one or more of the witnesses may witness the signing of the instrument by audio visual link.
Name of witness acting as special witness: [insert name of witness acting as special witness]
I certify that:
• I witnessed the signing of this enduring power of attorney by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014; and
• I am a special witness as:
*an Australian legal practitioner; and
*a justice of the peace appointed under section 7 of the Honorary Justices Act 2014; and
• this enduring power of attorney was signed and witnessed in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014; and
• an audio visual recording:
*was
*was not
made of the signing and witnessing of this enduring power of attorney by the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014.
Note: Under section 5C of the Powers of Attorney Act 2014, an audio visual recording of the execution or signing of an enduring power of attorney by the remote witnessing procedure may be made only if all of the parties to the procedure consent to a recording being made.
*Certification by other witness
***[Other witness (witness not acting as special witness) to complete this section if using the remote witnessing procedure]
*I witnessed the signing of this enduring power of attorney by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014.
Signed:
First witness: [signature of first witness]
*Qualification: [if first witness is witnessing in the physical presence of the principal and is acting as a medical practitioner or person authorised to witness affidavits]
Second witness: [signature of second witness]
*Qualification: [if second witness is witnessing in the physical presence of the principal and is acting as a medical practitioner or person authorised to witness affidavits]
Date:
*Note: If the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014 is used by one or more witnesses to witness the signing of this enduring power of attorney, the following requirements apply to any witness attending by audio visual link:
the witness must sign and date this enduring power of attorney in the presence by audio visual link of the principal and any other witnesses; and
one of the witnesses must be a special witness as defined under section 3(1) of the Powers of Attorney Act 2014 (an Australian legal practitioner or justice of the peace); and
the special witness must sign this enduring power of attorney last (following the principal and other witnesses), regardless of whether the special witness is physically present; and
all elements of the remote witnessing procedure must be carried out on the same day and within Victoria.
*Delete if not applicable.
Part 2
STATEMENT OF ACCEPTANCE OF APPOINTMENT—ATTORNEY
Name of attorney:
Address of attorney:
I acceptmy appointmentas attorney under this enduring power of attorney and state that:
I am eligible under Part 3 of the Powers of Attorney Act2014 to act as an attorney under an enduring power of attorney; and
I understand the obligations of an attorney under an enduring power of attorney and under the Powers of Attorney Act2014 and the consequences of failing to comply with those obligations; and
I undertake to act in accordance with the provisions of the Powers of Attorney Act2014 that relate to enduring powers of attorney.
*[If appointed for financial matters and you have been convicted or found guilty of an offence involving dishonesty] I have disclosed to the principal that I have been convicted or found guilty of an offence involving dishonesty.
Signed: [signature of attorney]
Date:
*Position: [if appointed as the occupant of a position]
Witnessed by:
Name of witness:
Address of witness:
*[If witnessing in the physical presence of the attorney] I witnessed the signing of the statement of acceptance by the attorney.
*[If witnessed in accordance with the remote witnessing procedure] I witnessed the signing of this statement of acceptance by the attorney by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014.
Signed: [signature of witness]
Date:
Note: Each attorney must sign a statement of acceptance and it must be witnessed separately in the enduring power of attorney.
If the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014 is used by one or more witnesses to witness the signing of this statement of acceptance, all elements of the remote witnessing procedure must be carried out on the same day and within Victoria.
*Delete if not applicable.
Part 3
STATEMENT OF ACCEPTANCE OF APPOINTMENT—ALTERNATIVE ATTORNEY
[To be completed only if the principal has appointed an alternative attorney in Part 1. Complete a separate form for each alternative attorney appointed]
Name of alternative attorney:
Address of alternative attorney:
I acceptmy appointmentas an alternative attorney under this enduring power of attorney and state that:
I am eligible under Part 3 of the Powers of Attorney Act 2014 to act as an attorney under an enduring power of attorney; and
I understand the obligations of an attorney under an enduring power of attorney and under the Powers of Attorney Act 2014 and the consequences of failing to comply with those obligations; and
I undertake to act in accordance with the provisions of the Powers of Attorney Act 2014 that relate to enduring powers of attorney; and
I understand the circumstances in which the alternative attorney is authorised to act under the Powers of Attorney Act 2014; and
I am prepared to act in place of the attorney for whom I am appointed, if still eligible to act as attorney, when authorised to do so under the Powers ofAttorney Act 2014.
*[If appointed for financial matters and you have been convicted or found guilty of an offence involving dishonesty] I have disclosed to the principal that I have been convicted or found guilty of an offence involving dishonesty.
Signed: [signature of alternative attorney]
Date:
*Position: [if appointed as the occupant of a position]
Witnessed by:
Name of witness:
Address of witness:
*[If witnessed in the physical presence of the alternative attorney] I witnessed the signing of the statement of acceptance by the alternative attorney.
*[If witnessed in accordance with the remote witnessing procedure] I witnessed the signing of this statement of acceptance by the alternative attorney by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014.
Signed: [signature of witness]
Date:
Note: Each alternative attorney must sign a statement of acceptance and it must be witnessed separately in the enduring power of attorney.
If the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014 is used by one or more witnesses to witness the signing of this statement of acceptance, all elements of the remote witnessing procedure must be carried out on the same day and within Victoria.
*Delete if not applicable.
Form 2
Revocation by principal of enduring power of attorney or appointment of attorney/alternative attorney
Regulation 7
Name of principal:
Address of principal:
I revoke under section 44 of the Powers of Attorney Act 2014:
*the enduring power of attorney made by me on [insert date made]
*the appointment of my attorney(s) [insert name (or position) of one or more attorneys] of [insert address(es) of attorney(s)] under the enduring power of attorney made by me on [insert date made]
*the appointment of my alternative attorney(s) [insert name (or position) of one or more alternative attorneys] of [insert address(es) of alternative attorney(s)] for [insert name of attorney(s)] under the enduring power of attorney made by me on [insert date made]
Signed: [signature of principal or person signing at the direction of (on behalf of) the principal]
*I sign this instrument of revocation at the direction of and in the presence of the principal.
*Name of person signing at direction of principal:
*Address of person signing at direction of principal:
Date:
CERTIFICATION OF WITNESSES
Witnessed by:
Name of first witness:
Address of first witness:
Name of second witness:
Address of second witness:
Each witness certifies that:
*the principal appeared to freely and voluntarily sign this instrument in my presence;
OR
*[If witnessing another person signing at the direction of and in the presence of the principal] in my presence, the principal appeared to freely and voluntarily direct the person to sign for the principal and that person signed this instrument in my presence and in the presence of the principal;
AND [to be completed in all cases]
at that time, the principal appeared to me to have decision making capacity to revoke this enduring power of attorney; and
I am not an attorney under this enduring power of attorney; and
I am not a relative of the principal or of an attorney under the enduring power of attorney; and
I am not a care worker or accommodation provider for the principal.
Note: care worker and accommodation provider are defined under section 3(1) of the Powers of Attorney Act 2014.
*[If witnessing another person signing at the direction of and in the presence of the principal] I am not the person who is signing at the direction of the principal.
Is any witness witnessing the signing of this instrument of revocation by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014? [tick appropriate box]
Note: under section 5A of the Powers of Attorney Act 2014, one or more of the witnesses may witness the signing of the instrument by audio visual link.
Name of witness acting as special witness: [insert name of witness acting as special witness]
I certify that:
• I witnessed the signing of this instrument of revocation by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014; and
• I am a special witness as:
*an Australian legal practitioner; and
*a justice of the peace appointed under section 7 of the Honorary Justices Act 2014; and
• this instrument of revocation was signed and witnessed in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014; and
• an audio visual recording:
*was
*was not
made of the signing and witnessing of this instrument of revocation by the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014.
Note: Under section 5C of the Powers of Attorney Act 2014, an audio visual recording of the execution or signing of an instrument of revocation by the remote witnessing procedure may be made only if all of the parties to the procedure consent to a recording being made.
*Certification by other witness
***[Other witness (witness not acting as special witness) to complete this section if using the remote witnessing procedure]
*I witnessed the signing of this instrument of revocation by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014.
Signed:
First witness: [signature of first witness]
*Qualification: [if first witness is witnessing in the physical presence of the principal and is acting as a medical practitioner or person authorised to witness affidavits]
Second witness: [signature of second witness]
*Qualification: [if second witness is witnessing in the physical presence of the principal and is acting as a medical practitioner or person authorised to witness affidavits]
Date:
Note: If the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014 is used by one or more witnesses to witness the signing of this instrument of revocation, the following requirements apply to any witness attending by audio visual link:
• the witness must sign and date this instrument of revocation in the presence by audio visual link of the principal and any other witnesses; and
• one of the witnesses must be a special witness as defined under section 3(1) of the Powers of Attorney Act 2014 (an Australian legal practitioner or justice of the peace); and
• the special witness must sign this instrument of revocation last (following the principal and other witnesses), regardless of whether the special witness is physically present; and
• all elements of the remote witnessing procedure must be carried out on the same day and within Victoria.
*Delete if not applicable.
Form 3
Notification by attorney
Regulation 8
To: [insert name of person(s) or organisation(s) to whom notice is being given] of [insert address(es) of person(s) or organisation(s) to whom notice is being given (if known)]
This notice is given under section 54 of the Powers of Attorney Act 2014.
*INDIVIDUAL
Name of attorney giving notice:
Address of attorney giving notice:
I give notice that my appointment as an attorney under the enduring power of attorney made by [insert name of principal] on [insert date made (if known)] is revoked because:
*I have become an insolvent under administration.
*I have become a care worker, health provider or an accommodation provider for the principal.
*[If an attorney for financial matters] I have been convicted or found guilty of an offence involving dishonesty.
*TRUSTEE COMPANY
Name of trustee company giving notice:
Address of trustee company giving notice:
The company, an attorney under the enduring power of attorney made by [insert name of principal] on [insert date made (if known)] gives notice that:
the company's appointment as an attorney under that enduring power of attorney is revoked because the company has been wound up or ceased to be registered.
a proceeding for winding up has commenced against the company.
the company has been convicted or found guilty of an offence involving dishonesty.
Signed: [signature of attorney]
Date:
*Delete if not applicable.
Form 4
Resignation by attorney or alternative attorney
Regulation 9
Name (or position) of attorney or alternative attorney resigning:
Address of attorney or alternative attorney resigning:
**I resign/The trustee company resigns under section *56/*59(1)(a)/
*59(1)(b)/*59(3) of the Powers of Attorney Act 2014 from *my/*its appointment as an *attorney/*alternative attorney for [insert name (or position) of attorney(s)] under the enduring power of attorney made by [insert name of principal] on [insert date made (if known)]
Signed: [signature of attorney or alternative attorney]
Date:
*Delete if not applicable.
Form 5
Part 1
Appointment of supportive attorney
Regulation 10
Name of principal:
Address of principal:
APPOINTMENT
I appoint [insert name of one or more supportive attorney(s)] of [insert address(es) of supportive attorney(s)] to act as my supportive attorney(s).
*and I appoint [insert name(s) of one or more alternative supportive attorney(s)] of [insert address(es) of alternative supportive attorney(s)] as alternative supportive attorney for [insert name of one supportive attorney]
*and I appoint [insert name of one alternative supportive attorney] of [insert address of alternative supportive attorney] as alternative supportive attorney for [insert names of more than one supportive attorney]
AUTHORISATION
I authorise my supportive attorney(s) to exercise the following power(s):
*Information power in accordance with section 87 of the Powers of Attorney Act 2014.
*Communication power in accordance with section 88 of the Powers of Attorney Act 2014.
*Power to give effect to decisions in accordance with section 89 of the Powers of Attorney Act 2014.
I authorise my supportive attorney(s) to exercise these powers in relation to the following matters:
*both personal and financial matters.
*personal matters only.
*financial matters only.
*the following specified:
[select all that apply and complete as required]
*personal matter(s) only: [list matter(s)]
*financial matter(s) only: [list matter(s)]
*other matter(s) only: [list matter(s)]
Note: Personal matter is defined under section 3(1) of the Powers of Attorney Act 2014 to mean any matter, including any legal matter, relating to the principal's personal or lifestyle affairs, but does not include any matter that relates to medical treatment or medical research procedures.
Financial matter is defined under section 3(1) of the Powers of Attorney Act 2014 to mean any matter, including any legal matter, relating to the principal's financial or property affairs.
COMMENCEMENT
*This supportive attorney appointment commences on its making.
*This supportive attorney appointment commences from the time, in the circumstance or on the occasion specified as follows: [insert time, circumstance or occasion]
EXECUTION BY PRINCIPAL
Signed: [signature of principal or person signing at the direction of (on behalf of) the principal]
*I sign this supportive attorney appointment at the direction of and in the presence of the principal.
*Name of person signing at direction of principal:
*Address of person signing at direction of principal:
Date:
CERTIFICATION OF WITNESSES
Witnessed by:
Name of first witness:
Address of first witness:
Name of second witness:
Address of second witness:
Each witness certifies that:
*the principal appeared to freely and voluntarily sign this supportive attorney appointment form in my presence;
OR
*[If witnessing another person signing at the direction of (on behalf of) and in the presence of the principal] in my presence, the principal appeared to freely and voluntarily direct the person to sign for the principal and that person signed this supportive attorney appointment form in my presence and in the presence of the principal;
AND [to be completed in all cases]
at that time, the principal appeared to me to have decision making capacity in relation to making this supportive attorney appointment.
Each witness states that:
I am not a supportive attorney under this appointment.
*[If witnessing another person signing this supportive attorney appointment form at the direction of and in the presence of the principal] I am not the person who is signing at the direction of the principal.
Is any witness witnessing the signing of this supportive attorney appointment by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014? [tick appropriate box]
Note: under section 5A of the Powers of Attorney Act 2014, one or more of the witnesses may witness the signing of the instrument by audio visual link.
Name of witness acting as special witness: [insert name of witness acting as special witness]
I certify that:
I witnessed the signing of this supportive attorney appointment by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014; and
I am a special witness as:
*an Australian legal practitioner; and
*a justice of the peace appointed under section 7 of the Honorary Justices Act 2014; and
• this supportive attorney appointment was signed and witnessed in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014; and
• an audio visual recording:
*was
*was not
made of the signing and witnessing of this supportive attorney appointment by the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014.
Note: Under section 5C of the Powers of Attorney Act 2014, an audio visual recording of the execution or signing of a supportive attorney appointment by the remote witnessing procedure may be made only if all of the parties to the procedure consent to a recording being made.
*Certification by other witness
***[Other witness (witness not acting as special witness) to complete this section if using the remote witnessing procedure]
*I witnessed the signing of this supportive attorney appointment by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014.
Signed:
First witness: [signature of first witness]
*Qualification: [if first witness is physically present and is acting as a person authorised to witness statutory declarations]
Second witness: [signature of second witness]
*Qualification: [if second witness is physically present and is acting as a person authorised to witness statutory declarations]
Date:
Note: If the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014 is used by one or both witnesses to witness the signing of this supportive attorney appointment, the following requirements apply to any witness attending by audio visual link:
the witness must sign and date this supportive attorney appointment in the presence by audio visual link of the principal and other witness; and
one witness must be a special witness as defined under section 3(1) of the Powers of Attorney Act 2014 (an Australian legal practitioner or a justice of the peace); and
the special witness must sign this supportive attorney appointment last (following the principal and other witness) regardless of whether the special witness is physically present; and
all elements of the remote witnessing procedure must be carried out on the same day and within Victoria.
*Delete if not applicable.
Part 2
STATEMENT OF ACCEPTANCE OF APPOINTMENT—SUPPORTIVE ATTORNEY
Name of supportive attorney:
Address of supportive attorney:
I acceptmy appointmentas supportive attorney under this supportive attorney appointment and state that:
I am eligible under the Powers of Attorney Act 2014 to act as a supportive attorney under a supportive attorney appointment; and
I understand the obligations of a supportive attorney under the Powers of Attorney Act 2014 and the consequences of failing to comply with the Powers of Attorney Act 2014; and
I undertake to act in accordance with the Powers of Attorney Act 2014.
*[If appointed for financial matters and you have been convicted or found guilty of an offence involving dishonesty] I have disclosed to the principal that I have been convicted or found guilty of an offence involving dishonesty.
Signed: [signature of supportiveattorney]
Date:
Witnessed by:
Name of witness:
Address of witness:
*[If witnessed in the physical presence of the supportive attorney] I witnessed the signing of the statement of acceptance by the supportive attorney.
*[If witnessed in accordance with the remote witnessing procedure] I witnessed the signing of this statement of acceptance by the supportive attorney by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014.
Signed: [signature of witness]
Date:
Note: Each supportive attorney must sign a statement of acceptance and it must be witnessed separately in the supportive attorney appointment.
If the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014 is used by one or both witnesses to witness the signing of this statement of acceptance, all elements of the remote witnessing procedure must be carried out on the same day and within Victoria.
*Delete if not applicable.
Part 3
STATEMENT OF ACCEPTANCE OF APPOINTMENT—ALTERNATIVE SUPPORTIVE ATTORNEY
[To be completed only if the principal has appointed an alternative supportive attorney in Part 1. Complete a separate form for each alternative supportive attorney appointed]
Name of alternative supportive attorney:
Address of alternative supportive attorney:
I acceptmy appointmentas an alternative supportive attorney under this supportive attorney appointment and state that:
I am eligible under the Powers of Attorney Act 2014 to act as a supportive attorney under a supportive attorney appointment; and
I understand the obligations of a supportive attorney under the Powers of Attorney Act 2014 and the consequences of failing to comply with the Powers of Attorney Act 2014; and
I undertake to act in accordance with the Powers of Attorney Act 2014; and
I understand the circumstances in which the alternative supportive attorney is authorised to act under the Powers of Attorney Act 2014; and
I am prepared to act in place of the supportive attorney for whom I am appointed when authorised to do so under the Powers of Attorney Act 2014.
*[If appointed for financial matters and you have been convicted or found guilty of an offence involving dishonesty] I have disclosed to the principal that I have been convicted or found guilty of an offence involving dishonesty.
Signed: [signature of alternative supportiveattorney]
Date:
Witnessed by:
Name of witness:
Address of witness:
*[If witnessed in the physical presence of the alternative supportive attorney] I witnessed the signing of the statement of acceptance by the alternative supportive attorney.
*[If witnessed in accordance with the remote witnessing procedure] I witnessed the signing of this statement of acceptance by the alternative supportive attorney by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014.
Signed: [signature of witness]
Date:
Note: Each alternative supportive attorney must sign a statement of acceptance and it must be witnessed separately in the supportive attorney appointment.
If the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014 is used by one or both witnesses to witness the signing of this statement of acceptance, all elements of the remote witnessing procedure must be carried out on the same day and within Victoria.
*Delete if not applicable.
Form 6
Revocation by principal of supportive attorney appointment or appointment of supportive attorney/alternative supportive attorney
Regulation 11
Name of principal:
Address of principal:
I revoke under section 103 of the Powers of Attorney Act 2014:
*the supportive attorney appointment made by me on [insert date made]
*the appointment of my supportive attorney(s) [insert name of supportive attorney or attorneys if revoking the appointment of more than one] of [insert address(es) of supportive attorney(s)] under the supportive attorney appointment made by me on [insert date made]
*the appointment of my alternative supportive attorney(s) [insert name of alternative supportive attorney or attorneys if revoking the appointment of more than one] of [insert address(es) of alternative supportive attorney(s)] for [insert name of supportive attorney(s)] under the supportive attorney appointment made by me on [insert date made]
Signed: [signature of principal or person signing at the direction of (on behalf of) the principal]
*I sign this form of revocation at the direction of and in the presence of the principal.
*Name of person signing at direction of principal:
*Address of person signing at direction of principal:
Date:
Witnessed by:
Name of witness:
Address of witness:
Is the witness witnessing the signing of this form of revocation by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014? [tick appropriate box]
Note: under section 5A of the Powers of Attorney Act 2014, the witness may witness the signing of the form of revocation by audio visual link.
I witnessed the signing of this form of revocation by audio visual link in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014; and
• this form of revocation was signed and witnessed in accordance with the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014; and
• I am a special witness as:
*an Australian legal practitioner; and
*a justice of the peace appointed under section 7 of the Honorary Justices Act 2014; and
• an audio visual recording
*was
*was not
made of the signing and witnessing of this form of revocation by the remote witnessing procedure under section 5A of the Powers of Attorney Act 2014.
Note: Under section 5C of the Powers of Attorney Act 2014, an audio visual recording of the execution or signing of a form of revocation by the remote witnessing procedure may be made only if all of the parties to the procedure consent to a recording being made.
Signed: [signature of witness]
*Qualification: [if witnessing in the physical presence of the principal, specifyhow authorised to witness the signing of a statutory declaration]
Date:
*Note: If the remote witnessing procedure set out in section 5A of the Powers of Attorney Act 2014 is used to witness the signing of this form of revocation, the following requirements apply to any witness attending by audio visual link:
the witness must sign and date this form of revocation in the presence by audio visual link of the principal; and
the witness must be a special witness as defined under section 3(1) of the Powers of Attorney Act 2014 (an Australian legal practitioner or justice of the peace); and
all elements of the remote witnessing procedure must be carried out on the same day and within Victoria.
*Delete if not applicable.
Form 7
Resignation by supportive attorney or alternative supportive attorney
Regulation 12
Name of supportive attorney or alternative supportive attorney resigning:
Address of supportive attorney or alternative supportive attorney resigning:
I resign under section 111 of the Powers of Attorney Act 2014 from my appointment as *a supportive attorney/*an alternative supportive attorney for [insert name of supportive attorney(s)] under the supportive attorney appointment made by [insert name of principal] on [insert date made (if known)]
Signed: [signature ofsupportive attorney or alternative supportive attorney resigning]
Date:
*Delete if not applicable.
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Endnotes
1 General information
See www.legislation.vic.gov.au for Victorian Bills, Acts and current Versions of legislation and up-to-date legislative information.
The Powers of Attorney Regulations 2025, S.R. No. 73/2025 were made on 5 August 2025 by the Governor in Council under section 139 of the Powers of Attorney Act 2014, No. 57/2014 and came into operation on 10 August 2025: regulation 3.
The Powers of Attorney Regulations 2025 will sunset 10 years after the day of making on 5 August 2035 (see section 5 of the Subordinate Legislation Act 1994).
INTERPRETATION OF LEGISLATION ACT 1984 (ILA)
Style changes
Section 54A of the ILA authorises the making of the style changes set out in Schedule 1 to that Act.
References to ILA s. 39B
Sidenotes which cite ILA s. 39B refer to section 39B of the ILA which provides that where an undivided regulation, rule or clause of a Schedule is amended by the insertion of one or more subregulations, subrules or subclauses the original regulation, rule or clause becomes subregulation, subrule or subclause (1) and is amended by the insertion of the expression "(1)" at the beginning of the original regulation, rule or clause.
Interpretation
As from 1 January 2001, amendments to section 36 of the ILA have the following effects:
• Headings
All headings included in a Statutory Rule which is made on or after
1 January 2001 form part of that Statutory Rule. Any heading inserted in a Statutory Rule which was made before 1 January 2001, by a Statutory Rule made on or after 1 January 2001, forms part of that Statutory Rule.
This includes headings to Parts, Divisions or Subdivisions in a Schedule; Orders; Parts into which an Order is divided; clauses; regulations; rules; items; tables; columns; examples; diagrams; notes or forms.
See section 36(1A)(2A)(2B).
• Examples, diagrams or notes
All examples, diagrams or notes included in a Statutory Rule which is made on or after 1 January 2001 form part of that Statutory Rule. Any examples, diagrams or notes inserted in a Statutory Rule which was made before 1 January 2001, by a Statutory Rule made on or after 1 January 2001, form part of that Statutory Rule. See section 36(3A).
• Punctuation
All punctuation included in a Statutory Rule which is made on or after
1 January 2001 forms part of that Statutory Rule. Any punctuation inserted in a Statutory Rule which was made before 1 January 2001, by a Statutory Rule made on or after 1 January 2001, forms part of that Statutory Rule.
See section 36(3B).
• Provision numbers
All provision numbers included in a Statutory Rule form part of that Statutory Rule, whether inserted in the Statutory Rule before, on or after
1 January 2001. Provision numbers include regulation numbers, rule numbers, subregulation numbers, subrule numbers, paragraphs and subparagraphs. See section 36(3C).
• Location of "legislative items"
A "legislative item" is a penalty, an example or a note. As from 13 October 2004, a legislative item relating to a provision of a Statutory Rule is taken to be at the foot of that provision even if it is preceded or followed by another legislative item that relates to that provision. For example, if a penalty at the foot of a provision is followed by a note, both of these legislative items will be regarded as being at the foot of that provision. See section 36B.
• Other material
Any explanatory memorandum, table of provisions, endnotes, index and other material printed after the Endnotes does not form part of a Statutory Rule. See section 36(3)(3D)(3E).
2 Table of Amendments
There are no amendments made to the Powers of Attorney Regulations 2025 by statutory rules, subordinate instruments and Acts.
3 Explanatory details
Reg. 4(a): S.R. No. 93/2015 as amended by S.R. Nos 17/2017 and 37/2021. ↑