Appendix A to Part 240 - Optional Forms for Powers of Attorney and Their Application
31:2.1.1.1.17.0.3.20.4 : Appendix A
Appendix A to Part 240 - Optional Forms for Powers of Attorney and
Their Application
Fiscal Service Form 231 - General Power of Attorney
(Individual). This general power of attorney form may be executed
by an individual, unincorporated partnership, or sole owner, for
checks drawn on the United States Treasury, in payment: (1) For
redemption of currencies or for principal or interest on U.S.
securities; (2) for tax refunds; and (3) for goods and
services.
Fiscal Service Form 232 - Specific Power of Attorney
(Individual). This specific power of attorney form may be executed
by an individual, unincorporated partnership, or sole owner to
authorize the indorsement of any class of check drawn on the United
States Treasury. To be valid, the form must be executed after the
issuance of the check and must describe the check in full,
including the check serial and symbol numbers, date of issue,
amount, and name of the payee.
Fiscal Service Form 233 - Special Power of Attorney
(Individual). This special power of attorney form may be executed
by an individual, unincorporated partnership, or sole owner, to
authorize the indorsement of payments other than those listed under
Fiscal Service Form 231, such as recurring benefit payments. It may
name any person (as the term person is defined in 31 CFR part 240)
as attorney-in-fact, but must describe the purpose for which the
checks are issued and recite that it is not given to carry into
effect an assignment of the right to receive payment, either to the
attorney-in-fact or to any other person. A special power of
attorney is not effective for purposes of negotiating checks issued
after the payee is determined to be incompetent, unless the payee
has indicated that the special power of attorney is to: (1) Remain
effective following a determination that the principal is
incompetent (a durable special power of attorney); or (2) become
effective following a determination that the principal is
incompetent (a springing durable special power of attorney). In no
instance may a special power of attorney be used as the basis for
negotiation of a check drawn on the United States Treasury more
than six months after a determination that the principal is
incompetent.
Fiscal Service Form 234 - Specific Power of Attorney
(Corporation). This general power of attorney form may be executed
by a corporation to authorize the indorsement by an
attorney-in-fact for the classes of payments listed under Fiscal
Service Form 231. When authority is given to an officer of the
corporation to execute a power of attorney authorizing a third
person to indorse and collect checks drawn on the United States
Treasury in the name of the corporation, the power of attorney on
Fiscal Service Form 234 should be accompanied by Fiscal Service
Form 235 (Resolution by Corporation Conferring Authority Upon an
Officer to Execute a Power of Attorney for the Collection of Checks
Drawn on the Treasurer of the United States), executed by the
officer authorized herein to execute such a power.
Fiscal Service Form 236 - Specific Power of Attorney
(Corporation). This specific power of attorney form may be executed
by a corporation to authorize the indorsement by an
attorney-in-fact of any class of check drawn on the United States
Treasury. To be valid, the form must be executed after the issuance
of the check and must describe the check in full, including the
check serial and symbol numbers, date of issue, amount, and name of
the payee. When authority is given to an officer of the corporation
to execute a power of attorney authorizing a third person to
indorse and collect checks drawn on the United States Treasury in
the name of the corporation, the power of attorney on Fiscal
Service Form 236 should be accompanied by Fiscal Service Form 235
(Resolution by Corporation Conferring Authority Upon an Officer to
Execute a Power of Attorney for the Collection of Checks Drawn on
the Treasurer of the United States), executed by the officer
authorized herein to execute such a power.