Form 5 - Statement of Grantor under Subsection 50 (1)

Subsection 50(2) of the Substitute Decisions Act, 1992 lists certain special provisions that may be included in a power of attorney for personal care, but only if the person granting the power of attorney completes this form within 30 days of granting the power of attorney.

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Form Number 004-0244
Title Form 5 - Statement of Grantor under Subsection 50 (1)
Description Subsection 50(2) of the Substitute Decisions Act, 1992 lists certain special provisions that may be included in a power of attorney for personal care, but only if the person granting the power of attorney completes this form within 30 days of granting the power of attorney.