Authorize someone to make decisions on your behalf. A sample form for is available to help you make decisions to record your wishes for healthcare if you are not able to do so yourself.Allegheny County Bar Association and the Allegheny County Medical Society. A Pennsylvania limited power of attorney form allows a person to select someone else to carry out one or more specific business-related tasks for them. A special power of attorney letter grants another person the authority to act on your behalf, so it's essential to ensure that it's properly drafted. Pennsylvania Law requires agents to sign and affix an "Acknowledgment" to the power of attorney before acting. How Do I Obtain an Apostille or Certification? Creating a Power of Attorney (POA) involves meeting the specific legal requirements of a Pennsylvania online notary. Some private companies offer forms or templates with blanks that you can fill out to create your POA. The customer will need to provide a copy of the letter to the authorized agent.