授 權 書

Power of Attorney

填表說明請詳下頁

(Filling out Instructions on next pages)

授權人 (Principal)	中文姓名 (Name in Chinese)	性別 (Sex)	英文姓名 (Name in English)	國內住址(Address in Taiwan, R.O.C.)

出生年月日 (DOB)	出生地 (Place of Birth)	護照號碼 (Passport No.)	國民身分證號碼 (ID No.)	國外住址 (Address in the US)

被授權人(Agent)	姓名(Name)	性別 (Sex)	出生年月日 (Date of Birth)	護照或身分證號碼 (Passport/ID No.)	國內住址 (Address)

授權人與被授權人之關係 (Relationship to the Principal)
房地標示及 權利範圍 (Land Location and Extent of Ownership)
辦理不動產變更登記之轄區地政事務所 (Competent Land Office)
授權事項 (Scope of Authorization)
授權期間 (Duration of Authorization)	自 中 華 民 國 年 月 日 至 中 華 民 國 年 月 日止 Starting from (DD) (MM) (YYYY) till (DD) (MM) (YYYY)

授權人親簽 (Principal’s Signature)：

備註：

授權（委託）辦理戶籍登記前，當事人應先向戶政事務所洽詢是否得授權(委託)他人申請。

請領國民身分證之當事人如在國外，應俟回國後再行辦理，不得授權（委託）辦理。

授權（委託）辦理印鑑登記、印鑑變更、印鑑廢止、印鑑證明，應附繳委任人之國民身分證影本或有效之中華民國護照或其他身分證明文件影本。

辦理業務如印鑑證明為必備文件者，務必填寫授權辦理印鑑證明及申請數量；申請印鑑證明時得載明申請目的或不限定用途，如無明確申請目的得填寫「不限定用途」。

授權書格式一(親辦)之填寫說明

一、授權人欄：請將授權人之姓名、性別、出生年月日、出生地、護照或身分證號碼、住址，逐欄詳實填寫。

二、被授權人欄：依被授權人之姓名、性別、出生年月日、出生地、 身分證字號、 戶籍住址逐欄詳實填寫。

三、房地標示及權利範圍：依授權處分房地標示範圍填寫。

例如：土地標示：台北市 區 段 小段 地號土地（全部或持分 分之 ）

房屋標示：台北市 區 路 段 巷 弄 號 樓建物（全部或權利範圍 分之 ）

四、授權事項欄：

（一）依實際授權事項填寫，非授權事項勿須填寫。

例如：代理本人就前開（土地、建物）全權行使（辦理出售、移轉、贈與、出典、 抵押、 出租、分割、補（換）發權利書狀、征收稅款等手續及其他有關權利變更管理、收益、處分等行為）。

例如：代理本人領取戶籍謄本或辦理有關戶籍登記事項等。

（二）授權事項為授權國內親友代為辦理有關不動產處分事宜者，務須於房地標示及權利範圍欄內逐一列明所處分之房地標示。如授權事項為授權國內親友代為辦理有關遺產繼承登記事宜者，應詳載房地標示，倘確無法詳填，至少應填寫不動產所在地之縣（市）名稱。

（三）授權事項僅為代領印鑑證明者，宜以「戶政事務所辦理印鑑登記作業規定」規定之「委任書」（請參考內政部戶政司全球資訊網/法規與申辦須知/申請書表單下載/委託書、同意書、約定書/委任書（印鑑類）填寫之，倘使用本授權書則須比照上揭「委任書」內容，在「授權事項」欄敘明：「代理本人申請印鑑登記（變更或廢止登記）」；授權請領印鑑證明者，應敘明「代理領取印鑑證明00份」，必要時得註明「如被授權人所持印鑑與原登記之印鑑不符時，得一併代理變更印鑑登記」，以利國內戶政事務所作業並保障授權人權益。

例如：代理本人申請印鑑登記並領取印鑑證明00份。

五、授權期間欄：由授權人自行填寫，俾便確定授權之起算及終止日期。

六、授權書內容不得塗改，如填寫錯誤，應全份重新填寫或由授權人於更正處簽章以示負責，再由駐外館處加蓋校正章。

七、授權書內如有空欄應加蓋「本欄空白」戳記，房地標示及權利範圍欄及授權事項欄內如有空白處，應在連接最後一行文字末尾處（或左方），加蓋「以下空白」戳記。

Instructions

Principal:	Provide the Principal’s name, sex, date of birth, place of birth, passport/ID numbers and address.

Agent:	Provide the Agent’s name, sex, date of birth, place of birth, ID numbers and registered address.

Land Location and Extent of Ownership:	(denoting the subject lands/buildings)

For example:

Land: Land No. , Parcel , Section ,

District, Taipei ( % ownership)

Building: Floor, No. , Alley, Street/Road,	Section , Taipei ( % ownership)

Scope of Authorization:

Describe the scope of authorization. For example, the Agent is authorized to handle the sale, transfer, gifting, mortgaging, leasing, or dividing of the subject lands/buildings, re-issuance of land/building deeds, tax payments, and other matters related to the management, proceeds, and disposals of the subject lands/buildings.

For example: the Agent is authorized to receive and/or apply for the certificate of household registration.

If the Scope of Authorization is related to authorizing relatives/friends in the ROC to dispose of lands/buildings on behalf of the Principal, the applicant shall provide detailed information on the “Land Location and Extent of Ownership” and the “Competent Land Office.” If the Scope of Authorization is related to authorizing relatives/friends in the ROC as Agents to apply for registration of inheritance on behalf of the Principal, the applicant shall provide detailed information of the Land Location, or the name of the county (city) in which the subject land(s)/building(s) is/are located in case the detailed information is not being available.

For matters related to the receiving of the seal certificate on behalf of the Principal, the applicant shall use the Letter of Appointment as described in the Regulations of Seal Registration. If the applicant wishes to use this Power of Attorney instead, he/she shall include all information as required in the Letter of Appointment. If the Principal has not applied for a seal certificate before, a supplementary phrase such as “to apply for seal registration on behalf of the Principal” shall be included in the Power of Attorney. If the Principal wishes to ask the Agent to apply for a change of registered seal on his/her behalf, the phrase shall be changed accordingly. The applicant shall also specify the number of copies to be issued.

For example: authorizing the Agent to apply for and receive copies of the seal certificate.

Duration of Authorization: The Principal shall specify the duration of authorization in order to decide when this document starts and ceases to take effect.

The contents of the Power of Attorney shall not be altered. In case of mistakes occurring while completing this document, the applicant shall either fill out a new application form or sign or attach his/her seal on the mistake(s) and have the Overseas Mission attach a correction mark on the mistake(s) as proof of the truthfulness of the document.

A “Blank” mark shall be stamped in the boxes of the Power of Attorney in case of unavailability of information. If the information provided in the boxes marked “Land Location,” “Extent of Ownership” and “Scope of Authorization” is not sufficient for the spaces to be filled, the applicant shall stamp “Blank” behind the last word written.