Montana Statutory Form Power Of Attorney (Page 2 of 4) in pdf

DESIGNATION OF AGENT

I, ____________________________________________ , name the following person as my agent:

Name of Agent:

_____________________________________________________

Agent's Address:

_____________________________________________________

Agent's Phone Number:

_____________________________________________________

DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL)

If my agent is unable or unwilling to act for me, I name as my successor agent:

Name of Successor Agent:

_____________________________________________________

Successor Agent's Address:

_____________________________________________________

Successor Agent's Phone Number:

_____________________________________________________

If my successor agent is unable or unwilling to act for me, I name as my second successor agent:

Name of Second Successor Agent:

___________________________________________________

Second Successor Agent's Address:

___________________________________________________

Second Successor Agent's Phone Number: ___________________________________________________

GRANT OF GENERAL AUTHORITY

I grant my agent and any successor agent general authority to act for me with respect to the following

subjects as defined in the Uniform Power of Attorney Act, Title 72, chapter 31, part 2:

(INITIAL each subject you want to include in the agent's general authority. If you wish to grant general

authority over all of the subjects you may initial "All Preceding Subjects" instead of initialing each

subject.)

__________ Real Property

__________ Tangible Personal Property

__________ Stocks and Bonds

__________ Commodities and Options

__________ Banks and Other Financial Institutions

__________ Operation of an Entity or Business

__________ Insurance and Annuities

__________ Estates, Trusts, and Other Beneficial Interests

__________ Claims and Litigation

__________ Personal and Family Maintenance

__________ Benefits from Governmental Programs or Civil or Military Service

__________ Retirement Plans

__________ Taxes

__________ All Preceding Subjects

LIMITATIONS ON AGENT'S AUTHORITY

An agent that is not my ancestor, spouse, or descendant MAY NOT use my property to benefit the agent

or a person to whom the agent owes an obligation of support unless I have included that authority in the

Special Instructions.

Montana Statutory Form Power Of Attorney Page 2

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