Statutory Short Form Power Of Attorney (Page 3 of 4) in pdf

Statutory Short Form Power Of Attorney Page 3

THIRD: (You may indicate below weather or not this power of attorney authorizes the attorney-

in-fact to transfer your property to the attorney-in-fact. Make a check or “X” on the line in front

of the statement that expresses your intent.

____ This power of attorney authorizes the attorney-in-fact to transfer my property to the

attorney-in-fact.

____ This power of attorney does not authorize the attorney-in-fact to transfer my property to the

attorney-in-fact.

FOURTH: (You may indicate below weather or not the attorney-in-fact is required to make an

accounting. Make a check or “X” on the line in front of the statement that expresses your intent.)

____My attorney-in-fact need not render an accounting unless I request it or the accounting is

otherwise required by Minnesota Statutes section 523.21.

____My attorney-in-fact must render ________________________ accountings to me.

(Monthly, Quarterly, Annual)

Or___________________________________________ during my lifetime, and a final

(Name and Address)

accounting to the personal representative of my estate, if any is appointed, after my death.

In Witness Whereof I have hereunto signed my name this ____ day of ___________, 20____.

__________________________________

(Signature of principal)

(Acknowledgement of Principal)

STATE OF MINNESOTA

County of _________________________

The foregoing instrument was acknowledged before me this____ day of____________, 20____,

By ________________________.

________________________________________

Signature of Notary Public or other Official

___________________________________________

Specimen Signature of Attorney (s)-in-fact

Statutory Short Form Power Of Attorney Page 3