Montana Durable Power of Attorney
This Durable Power of Attorney document is designed to comply with the requirements of the Montana Uniform Power of Attorney Act and is intended to grant powers to a designated agent to act on behalf of the principal in specified or all legal or financial matters, especially when the principal is unable to manage their own affairs due to health reasons or other incapacities. This document becomes effective immediately upon execution unless otherwise stated herein and remains in effect despite the principal's subsequent disability or incapacity.
Please fill in the following information accurately:
Principal's Full Name: __________________________________________
Principal's Physical Address: ____________________________________
City: _______________________, State: Montana, Zip Code: ___________
Principal's Date of Birth: ________________________________________
Agent's Full Name: _____________________________________________
Agent's Physical Address: ________________________________________
City: _______________________, State: __________________, Zip Code: ___________
Relationship to Principal: ________________________________________
Powers Granted: Mark clearly the powers you are granting to your Agent with a checkmark (✔) beside the respective power. In the space below, specify any limitations or special instructions regarding these powers.
- Real property transactions
- Tangible personal property transactions
- Stock and bond transactions
- Commodity and option transactions
- Banking and other financial institution transactions
- Business operating transactions
- Insurance and annuity transactions
- Estate, trust, and other beneficiary transactions
- Claims and litigation
- Personal and family maintenance
- Benefits from social security, Medicare, Medicaid, or other governmental programs, or military service
- Retirement plan transactions
- Tax matters
Special Instructions: ____________________________________________
________________________________________________________________
Effective Date and Duration: Unless a different effective date is specified here, this Power of Attorney is effective immediately upon signing and continues to be effective even if the principal becomes disabled, incapacitated, or incompetent.
Effective Date: __________________________________________________
Third Party Reliance: It is expressly understood that third parties may rely upon the representations of the Agent as if the Principal had personally conducted such affairs. This document is intended to be relied upon by any person, organization, corporation, or government agency.
Revocation: This Durable Power of Attorney may only be revoked by the Principal through a written document specifically indicating the desire to revoke, signed and dated by the Principal, and provided to any entity or individual that has, or would have had, reliance on this document.
Signature of Principal: ___________________________ Date: ______________
Signature of Agent: _____________________________ Date: ______________
This document was prepared in accordance with the laws of the State of Montana and should be signed in the presence of a notary public or other individuals as required by state law.
State of Montana
County of __________________________
On this ______ day of ________________, 20____, before me, ______________________________, a notary public, personally appeared ______________________________, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained.
In witness whereof I hereunto set my hand and official seal.
______________________________________
Notary Public
My commission expires: __________________