North Dakota Power of Attorney
Date: ____/____/______
[Legal Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
Appoint,
[Legal Name]
A resident of
[City][State]
Located at
[Address]
[City], [State] [Zip Code]
As my attorney-in-fact.
My attorney-in-fact may act on my behalf for the following purpose(s):
[____] Real Estate Transactions
[____] Stock and Bond Transactions
[____] Commodity and Option Transactions
[____] Tangible Personal Property 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 Government Programs
[____] Retirement Plan Transactions
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