North Dakota General Durable Power of Attorney for Property & Finances (Upon Disability)

North Dakota General Durable Power of Attorney
for Property & Finances (Upon Disability)

PACKET GUIDE — REMOVE THIS GUIDE BEFORE SIGNING OR RECORDING. THIS GUIDE IS NOT PART OF THE LEGAL INSTRUMENT. THE INSTRUMENT BEGINS ON THE PAGE TITLED "NORTH DAKOTA DURABLE POWER OF ATTORNEY."

North Dakota General Durable Power of Attorney for Property & Finances — Packet Guide

This packet contains a North Dakota general durable power of attorney that becomes effective only upon a written certification that you are under a disability (springing), an Important Information for the Agent page, an Agent's Affidavit of Non-Revocation your agent may use when dealing with banks and others (with a spare copy), an Agent's Certification for digital-asset requests, a Determination of Disability certification slip with a standalone HIPAA authorization, an optional Revocation of Power of Attorney page, and an optional recording cover page.

See the full product page and completed sample

What this document is

This is a durable power of attorney for property and finances drafted for North Dakota under the Uniform Durable Power of Attorney Act, N.D.C.C. chapter 30.1-30, together with North Dakota's agency statutes (Title 3), the notarial-acts chapter (44-06.1), the Uniform Fiduciary Access to Digital Assets Act (ch. 47-36), and the recording statutes (ch. 47-19). North Dakota does not publish an official statutory form — this is a PublicLegal-drafted instrument built directly on those statutes. "Durable" means your agent's authority continues even if you later become disabled or incapacitated (N.D.C.C. 30.1-30-01). It covers property and finances only — it does not authorize health-care decisions (North Dakota health-care directives are a separate instrument under ch. 23-06.5).

Which version you purchased

Upon Disability (springing). This power of attorney becomes effective only upon a written certification that you are under a disability. Chapter 30.1-30 recognizes the springing formula ("becomes effective upon the disability or incapacity of the principal") but prescribes no determination mechanism, so this instrument defines one itself: a written certification, signed by one licensed physician who has examined you (or, if you complete the optional block, by the certifier you designate), stating to a reasonable degree of medical certainty that you are unable to manage your property and business affairs. The Determination of Disability slip at the end of this packet is that certification form, and a standalone HIPAA authorization lets the physician disclose what the certification needs. Practical note: North Dakota has no statute requiring banks to accept a power of attorney, and springing powers are the ones banks most often hold until they see the physician's certification — keep the completed slip with the instrument.

How to sign (the execution ceremony)

Sign and date the instrument in ink, and initial each election line you grant in ink. North Dakota's Century Code requires NO witnesses and does not make notarization a condition of a valid financial power of attorney. Even so, this instrument includes an acknowledgment certificate (N.D.C.C. 44-06.1-19(1)) and you should sign before a notary public (or a clerk of court, which is also a notarial officer — 44-06.1-09): acknowledgment is the safe practice, and it is REQUIRED if you will record this power for a real-estate transaction (47-19-03(1)). Do not substitute the jurat ("signed and sworn") wording used on the courts' free self-help form — a power of attorney is not an affidavit, and a jurat alone will not satisfy recording practice for a deed or mortgage. Sign ONE original and keep it safe. You must have capacity when you sign. North Dakota permits remote online notarization (44-06.1-13.1); if you use it, the certificate must state that the act used communication technology. If you sign outside North Dakota, an acknowledgment taken by a notarial officer of that state (or a U.S. consular officer) has the same effect in North Dakota (44-06.1-10). If you are physically unable to sign, another person (not the notarial officer) may sign at your direction (44-06.1-08).

What your agent can do — and what requires your initials

The GRANT OF GENERAL AUTHORITY and the ENUMERATED POWERS give your agent the broad powers North Dakota law allows over your property and finances. The enumerated list illustrates the general grant — it does not cut it down (a savings clause in the instrument says so expressly, because N.D.C.C. 3-02-04 would otherwise read a partly-specific grant as the ceiling of the general one).

GIFTS — read this carefully. Under N.D.C.C. 30.1-30-06, a broad grant of authority by itself gives an agent UNLIMITED power to make gifts of your property — in any amount, to any individual, including the agent. This instrument turns that default OFF: its base text says your agent has NO authority to make gifts except as you expressly initial in Section 5. In Section 5 you may initial ONE of two gift elections — (A) limited gifts (up to the federal gift-tax annual exclusion per recipient per year, plus direct tuition and medical payments), or (B) unlimited gifts — and, separately, a third "hot" line (C) that permits gifts to the agent personally. If you initial NEITHER A nor B, your agent may make no gifts at all. The agent self-gift bar is built into the instrument; only line C lifts it.

CONTENT OF ELECTRONIC COMMUNICATIONS. Under North Dakota's Uniform Fiduciary Access to Digital Assets Act (ch. 47-36), your agent can reach a catalogue of your electronic communications and your other digital assets with general authority (47-36-09), but the CONTENT of your electronic communications requires an express grant (47-36-08) — initial that line in Section 5 only if you want it. A direction you give through a provider's own online tool overrides this document (47-36-03).

COMPENSATION. If you initial the compensation line, your agent is entitled to reasonable compensation; if you do not, the default is no compensation. Reasonable out-of-pocket expense reimbursement applies either way.

Naming your agent — and successors

Name one attorney-in-fact, plus optional successors. Successors serve ONE AT A TIME, in the order named, each acting only if the incumbent dies, resigns, becomes unable or unwilling to act, or has the appointment revoked. Chapter 30.1-30 supplies no default for agents serving at the same time — if you name co-agents in the Special Instructions, state expressly whether they may act severally or must act jointly. Your agent may not delegate powers to others unless the instrument specifically provides (Title 3 agency law) — use the Special Instructions if you want to permit delegation.

If a court later appoints a guardian or conservator

If a court appoints a conservator, a guardian of your estate, or a guardian of your person, this power of attorney does not end by itself: your agent becomes accountable to the court-appointed fiduciary, who may revoke or amend the power as you could (N.D.C.C. 30.1-30-03(1)). The NOMINATION clause lets you nominate whom you want the court to appoint — the court SHALL follow your most recent nomination except for good cause or disqualification (30.1-30-03(2)). Date the instrument: the court keys to your most recent nomination. Guardianship proceedings are in the district court (ch. 30.1-28 / 30.1-29).

If the agent will deal with real estate: recording and homestead

This power of attorney is valid without recording (47-19-01 is permissive), but if your agent will execute a deed or a mortgage, record the power — before or with the instrument — with the county recorder of the county where the land lies. A power of attorney used to execute a mortgage must be in writing, subscribed, acknowledged or proved, certified, AND recorded (35-03-03). Recording generally requires your ORIGINAL signature (47-19-03). The optional recording cover page collects the recorder information; attach it only if you record. The Agent's Affidavit of Non-Revocation is recordable together with recordable instruments (30.1-30-05).

Homestead — important limitation on the agent's deed. If you are married, North Dakota does not allow the homestead to be conveyed or encumbered unless the deed or mortgage is executed AND acknowledged by BOTH spouses (N.D.C.C. 47-18-05); this power of attorney can supply YOUR signature but cannot supply your spouse's. A non-purchase-money mortgage on a homestead also requires a conspicuous waiver with a separate signature (47-18-05.1). (47-18-22 provides a court path when a spouse is mentally ill.)

Banks and others may rely on this document

Any third party may rely on this power of attorney until it receives actual notice of revocation, termination, or your death; acts your agent takes in good faith WITHOUT actual knowledge of your death bind you and your successors (N.D.C.C. 30.1-30-04). A third party may require your agent to sign the included Affidavit of Non-Revocation, which is CONCLUSIVE PROOF that the power has not been revoked or terminated (30.1-30-05). North Dakota has NO statute compelling a bank or other third party to accept a power of attorney — the affidavit is the reliance tool, and no one can promise you automatic acceptance.

Revoking or changing this document

You may revoke this power of attorney at any time while you have capacity. Give WRITTEN notice of the revocation to your agent and to everyone who has a copy; if you can, collect and destroy the original and all copies. An optional Revocation of Power of Attorney page is included for this. If you recorded this power, the revocation must itself be acknowledged (or proved), certified, and recorded in the SAME office (N.D.C.C. 47-19-44). Signing a new power of attorney does not by itself revoke this one — this instrument's revocation sentence keeps earlier general powers from surviving alongside it.

When this power ends — and what it does not replace

This power of attorney terminates on your death; from then on only the personal representative of your estate may act (acts an agent completes in good faith without actual knowledge of your death remain valid — N.D.C.C. 30.1-30-04). This document does not replace the specialized forms some agencies require: the IRS honors only its own Form 2848 (or 8821) for representation before it; the Social Security Administration does not honor state powers of attorney — a representative payee is appointed through the SSA; and the North Dakota Department of Transportation often wants its own power-of-attorney form for vehicle title work. Health-care decisions require a health-care directive under ch. 23-06.5, not this document. North Dakota also authorizes electronic nontestamentary estate-planning documents, including a durable power of attorney (ch. 59-22); this packet is designed for wet-ink originals because recording wants an original signature (47-19-03), with the notary-certified tangible-copy path (44-06.1-18(3)) as the electronic fallback. The state courts publish a basic free self-help form; this packet provides successors, gift elections, a digital-assets grant, the conclusive affidavit, and recording mechanics that form does not include.

Sources: Uniform Durable Power of Attorney Act, N.D.C.C. ch. 30.1-30 (durability, springing, conservator relation, actual-knowledge protection, conclusive affidavit, gift default); N.D.C.C. Title 3 (agency — 3-02-04 savings clause, 3-02-05 self-dealing bar); N.D.C.C. ch. 44-06.1 (acknowledgment and jurat short forms, remote notarization, out-of-state acts); Uniform Fiduciary Access to Digital Assets Act, N.D.C.C. ch. 47-36 (content vs. catalogue, perjury certification, 60-day custodian rule); N.D.C.C. ch. 47-19 (recording) and 35-03-03 (mortgage POA); N.D.C.C. 47-18-05 / 47-18-05.1 (homestead joinder); N.D.C.C. ch. 59-22 (electronic documents); N.D.C.C. ch. 23-06.5 (health care, not included). Official text: North Dakota Legislative Branch, ndlegis.gov.

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NORTH DAKOTA DURABLE POWER OF ATTORNEY

(General Durable Power of Attorney for Property & Finances — Effective Upon Disability)

NOTICE TO THE PRINCIPAL

The powers you grant in this document are broad and sweeping. They are governed by the Uniform Durable Power of Attorney Act, N.D.C.C. chapter 30.1-30, and related North Dakota law. This document does NOT authorize anyone to make medical or other health-care decisions for you — North Dakota health-care directives use a separate instrument (N.D.C.C. ch. 23-06.5). You may revoke this power of attorney at any time while you have capacity. Your agent is a fiduciary who must act solely for your benefit. If you have any questions about these powers, obtain competent legal advice before you sign.

1. DESIGNATION OF ATTORNEY-IN-FACT

I, the Principal named below, appoint the following person as my Attorney-in-Fact (agent) to act for me as provided in this power of attorney:

_____________________________________________________

Name of Attorney-in-Fact

_____________________________________________________

Address of Attorney-in-Fact (street, city, state, ZIP)

Telephone of Attorney-in-Fact: _________________________

Optional successors. I appoint the following person(s) as successor Attorney(s)-in-Fact. Successors serve ONE AT A TIME, in the order named: a successor acts only if the incumbent Attorney-in-Fact dies, resigns, becomes unable or unwilling to act, or has the appointment revoked:

_____________________________________________________

Name of first successor Attorney-in-Fact (optional)

_____________________________________________________

Address of first successor (street, city, state, ZIP)

_____________________________________________________

Name of second successor Attorney-in-Fact (optional)

_____________________________________________________

Address of second successor (street, city, state, ZIP)

Co-agents. North Dakota law supplies no default rule for agents serving at the same time. If I name more than one person to serve at the same time in the Special Instructions, I will state there expressly whether they may act severally or must act jointly.

2. DURABILITY

THIS POWER OF ATTORNEY BECOMES EFFECTIVE UPON THE DISABILITY OR INCAPACITY OF THE PRINCIPAL

The statement above is the durability language prescribed by N.D.C.C. 30.1-30-01. Separately, this power of attorney does not terminate by lapse of time (N.D.C.C. 30.1-30-02) unless I state a time of termination in the Special Instructions.

3. EFFECTIVE DATE

This power of attorney becomes effective ONLY upon a written certification that I am under a disability, as provided below. Until that certification, my Attorney-in-Fact has no authority under this power of attorney.

Definition and manner of certification (prescribed by this instrument, chapter 30.1-30 supplying none): I am "under a disability" when I am unable to manage my property and business affairs. That fact shall be established by a written certification, signed and dated, in which the signer certifies that he or she has examined me and determined, to a reasonable degree of medical certainty, that I am unable to manage my property and business affairs. The certification shall be made by:

(a) the certifier I have designated below, if I have designated one and that person is able and willing to act — the designated certifier's written certification controls; or

(b) otherwise, any physician licensed to practice medicine who has examined me.

Optional certifier designation:

_____________________________________________________

Name of person designated to make the certification (optional)

Address and telephone of designated certifier: ______________________________________

I authorize any certifier named or identified above, and any physician making the certification, to act as my personal representative under HIPAA solely to the extent necessary or convenient to obtain the health information needed to make the certification described above.

My Attorney-in-Fact shall obtain the dated, signed written certification before exercising any authority under this power of attorney, and a copy of the certification shall be retained with this power of attorney. The Determination of Disability slip included with this power of attorney may be used for that certification. Once effective, the Agent's Affidavit of Non-Revocation may recite the certification to confirm that the power is in effect (N.D.C.C. 30.1-30-05).

Once effective, this power of attorney remains effective in accordance with the durability statement above, even during later intervals when I am able to manage my property and business affairs, unless I provide otherwise in the Special Instructions.

4. GRANT OF GENERAL AUTHORITY

I grant my Attorney-in-Fact GENERAL POWERS to act in a fiduciary capacity on my behalf with respect to ALL LAWFUL SUBJECTS AND PURPOSES concerning my property and finances, except as limited or conditioned in this power of attorney. This grant includes every act I could perform through an agent if personally present and capable of acting. The enumeration of specific powers in Section 5 ILLUSTRATES and does NOT limit this general grant (this sentence is the savings clause N.D.C.C. 3-02-04 requires so that a grant partly in general and partly in specific terms is not read down to the specific terms). This grant does NOT authorize my Attorney-in-Fact to make, alter, or revoke a will for me, to make health-care decisions for me, or to act after my death (this power of attorney terminates on my death).

GIFTS. Notwithstanding this Section 4 and N.D.C.C. 30.1-30-06, my Attorney-in-Fact has NO authority to make gifts of my property except as I expressly initial in Section 5. This express limitation controls over the statutory default, which would otherwise let a broad grant confer unlimited gift authority (N.D.C.C. 30.1-30-06 — "by express words in the power of attorney ... [the principal] may authorize, or limit the authority of, any attorney in fact ... to make gifts").

5. ENUMERATED POWERS

Without limiting the general grant (Section 4), my Attorney-in-Fact may:

A. Real property — buy, sell, exchange, lease, mortgage, encumber, manage, improve, insure, and convey any interest in real property; execute and deliver deeds (with the usual covenants of warranty — N.D.C.C. 3-02-10), mortgages, leases, easements, closing documents, and affidavits of title; and record any instrument. HOMESTEAD: if I am married, a conveyance or encumbrance of my homestead must be executed AND acknowledged by BOTH spouses (N.D.C.C. 47-18-05), and a non-purchase-money mortgage on a homestead requires the conspicuous waiver and separate signature of N.D.C.C. 47-18-05.1 — my Attorney-in-Fact can sign for me but cannot supply my spouse's joinder.

B. Tangible personal property — buy, sell, lease, store, ship, insure, and otherwise deal with tangible personal property, including vehicles and watercraft, and execute titles and registrations.

C. Banking — open, maintain, and close accounts; deposit and withdraw funds; draw, sign, and deliver checks and drafts; access safe-deposit boxes; borrow and secure loans; use electronic transfers and cards; and otherwise conduct banking and financial-institution transactions.

D. Business operations — operate, manage, reorganize, or terminate any business interest; exercise rights under entity documents; vote ownership interests; and deal with partnerships, limited liability companies, and corporations.

E. Insurance and annuities — purchase, maintain, surrender, borrow against, and deal with insurance policies and annuity contracts (but not change a beneficiary designation except as initialed in Section 5's express elections, if so provided).

F. Estates, trusts, and inheritances — receive, disclaim (if initialed in Section 5's express elections), transfer, and otherwise deal with any interest in an estate, trust, escrow, or inheritance, and represent me in probate and other proceedings.

G. Claims and litigation — institute, prosecute, defend, settle, arbitrate, and compromise claims; collect debts; and execute releases.

H. Personal and family maintenance — pay for the support, maintenance, education, and accustomed standard of living of me and those I am legally obligated to support.

I. Government benefits — apply for, receive, and manage Social Security, Medicare, Medicaid, veterans', and other government benefits, and appeal adverse determinations. (Some agencies insist on their own forms — see the guide.)

J. Retirement plans — deal with pension, profit-sharing, IRA, and other retirement plans and accounts, including elections, rollovers, and distributions (but not change a beneficiary designation except as initialed in Section 5's express elections, if so provided).

K. Taxes — prepare, sign, and file federal, state, and local tax returns and information filings; represent me before the IRS and the North Dakota Office of State Tax Commissioner; pay taxes; and receive refunds. (The IRS generally requires its own Form 2848 or 8821 for representation — see the guide.)

L. Digital assets — access, manage, control, archive, and delete my digital assets (electronic records, accounts, files, and stored data) and obtain a catalogue of my electronic communications, as an agent with general authority may under N.D.C.C. 47-36-09 (access to the CONTENT of electronic communications requires the express election in Section 5's express elections, N.D.C.C. 47-36-08).

M. All other lawful acts — to do any other lawful act concerning my property and finances that I could do through an agent if personally present and capable of acting, and to employ and compensate attorneys, accountants, brokers, and other assistants. This catch-all does NOT authorize gifts of my property (see Section 4's express limitation and Section 5's express elections) or any other power granted only by an initialed election.

6. EXPRESS ELECTIONS — INITIAL EACH POWER YOU GRANT

INITIAL each power you grant. A line you do not initial is NOT granted. The two gift elections (A and B) are alternatives — initial at most ONE of them. The agent-as-donee line (C) is separate and applies only if you also initialed A or B.

(___) (A) LIMITED GIFTS — my Attorney-in-Fact may make gifts of my property, in trust or otherwise, only up to the federal gift-tax annual exclusion then in effect under Internal Revenue Code § 2503(b), per recipient per calendar year, plus amounts paid directly for tuition or medical care under IRC § 2503(e) — and never to my Attorney-in-Fact personally unless line (C) is also initialed.

(___) (B) UNLIMITED GIFTS — my Attorney-in-Fact may make gifts of my property in any amount to any individual or to an organization described in IRC §§ 170(c) and 2522(a), as N.D.C.C. 30.1-30-06 would otherwise provide by default — and never to my Attorney-in-Fact personally unless line (C) is also initialed.

_____ (C) AGENT AS DONEE (separate, optional) — if (and ONLY if) I also initialed (A) or (B) above, and I initial THIS line, my Attorney-in-Fact may make gifts to himself or herself [and to persons the Attorney-in-Fact is legally obligated to support], always subject to the fiduciary duty to act solely for my benefit. Leave blank to forbid gifts to my Attorney-in-Fact.

(___) CONTENT of electronic communications — I EXPRESSLY GRANT my Attorney-in-Fact authority over the content of my electronic communications, as N.D.C.C. 47-36-08 requires for content. (A direction I give through a provider's online tool overrides this document — N.D.C.C. 47-36-03.)

(___) Beneficiary designations and survivorship — to create or change beneficiary designations and survivorship interests in my property. (This modifies my estate plan; initial only if intended. North Dakota treats these as will-substitutes — extra caution, not a statutory express-grant item.)

(___) Disclaimers — to disclaim or renounce, in whole or in part, any gift, devise, inheritance, or other interest in property to which I may become entitled.

(___) REASONABLE COMPENSATION — my Attorney-in-Fact shall be entitled to reasonable compensation for services performed as my agent, in addition to reimbursement of reasonable out-of-pocket expenses. (Without this initial, the default is NO compensation; reasonable expense reimbursement applies either way.) [OPTIONAL ELECTION — leave blank to keep the North Dakota-law default]

Withholding. Unless I have initialed the matching line above (or stated otherwise in the Special Instructions), my Attorney-in-Fact shall NOT: make gifts of my property (Section 4's express limitation); make gifts to himself or herself; change beneficiary designations or survivorship interests; disclaim or renounce property; access the content of my electronic communications (N.D.C.C. 47-36-08); or create, amend, or revoke a trust.

7. SPECIAL INSTRUCTIONS

(Optional — for example: limits on particular powers; a direction that co-agents may act severally or must act jointly (see Section 1); permission for my agent to delegate (Title 3 agency law); a statement that an earlier power of attorney remains in effect despite Section 9; or, if I want this power to expire, a stated time of termination — N.D.C.C. 30.1-30-01. Attach additional signed pages if needed.)

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

8. NOMINATION OF CONSERVATOR OR GUARDIAN (OPTIONAL)

If protective proceedings for my person or estate are commenced, I nominate the following person for the court's appointment as my conservator, guardian of my estate, or guardian of my person (N.D.C.C. 30.1-30-03(2)) — the court shall appoint in accordance with my most recent nomination except for good cause or disqualification. I have dated this instrument so the court can identify my most recent nomination:

_____________________________________________________

Name of nominee (optional)

_____________________________________________________

Address and telephone of nominee

9. REVOCATION, GOVERNING LAW, AND RELIANCE

I revoke every earlier general power of attorney for property or financial matters that I have signed (never any health-care directive). Signing a later power of attorney would not revoke this one unless it expressly said so; this sentence keeps earlier general powers from surviving alongside this document. If you want an earlier power to remain in effect, say so in the Special Instructions.

I may revoke this power of attorney at any time while I have capacity, by written notice delivered to my Attorney-in-Fact; if I have recorded this power, the revocation must itself be acknowledged (or proved), certified, and recorded in the same office (N.D.C.C. 47-19-44). This power of attorney is executed under and governed by the Uniform Durable Power of Attorney Act, N.D.C.C. chapter 30.1-30, and related North Dakota law.

Any third party may rely on this power of attorney until it receives actual notice of its revocation or termination or of my death; an act my Attorney-in-Fact takes in good faith WITHOUT actual knowledge of my death binds me and my successors (N.D.C.C. 30.1-30-04). A third party may require my Attorney-in-Fact to execute an affidavit of non-revocation, which is conclusive proof that this power has not been revoked or terminated (N.D.C.C. 30.1-30-05) and is recordable with recordable instruments.

My Attorney-in-Fact is a fiduciary who must act within the powers granted and solely for my benefit and must maintain accurate books and records (North Dakota common-law agency; N.D.C.C. Title 3; N.D.C.C. 47-36-14 for digital assets). If a court appoints a conservator or guardian for me, my Attorney-in-Fact becomes accountable to that fiduciary as well (N.D.C.C. 30.1-30-03(1)). This power of attorney terminates on my death.

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10. EXECUTION AND ACKNOWLEDGMENT

I sign my name to this Durable Power of Attorney on the date below. North Dakota does not require notarization for a valid financial power of attorney, but I acknowledge it before a notarial officer as the safe practice and because acknowledgment is required to record this power for a real-estate transaction (N.D.C.C. 47-19-03(1)).

_____________________________________________________

Signature of Principal

_____________________________________________________

Printed name of Principal

_____________________________________________________

Date signed (month, day, year)

_____________________________________________________

Address of Principal (street, city, state, ZIP)

CERTIFICATE OF ACKNOWLEDGMENT

(Notarial officer — North Dakota individual acknowledgment short form, N.D.C.C. 44-06.1-19(1))

State of _______________________

[County] of _______________________

This record was acknowledged before me on _______________________ (Date) by

_______________________________________________________

(Name(s) of individual(s))

_____________________________________________________

Signature of notarial officer

(Stamp)

_____________________________________________________

Title of office (e.g., Notary Public)

[My commission expires: ________________________

]

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IMPORTANT INFORMATION FOR THE AGENT

A summary for the Attorney-in-Fact — keep with the power of attorney. (N.D.C.C. ch. 30.1-30; Title 3 agency law; ch. 47-36 for digital assets.)

If you act under this power of attorney, North Dakota law makes you a fiduciary. In summary:

• You must act within the powers the power of attorney delegates and SOLELY for the benefit of the Principal. North Dakota courts recognize an agent's fiduciary status at common law (the confidential-relationship and undue-influence principles of Matter of Estate of Mehus, 278 N.W.2d 625 (N.D. 1979), and Estates of Vizenor, 2014 ND 143), and N.D.C.C. 3-02-05 bars an agent acting under a merely general grant from doing what a trustee is forbidden to do.

• You must maintain accurate books and records of ALL financial transactions, and you may be required to account to the Principal, to a court-appointed conservator or guardian, or to the personal representative of the Principal's estate.

• You may NOT make gifts of the Principal's property — to yourself or to anyone else — unless the Principal initialed a gift election in Section 6. North Dakota's default (N.D.C.C. 30.1-30-06) would otherwise let a broad grant confer unlimited gift authority, but this instrument turns that default OFF; only an initialed election restores gift power, and only the separate "agent as donee" line permits gifts to you personally. Check the Principal's initials before making any gift.

• You may NOT delegate your powers to others unless the power of attorney specifically provides for delegation (Title 3 agency law).

• You have no greater authority than the Principal granted, and you may never make, alter, or revoke a will for the Principal or act after the Principal's death (the power terminates at death).

• If a court appoints a conservator or guardian of the Principal's estate, you become accountable to that fiduciary, who may revoke or amend the power as the Principal could (N.D.C.C. 30.1-30-03(1)).

• Third parties may rely on the power of attorney until they receive actual notice of revocation, termination, or the Principal's death (N.D.C.C. 30.1-30-04); they may ask you to sign the Affidavit of Non-Revocation included with this packet, which is conclusive proof that the power remains in effect (N.D.C.C. 30.1-30-05). North Dakota has NO statute compelling a bank or other third party to accept a power of attorney — present the affidavit and be prepared to show the original signed instrument.

• If the Principal granted you authority over digital assets: handle them under the duties of care, loyalty, and confidentiality (N.D.C.C. 47-36-14); you may not use them to impersonate the Principal; access to the CONTENT of electronic communications exists only if expressly granted in Section 6 (N.D.C.C. 47-36-08), and a direction the Principal set in a provider's online tool overrides the document (47-36-03).

• You are entitled to compensation only if the Principal initialed the compensation election in Section 6; otherwise the default is no compensation, but reasonable out-of-pocket expenses are reimbursable either way.

OPTIONAL — AGENT'S ACKNOWLEDGMENT AND ACCEPTANCE

North Dakota law does not require the agent to sign an acknowledgment, but signing below confirms that you have read this page and accept the duties it summarizes.

_____________________________________________________

Signature of Attorney-in-Fact (optional)

_____________________________________________________

Printed name

Date: ______________________________

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AGENT'S AFFIDAVIT OF NON-REVOCATION

For use when a third party requests confirmation — under N.D.C.C. 30.1-30-05 this affidavit is CONCLUSIVE PROOF that the power of attorney has not been revoked or terminated; when authenticated for record it is recordable with recordable instruments. (N.D.C.C. 30.1-30-04 separately protects acts taken in good faith without actual knowledge of revocation or the Principal's death.)

State of _______________________

County of _______________________

I, the undersigned Attorney-in-Fact (or successor Attorney-in-Fact) named in the attached Durable Power of Attorney, being duly sworn, depose and state:

1. The attached Durable Power of Attorney was executed by the Principal, is genuine, and is in full force and effect. At the time I acted or now act under it, I did not have and do not have actual knowledge of the termination of the power of attorney by revocation or of the Principal's death (N.D.C.C. 30.1-30-05).

2. The Principal is alive. To the best of my knowledge and belief, the Principal had legal capacity when the power of attorney was executed.

3. This power of attorney became effective upon the Principal's disability. The physician's written certification of disability, dated _______________________, by which this power became effective, is attached. (On this springing power, disability is the event that TRIGGERED the power, not a terminating fact.)

4. I am the person designated as Attorney-in-Fact (or successor) in the power of attorney and am qualified and authorized to act under it.

_____________________________________________________

Signature of Attorney-in-Fact (or successor)

_____________________________________________________

Printed name

Date: ______________________________

Capacity (Attorney-in-Fact / successor): ________________________

JURAT

(Notarial officer — North Dakota verification-on-oath short form, N.D.C.C. 44-06.1-19(3))

Signed and sworn to (or affirmed) before me on _______________________ (Date) by

____________________________________________________

(Name(s) of individual(s) making statement)

_____________________________________________________

Signature of notarial officer

(Stamp)

_____________________________________________________

Title of office (e.g., Notary Public)

[My commission expires: ________________________

]

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AGENT'S AFFIDAVIT OF NON-REVOCATION

SPARE COPY — use the first copy before this one

State of _______________________

County of _______________________

I, the undersigned Attorney-in-Fact (or successor Attorney-in-Fact) named in the attached Durable Power of Attorney, being duly sworn, depose and state:

1. The attached Durable Power of Attorney was executed by the Principal, is genuine, and is in full force and effect. At the time I acted or now act under it, I did not have and do not have actual knowledge of the termination of the power of attorney by revocation or of the Principal's death (N.D.C.C. 30.1-30-05).

2. The Principal is alive. To the best of my knowledge and belief, the Principal had legal capacity when the power of attorney was executed.

3. This power of attorney became effective upon the Principal's disability. The physician's written certification of disability, dated _______________________, by which this power became effective, is attached. (On this springing power, disability is the event that TRIGGERED the power, not a terminating fact.)

4. I am the person designated as Attorney-in-Fact (or successor) in the power of attorney and am qualified and authorized to act under it.

_____________________________________________________

Signature of Attorney-in-Fact (or successor)

_____________________________________________________

Printed name

Date: ______________________________

Capacity (Attorney-in-Fact / successor): ________________________

JURAT

(Notarial officer — North Dakota verification-on-oath short form, N.D.C.C. 44-06.1-19(3))

Signed and sworn to (or affirmed) before me on _______________________ (Date) by

____________________________________________________

(Name(s) of individual(s) making statement)

_____________________________________________________

Signature of notarial officer

(Stamp)

_____________________________________________________

Title of office (e.g., Notary Public)

[My commission expires: ________________________

]

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AGENT'S CERTIFICATION FOR DIGITAL-ASSET REQUESTS

Packet addition — present to a custodian (Google, Apple, Meta, banks' online portals, etc.) together with the power of attorney when requesting access to the Principal's digital assets. North Dakota's Uniform Fiduciary Access to Digital Assets Act entitles the custodian to this certification under penalty of perjury (N.D.C.C. 47-36-08(c) and 47-36-09(c)); the custodian generally must comply within 60 days of a complete request and has good-faith immunity (N.D.C.C. 47-36-15). This is an unsworn declaration under penalty of perjury (N.D.C.C. 31-15-05); notarize only if a custodian demands it.

I, the undersigned Attorney-in-Fact (or successor Attorney-in-Fact) named in the attached Durable Power of Attorney, certify under penalty of perjury that:

1. The attached power of attorney is in full force and effect; it has not been revoked, terminated, or suspended, and I have no actual knowledge of the Principal's death or of any event terminating or suspending it or my authority.

2. I am the person designated as Attorney-in-Fact (or successor) in the power of attorney and am qualified and authorized to act under it.

3. This certification accompanies a written request for disclosure directed to (custodian): ____________________________________

4. The request concerns (check one): ☐ a catalogue of electronic communications and digital assets other than content (N.D.C.C. 47-36-09) ☐ the content of electronic communications — granted expressly in Section 6 of the power of attorney (N.D.C.C. 47-36-08).

5. If requested by the custodian, the following identifies the Principal's account or links the account to the Principal:

______________________________________________________________________________

_____________________________________________________

Signature of Attorney-in-Fact (or successor)

_____________________________________________________

Printed name

Date: ______________________________

Address and telephone: __________________________________________

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DETERMINATION OF DISABILITY — PHYSICIAN'S WRITTEN CERTIFICATION

PACKET ADDITION for the "Effective Upon Disability" power of attorney — this is the written certification the instrument prescribes to establish that the Principal is under a disability. Because North Dakota has no statute compelling a bank to accept a power of attorney, a completed certification like this is the proof most banks and others will want before relying on a springing power.

This certification concerns the Durable Power of Attorney executed by:

_____________________________________________________

Name of Principal

Date of the power of attorney: ________________________________

_____________________________________________________

Name of Attorney-in-Fact presenting this certification

CERTIFICATION

I, the undersigned physician, certify that:

1. I am a physician licensed to practice medicine in _______________________________________.

2. I examined the Principal named above on _______________________________ (month, day, year).

3. In my professional judgment, to a reasonable degree of medical certainty and as a result of that examination, the Principal is unable to manage his or her property and business affairs — that is, the Principal is under a disability within the meaning of the power of attorney described above and N.D.C.C. 30.1-30-01.

4. The Principal has authorized the disclosure of the health information necessary to make this certification (HIPAA authorization accompanying the power of attorney).

_____________________________________________________

Signature of physician

_____________________________________________________

Printed name of physician

License number and state: ______________________________

Date signed: ______________________________

_____________________________________________________

Address and telephone of physician

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AUTHORIZATION TO DISCLOSE HEALTH INFORMATION (HIPAA)

PACKET ADDITION for the "Effective Upon Disability" power of attorney — a standalone authorization (45 C.F.R. § 164.508) so the physician or other certifier may disclose to your agent the health information needed to make the written certification of disability the power of attorney requires. Sign it when you sign the power of attorney — not later.

1. Patient / Principal:

_____________________________________________________

Name of Principal (patient)

Date of birth: ______________________________

2. I authorize the following to make the disclosure: ANY physician, psychologist, or other health-care provider who has examined or treated me — including the certifier designated in my Durable Power of Attorney.

3. Disclosure may be made TO: the Attorney(s)-in-Fact named in my Durable Power of Attorney:

_____________________________________________________

Name(s) of Attorney(s)-in-Fact authorized to receive the information

4. Information to be disclosed: information sufficient to determine whether I am unable to manage my property and business affairs — including cognitive, functional, and diagnostic findings bearing on that determination — and no more.

5. Purpose: to make the written certification of disability required for my Durable Power of Attorney to become effective.

6. Expiration: this authorization expires when the certification described in paragraph 5 has been made, or when I revoke it, whichever is earlier. I may revoke this authorization in writing at any time, except to the extent a provider has already relied on it.

7. I understand that information disclosed under this authorization may be re-disclosed by the recipient and may no longer be protected by federal privacy rules, and that my treatment may not be conditioned on my signing this authorization.

_____________________________________________________

Signature of Principal (patient)

_____________________________________________________

Printed name of Principal

Date signed: ______________________________

If signed by a personal representative, describe the representative's authority: __________________________________________

OPTIONAL REVOCATION PAGE — USE ONLY IF YOU WANT TO REVOKE A POWER OF ATTORNEY. COMPLETING THIS PAGE CANCELS THE POWER. THIS PAGE IS SEPARATE FROM THE POWER OF ATTORNEY.

REVOCATION OF POWER OF ATTORNEY

I, the undersigned Principal, REVOKE the Durable Power of Attorney that I signed on _______________________ (date), naming _______________________________________ as my Attorney-in-Fact, and all authority granted by it. This revocation is effective on delivery of written notice to my Attorney-in-Fact.

If the power of attorney was recorded, this revocation must be acknowledged (or proved), certified, and recorded in the SAME office (N.D.C.C. 47-19-44). Give written notice to your Attorney-in-Fact and to everyone who has a copy of the power of attorney, and collect and destroy the original and all copies if you can.

_____________________________________________________

Signature of Principal

_____________________________________________________

Printed name of Principal

Date signed: ______________________________

CERTIFICATE OF ACKNOWLEDGMENT

(Notarial officer — North Dakota individual acknowledgment short form, N.D.C.C. 44-06.1-19(1))

State of _______________________

[County] of _______________________

This record was acknowledged before me on _______________________ (Date) by

_______________________________________________________

(Name(s) of individual(s))

_____________________________________________________

Signature of notarial officer

(Stamp)

_____________________________________________________

Title of office (e.g., Notary Public)

[My commission expires: ________________________

]

OPTIONAL RECORDING COVER PAGE — ATTACH AS THE FIRST PAGE ONLY IF YOU RECORD THIS POWER OF ATTORNEY WITH THE COUNTY RECORDER. THIS PAGE IS NOT PART OF THE LEGAL INSTRUMENT.

Recording Cover Page — North Dakota Durable Power of Attorney

Title of document: North Dakota Durable Power of Attorney

_____________________________________________________

Date of document (date the power of attorney was signed)

_____________________________________________________

Grantor — Principal's full name

_____________________________________________________

Grantor's mailing address (street, city, state, ZIP)

_____________________________________________________

Grantee — Attorney-in-Fact's full name

_____________________________________________________

Grantee's mailing address (street, city, state, ZIP)

County(ies) where the affected real property is located (if recorded for a real-estate transaction):

______________________________________________________________________________

After recording, return to:

_____________________________________________________

Name and address for return of the recorded document

Record with the County Recorder of the county where the land lies. A power of attorney used to execute a mortgage must be acknowledged or proved, certified, AND recorded (N.D.C.C. 35-03-03); recording generally requires an original signature (N.D.C.C. 47-19-03). The Agent's Affidavit of Non-Revocation is recordable together with recordable instruments (N.D.C.C. 30.1-30-05). The county recorder sets reproduction and margin standards. Names should be printed beneath signatures on the instrument.