Missouri General Durable Power of Attorney for Property & Finances (Immediate)

Missouri General Durable Power of Attorney
for Property & Finances (Immediate)

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 "MISSOURI DURABLE POWER OF ATTORNEY."

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

This packet contains a Missouri-drafted general durable power of attorney that is effective immediately when you sign and acknowledge it, an Agent's Duties summary, an Agent's Affidavit form your agent may use when dealing with banks and others, and an optional recording cover page.

Missouri Durable Power of Attorney Law (§§ 404.700–404.735, RSMo)

What this document is

This is a durable power of attorney for property and finances drafted for Missouri under the Durable Power of Attorney Law of Missouri (§§ 404.700 to 404.735, RSMo). Missouri does not publish an official statutory form — this is a PublicLegal-drafted instrument built directly on that law. "Durable" means your agent's authority continues even if you later become disabled or incapacitated (§ 404.705, RSMo). It covers property and finances only — it does not authorize health-care decisions (Missouri health-care powers of attorney use a separate instrument under §§ 404.800 to 404.865, RSMo).

Which version you purchased

Immediate. The EFFECTIVE DATE section says this power of attorney is effective when you sign and acknowledge it, and no determination of disability is needed. (If you want authority that begins only upon your disability or incapacity, use the "Upon Disability" version of this product instead.)

How to sign (the execution ceremony)

Sign and date the instrument in the presence of a notary public, who will complete the acknowledgment certificate. Missouri requires a durable power of attorney to be subscribed by you, dated, and "acknowledged in the manner prescribed by law for conveyances of real estate" (§ 404.705(1)(3), RSMo) — the acknowledgment certificate in this packet is the conveyance form Missouri prescribes for exactly that act (§ 442.210(1)(1), RSMo; an acknowledgment so taken satisfies all legal requirements for execution and recording). NO witnesses are required — Missouri's law never calls for them. Sign in ink; initial the election lines in ink. Missouri authorizes remote online notarization (§§ 486.1100 to 486.1205, RSMo); if you use it, follow your Missouri remote notary's process — this instrument is designed for wet-ink signing.

What your agent can do — and what requires your initials

The GRANT OF GENERAL AUTHORITY gives your agent the broad powers Missouri law allows — everything an adult can delegate — EXCEPT the sensitive powers listed in § 404.710(6), RSMo, which Missouri grants only when expressly enumerated (§ 404.710(2), RSMo). Those powers appear as initial-off election lines: INITIAL ONLY the ones you intend. A line you do not initial is NOT granted.

Among the elections: trusts and trust funding; gifts (Missouri sets no dollar cap — your agent's duty is to act in your best interest and, absent explicit authorization, to preserve your estate plan, § 404.714(1), RSMo; the election lines ARE that explicit authorization); disclaimers; survivorship interests; beneficiary designations; nomination of a guardian or conservator (including self-nomination by your agent, if you permit); powers of appointment; and digital assets — including an express grant of access to the CONTENT of your electronic communications, which Missouri's digital-assets law requires for content (§ 472.440, RSMo; a direction you give through a provider's own online tool overrides this document, § 472.415, RSMo). Two elections are grouped as DECISIONS EFFECTIVE AFTER MY DEATH because Missouri law lets them continue for a reasonable time after death (§ 404.717(1)(4), RSMo): consent to autopsy and anatomical gifts/right of sepulcher.

No one can ever be given power under a power of attorney to make or change your will, to make or revoke a living will declaration for you, or to force you to act against your will (§ 404.710(7), RSMo).

Optional provisions (labeled elections)

Four elections appear under OPTIONAL PROVISIONS; a line left blank keeps the Missouri-law default: (i) REVOKE EARLIER POWERS — initialing revokes your earlier property/financial powers of attorney (if an earlier power was recorded, record the revocation too). (ii) NO COMPENSATION — Missouri entitles your agent to reasonable compensation by default (§ 404.725, RSMo); initialing removes compensation but keeps expense reimbursement. (iii) DIVORCE-FILING CONTINUATION — if your agent is your spouse, the filing of a divorce or dissolution action automatically ends the agent's authority (§ 404.717(1)(6), RSMo); initialing keeps it in place despite a filing. (iv) RESTRICT DELEGATION — by default your agent may revocably delegate powers to qualified persons while remaining responsible to you (§ 404.723(1), RSMo); initialing forbids delegation.

Naming your agent — and successors, co-agents

Name one attorney in fact, plus an optional successor who acts if the first cannot or will not (§ 404.723(2), RSMo). If you name two co-agents, Missouri requires the instrument itself to say whether they act JOINTLY or SEVERALLY (§ 404.707(1), RSMo) — mark one box if you name two. Anyone not disqualified from serving as your guardian or conservator under § 475.055(2), RSMo, may serve.

If a court later appoints a conservator or guardian

A conservator or guardian's appointment does NOT terminate this power of attorney. Your agent must follow the instructions of the court or the legal representative and is accountable to your conservator on property matters and your guardian on personal-welfare matters (§ 404.714(5), RSMo). A court may also appoint a successor attorney in fact instead of a conservator when your document is adequate (§ 404.723(4), RSMo).

If the agent will deal with real estate: recording

This power of attorney is valid without recording, but for transactions affecting Missouri real estate it should be recorded with the recorder of deeds where the land lies (§§ 404.705(3), 442.360, 442.370, RSMo). Missouri's formatting statute requires a 3-inch top margin on the first recorded page and specific first-page information — including the grantor's marital status and a legal description (§ 59.310, RSMo). The OPTIONAL RECORDING COVER PAGE at the end of this packet satisfies those rules and keeps recorder stamps off the instrument — attach it only if you record.

Banks and others may rely on this document

Missouri law protects third persons who accept a power of attorney in good faith (§ 404.719, RSMo), and expressly lets them rely on your agent's affidavit about your capacity, the happening of any contingency, a successor's authority, and the fact that you are alive (§ 404.719(1)(15), RSMo) — the Agent's Affidavit in this packet is built for that. A third person may ask for signature specimens and a reasonable indemnity (§ 404.719(4), RSMo).

Revoking or changing this document

You may revoke this power of attorney at any time while you have capacity. As between you and your agent, telling your agent — orally or in writing — modifies or terminates it (§ 404.717(1)(2), RSMo); best practice is a signed written revocation with notice to your agent and to everyone relying on the document. You may also file a written notice of revocation with the recorder of deeds (§ 404.717(1)(3), RSMo). If this power of attorney was RECORDED, a revocation is not effective against that recorded instrument until the revocation is deposited for record in the SAME recorder's office (§ 442.370, RSMo) — record the revocation in the same county. Death ends the power except for the Section 6 elections, which continue for a reasonable length of time (§ 404.717(1)(4), RSMo).

Sources: Durable Power of Attorney Law of Missouri, §§ 404.700–404.735 RSMo (incl. §§ 404.703, 404.705, 404.707, 404.710, 404.712, 404.714, 404.717, 404.719, 404.721, 404.723, 404.725, 404.727, 404.730); § 475.010 RSMo (definitions); § 194.119 RSMo (right of sepulcher); § 442.210 RSMo (acknowledgment form); §§ 486.750, 486.755 RSMo (notarial certificates); §§ 486.1100–486.1205 RSMo (remote notarization); §§ 472.400–472.490 RSMo (digital assets); § 59.310 RSMo (recording format); §§ 442.360, 442.370 RSMo (real-estate recording); §§ 404.800–404.865 RSMo (health care, not included). Official text: revisor.mo.gov (chapter 404).

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MISSOURI DURABLE POWER OF ATTORNEY

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

NOTICE TO THE PRINCIPAL

The powers you grant in this document are broad and sweeping. They are governed by the Durable Power of Attorney Law of Missouri, §§ 404.700 to 404.735 of the Revised Statutes of Missouri. This document does NOT authorize anyone to make medical or other health-care decisions for you — Missouri health-care powers use a separate instrument. You may revoke this power of attorney at any time while you have capacity. 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 successor. If my Attorney in Fact resigns, dies, becomes disabled or incapacitated, is not qualified to act, or refuses to act, I appoint the following person as successor Attorney in Fact (§ 404.723(2), RSMo). If I name more than one successor in the Special Instructions, they serve successively in the order named, not simultaneously:

_____________________________________________________

Name of successor Attorney in Fact (optional)

_____________________________________________________

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

Optional co-agents. If I have named two persons to serve at the same time in the Special Instructions, Missouri law requires this document to say whether they must act together or may act independently (§ 404.707(1), RSMo). Mark ONE only if you named co-agents:

☐ My co-agents shall act JOINTLY (both must participate in each act).

☐ My co-agents may act SEVERALLY (each may act independently).

If I name co-agents and mark neither box, my co-agents shall act SEVERALLY.

2. DURABILITY

THIS IS A DURABLE POWER OF ATTORNEY AND THE AUTHORITY OF MY ATTORNEY IN FACT SHALL NOT TERMINATE IF I BECOME DISABLED OR INCAPACITATED OR IN THE EVENT OF LATER UNCERTAINTY AS TO WHETHER I AM DEAD OR ALIVE

The statement above is the durability provision prescribed by § 404.705(1), RSMo.

3. EFFECTIVE DATE

This power of attorney is effective IMMEDIATELY upon my execution and acknowledgment of it, and no determination of disability or incapacity is required. (A separate "Effective Upon Disability" version exists if you want authority that begins only upon a later determination of disability.)

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, except as limited or conditioned in this power of attorney. As provided by § 404.710(2), RSMo, this grant extends to and includes each and every action or power which an adult who is not disabled or incapacitated may carry out through a specifically authorized agent, with respect to any and all matters whatsoever — including property I own jointly or by the entireties with another or others — EXCEPT the actions listed in § 404.710(6), RSMo, which are granted ONLY where I have expressly enumerated and authorized them by initialing below, and subject to § 404.710(7), RSMo: my Attorney in Fact may NEVER (i) make, publish, declare, amend, or revoke a will for me; (ii) make, execute, modify, or revoke a living will declaration for me; (iii) require me, against my will, to take any action or to refrain from taking any action; or (iv) carry out any action I have specifically forbidden while not under any disability or incapacity.

Without limiting the general grant, my Attorney in Fact may make, execute, and deliver indemnity agreements to third persons asked to rely on this power of attorney (which bind me), and may employ and compensate agents, brokers, attorneys, and accountants, all as provided by § 404.710(4), RSMo.

5. EXPRESS POWERS — INITIAL EACH POWER YOU GRANT

Missouri grants the following powers ONLY where expressly enumerated AND authorized (§ 404.710(6), RSMo). INITIAL each power you grant. A line you do not initial is NOT granted. Initialing a power in this Section 5 or in Section 6 is my explicit authorization, for purposes of § 404.714(1), RSMo, for my Attorney in Fact to take the initialed actions even to the extent they modify my estate plan; powers I do NOT initial remain subject to my Attorney in Fact's duty to preserve my estate plan without modification.

(___) Trusts — to execute, amend, or revoke any trust agreement (§ 404.710(6)(1), RSMo).

(___) Trust funding — to fund with my assets any trust not created by me (§ 404.710(6)(2), RSMo).

(___) Gifts — to make or revoke gifts of my property, in trust or otherwise (§ 404.710(6)(3), RSMo). Missouri sets no dollar cap; my Attorney in Fact remains bound by the duties of Section 404.714, RSMo.

_____ If (and ONLY if) this second line is also initialed, the gift power includes gifts to my Attorney in Fact personally. Leave blank to forbid gifts to my Attorney in Fact.

(___) Disclaimers — to disclaim a gift or devise of property to or for my benefit, including the release, in whole or part, of any power of appointment granted to me, to the extent authorized by §§ 456.970 to 456.1135, RSMo (§ 404.710(6)(4), RSMo).

(___) Survivorship interests — to create or change survivorship interests in my property or in property in which I may have an interest (§ 404.710(6)(5), RSMo). (No initial is needed for my Attorney in Fact to withdraw funds from accounts or contracts I hold jointly with others at a financial institution, brokerage, or depository, to the same extent I could.)

_____ If (and ONLY if) this second line is also initialed, the survivorship power includes creating or changing survivorship interests in favor of my Attorney in Fact personally. Leave blank to forbid.

(___) Beneficiary designations — to designate or change the designation of beneficiaries to receive any property, benefit, or contract right on my death (§ 404.710(6)(6), RSMo).

(___) Guardian or conservator nomination — to nominate a guardian or conservator for me (§ 404.710(6)(9), RSMo):

☐ If initialed above, my Attorney in Fact may nominate himself or herself as my guardian or conservator.

(___) Successor designations by my agent — to designate one or more substitute, successor, or additional attorneys in fact (§ 404.710(6)(11), RSMo).

(___) Powers of appointment — to exercise, to revoke or amend the release of, or to contract to exercise or not to exercise, any power of appointment granted to me, to the extent authorized by §§ 456.970 to 456.1135, RSMo (§ 404.710(6)(12), RSMo).

DIGITAL ASSETS (Missouri Revised Uniform Fiduciary Access to Digital Assets Act, §§ 472.400 to 472.490, RSMo):

(___) Digital assets — catalogue and other assets — to access, manage, and take control of my digital assets and the catalogue of my electronic communications (§ 472.445, RSMo; this confirms what the general grant already carries).

(___) CONTENT of electronic communications — I EXPRESSLY GRANT my Attorney in Fact authority over the content of my electronic communications, as § 472.440, RSMo, requires for content. (A direction I give through a provider's online tool overrides this document — § 472.415, RSMo.)

6. AUTHORITY THAT CONTINUES AFTER MY DEATH — INITIAL EACH YOU GRANT

The following two powers may be exercised during my lifetime and, if initialed, CONTINUE for a reasonable length of time after my death for the limited purpose of carrying them out (§ 404.717(1)(4), RSMo). These are not health-care powers — Missouri health-care decisions use a separate instrument (§§ 404.800 to 404.865, RSMo).

(___) Autopsy — to give or withhold consent to an autopsy or postmortem examination (§ 404.710(6)(7), RSMo).

(___) Anatomical gifts and sepulcher — to MAKE an anatomical gift of, or to PROHIBIT an anatomical gift of, all or part of my body under the Revised Uniform Anatomical Gift Act, or to exercise the right of sepulcher over my body under § 194.119, RSMo (§ 404.710(6)(8), RSMo). IMPORTANT: under § 194.119, RSMo, an attorney in fact specifically granted the right of sepulcher in a durable power of attorney has FIRST priority to control my final arrangements — ahead of my spouse and next of kin. Initial only if you intend that result.

7. OPTIONAL PROVISIONS — INITIAL ONLY TO CHANGE THE MISSOURI-LAW DEFAULT

_____ REVOKE EARLIER POWERS — I revoke every earlier power of attorney I signed covering property or financial matters (never any health-care directive). [OPTIONAL ELECTION — leave blank to keep the Missouri-law default]

_____ NO COMPENSATION — my Attorney in Fact shall serve WITHOUT compensation but remains entitled to reimbursement of reasonable expenses (§ 404.725, RSMo). [OPTIONAL ELECTION — leave blank to keep the Missouri-law default]

_____ DIVORCE-FILING CONTINUATION — if my Attorney in Fact is my spouse, the filing of an action for divorce or dissolution of our marriage shall NOT terminate the agent's authority (overriding the default rule of § 404.717(1)(6), RSMo). [OPTIONAL ELECTION — leave blank to keep the Missouri-law default]

_____ RESTRICT DELEGATION — my Attorney in Fact may NOT delegate any power granted in this document (restricting § 404.723(1), RSMo). [OPTIONAL ELECTION — leave blank to keep the Missouri-law default]

8. SPECIAL INSTRUCTIONS

(Optional — for example: limits on gifts, instructions about particular property, co-agent designations, or other directions. Attach additional signed pages if needed.)

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

9. GOVERNING LAW AND RELIANCE

This power of attorney is executed under and governed by the Durable Power of Attorney Law of Missouri, §§ 404.700 to 404.735, RSMo. Third persons may rely on this power of attorney, and on an affidavit of my Attorney in Fact, as provided by §§ 404.719 and 404.721, RSMo. This power of attorney does not have to be recorded to be valid and binding, except to the extent recording may be required for transactions affecting real estate (§ 404.705(3), RSMo). It terminates on my death, except that the powers initialed in Section 6 continue for a reasonable length of time as provided by § 404.717(1)(4), RSMo.

My Attorney in Fact shall clearly indicate that capacity when acting for me and shall keep my property and accounts separate from all other property (§ 404.712, RSMo). My Attorney in Fact has no duty to exercise the authority granted unless he or she has agreed expressly in writing to do so (§ 404.705(4), RSMo). The appointment of a conservator or guardian for me does NOT terminate this power of attorney; my Attorney in Fact becomes accountable to the conservator or guardian as provided by §§ 404.714(5) and 404.731(3), RSMo.

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10. EXECUTION AND ACKNOWLEDGMENT

I sign my name to this Durable Power of Attorney on the date below, and I acknowledge it in the manner prescribed by law for conveyances of real estate (§ 404.705(1)(3), RSMo).

_____________________________________________________

Signature of Principal

_____________________________________________________

Printed name of Principal

_____________________________________________________

Date signed (month, day, year)

_____________________________________________________

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

CERTIFICATE OF ACKNOWLEDGMENT

(Notary public or other officer — Missouri conveyance form, § 442.210(1)(1), RSMo)

State of Missouri

County (and/or City) of _______________________

On this _______ day of _______________________, 20_____, before me personally appeared

_______________________________________________________

(name of Principal)

to me known to be the person described in and who executed the foregoing instrument, and acknowledged that he (or she) executed the same as his (or her) free act and deed.

(If the signer is not personally known to the officer, identity is proved by identification documents or the oaths of two witnesses, whose names and residences the officer inserts — § 442.210(1), RSMo.)

_____________________________________________________

Signature and title of officer taking the acknowledgment

_____________________________________________________

Printed name of notary (affix seal)

My commission expires: ______________________________

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AGENT'S DUTIES UNDER MISSOURI LAW

A summary for the Attorney in Fact — keep with the power of attorney. (§§ 404.712 and 404.714, RSMo)

If you elect to act under this power of attorney, Missouri law makes you a fiduciary. In summary:

• Act in the Principal's interest and avoid conflicts of interest and self-dealing, as a trustee would for a beneficiary (§ 404.714(1), RSMo).

• Absent explicit authorization in the power of attorney, exercise a high degree of care to maintain, WITHOUT modification, any estate plan the Principal has in place — including beneficiary designations, joint tenancy or tenancy by the entirety arrangements, trusts, and wills or codicils (§ 404.714(1), RSMo). The election lines the Principal initialed in Sections 5 and 6 ARE that explicit authorization for the actions they describe.

• Exercise the care of a prudent person dealing with another's property and affairs; invest under the Missouri Prudent Investor Act (§§ 469.900 to 469.913, RSMo); use any special skills you have or claimed (§ 404.714(1), RSMo).

• To the extent reasonably possible, keep in regular contact with the Principal, communicate with the Principal, and obtain and follow the Principal's instructions (§ 404.714(2), RSMo). You may consult with the Principal's spouse, physician, attorney, accountant, family members, and others about matters affecting the Principal (§ 404.714(4), RSMo).

• Clearly indicate your capacity when acting, and keep the Principal's property and accounts separate and distinct from all other property, identifiable as the Principal's (§ 404.712, RSMo).

• Follow the instrument, any lawful modification, and the written instructions of the Principal, the Principal's legal representative, or a court (§ 404.714(7), RSMo). If a court appoints a guardian or conservator, follow the instructions of the court or the legal representative, and be accountable to the conservator on property matters and the guardian on personal-welfare matters (§ 404.714(5), RSMo).

• You have NO duty to exercise authority unless you expressly agreed in writing to do so; but once you act, fiduciary duties apply to what you do (§ 404.705(4), RSMo). Acting in some transactions does not obligate you to act in others.

• You may revocably delegate powers unless the power of attorney restricts delegation, but you remain responsible to the Principal for the exercise or nonexercise of delegated powers (§ 404.723(1), RSMo).

• A third person may ask you for signature specimens and a reasonable indemnity before relying on the power of attorney; a bond may be required unless the conditions of § 404.719(4), RSMo, are met (a durable power, two-year Missouri residency, and a satisfactory indemnity agreement delivered to the third person).

• On the Principal's death, follow the instructions of the court having jurisdiction of the estate, communicate with and be accountable to the personal representative, and promptly deliver the Principal's property and your records (§ 404.714(9), RSMo). Only the powers initialed in Section 6 (autopsy; anatomical gifts/sepulcher) may be exercised for a reasonable time after death (§ 404.717(1)(4), RSMo).

• Willful misconduct, fraud, willful disregard of the power of attorney, or intentional acts after actual notice of revocation make you liable for damages, attorney's fees, and punitive damages (§ 404.717(5), RSMo).

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AGENT'S AFFIDAVIT

For use when a third person requests confirmation — third persons may rely on this affidavit (§ 404.719(1)(15), RSMo)

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

1. The attached Durable Power of Attorney was executed by the Principal and is in full force and effect; it has not been modified, suspended, or terminated, and I have no actual knowledge of any event that would modify, suspend, or terminate it. I certify under penalty of perjury that the power of attorney is in effect (§§ 472.440(3) and 472.445(3), RSMo).

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

4. [Complete if the power of attorney is effective upon a contingency, such as the Principal's disability or incapacity, or if a successor's authority has vested:] The event or events making the power of attorney effective, or vesting authority in a successor or contingent Attorney in Fact, have occurred, as follows:

______________________________________________________________________________

______________________________________________________________________________

5. [Complete if applicable:] The person designated in the power of attorney to appoint a substitute or successor Attorney in Fact, and the identity and authority of that person, are as follows:

______________________________________________________________________________

6. [Complete if the Principal and I are or were married to each other:] No action for divorce or dissolution of the marriage has been filed (or the power of attorney provides otherwise) (§§ 404.717(1)(6) and 404.719(1)(14), RSMo).

_____________________________________________________

Signature of Attorney in Fact (or successor)

_____________________________________________________

Printed name

Date: ______________________________

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

JURAT

(Notary public — Missouri form, § 486.755, RSMo)

State of Missouri

County (and/or City) of _______________________

On this _______ day of _______________________, 20_____, before me, the undersigned notary, personally appeared

____________________________________________________________

(name of document signer)

(personally known to me) (proved to me through identification documents, which were ________________________,) (proved to me on the oath or affirmation of ________________________, who is personally known to me and stated to me that (he)(she) personally knows the document signer and is unaffected by the document,) (proved to me on the oath or affirmation of ________________________ and ________________________, whose identities have been proven to me through identification documents and who have stated to me that they personally know the document signer and are unaffected by the document,) to be the person who signed the preceding or attached document in my presence and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of (his)(her) knowledge and belief.

_____________________________________________________

Official signature and seal of notary

_____________________________________________________

Printed name of notary

My commission expires: ______________________________

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AGENT'S AFFIDAVIT

SPARE COPY — use the first copy before this one

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

1. The attached Durable Power of Attorney was executed by the Principal and is in full force and effect; it has not been modified, suspended, or terminated, and I have no actual knowledge of any event that would modify, suspend, or terminate it. I certify under penalty of perjury that the power of attorney is in effect (§§ 472.440(3) and 472.445(3), RSMo).

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

4. [Complete if the power of attorney is effective upon a contingency, such as the Principal's disability or incapacity, or if a successor's authority has vested:] The event or events making the power of attorney effective, or vesting authority in a successor or contingent Attorney in Fact, have occurred, as follows:

______________________________________________________________________________

______________________________________________________________________________

5. [Complete if applicable:] The person designated in the power of attorney to appoint a substitute or successor Attorney in Fact, and the identity and authority of that person, are as follows:

______________________________________________________________________________

6. [Complete if the Principal and I are or were married to each other:] No action for divorce or dissolution of the marriage has been filed (or the power of attorney provides otherwise) (§§ 404.717(1)(6) and 404.719(1)(14), RSMo).

_____________________________________________________

Signature of Attorney in Fact (or successor)

_____________________________________________________

Printed name

Date: ______________________________

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

JURAT

(Notary public — Missouri form, § 486.755, RSMo)

State of Missouri

County (and/or City) of _______________________

On this _______ day of _______________________, 20_____, before me, the undersigned notary, personally appeared

____________________________________________________________

(name of document signer)

(personally known to me) (proved to me through identification documents, which were ________________________,) (proved to me on the oath or affirmation of ________________________, who is personally known to me and stated to me that (he)(she) personally knows the document signer and is unaffected by the document,) (proved to me on the oath or affirmation of ________________________ and ________________________, whose identities have been proven to me through identification documents and who have stated to me that they personally know the document signer and are unaffected by the document,) to be the person who signed the preceding or attached document in my presence and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of (his)(her) knowledge and belief.

_____________________________________________________

Official signature and seal of notary

_____________________________________________________

Printed name of notary

My commission expires: ______________________________

Title of document: Missouri Durable Power of Attorney

_____________________________________________________

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

_____________________________________________________

Grantor(s) — Principal's full name(s)

☐ Single ☐ Married ☐ Widowed ☐ Divorced (Grantor marital status is required on the first recorded page — § 59.310(2)(3), RSMo)

_____________________________________________________

Grantee(s) — Attorney in Fact's full name(s)

_____________________________________________________

Statutory address(es) — mailing address(es) of the parties

_____________________________________________________

Legal description of the property (if this power will be used for a specific parcel — not the street address)

______________________________________________________________________________

The legal description above, if any, is recording-index information only and does not limit the general authority granted by the power of attorney (§ 404.710(8), RSMo).

_____________________________________________________

Reference book and page (if required by statute — otherwise leave blank)

After recording, return to:

_____________________________________________________

Name and address for return of the recorded document

Optional cover page — attach as the first page only if you record this power of attorney; it is not part of the legal instrument. The blank 3-inch space at the top of this page is reserved for the recorder of deeds (§ 59.310, RSMo).