STATUTORY SHORT FORM POWER OF ATTORNEY
MINNESOTA STATUTES, SECTION 523.23
Before completing and signing this form, the principal must read and initial the IMPORTANT
NOTICE TO THE PRINCIPAL that appears after the signature lines in this form. Before acting on
behalf of the principal, the attorney(s)-in-fact must sign this form acknowledging having read
and understood the IMPORTANT NOTICE TO THE ATTORNEY(S)-IN-FACT that appears after the
notice to the principal
PRINCIPAL (Name and address of person granting the power)
ATTORNEY(S)-IN-FACT SUCCESSOR ATTORNEY(S)-IN-FACT
(Names and Addresses)
(Optional) To act if any named attorney-in-fact dies,
resigns or is otherwise unable to serve.
(Name and Address)
NOTICE: If more than one attorney-in-fact is
designated to act at the same time, make a check
or “x” on the line in front of one of the following
Each attorney-in-fact may independently
EXPIRATION DATE (Optional)
exercise the powers granted.
Use specific month, day and year only
All attorneys-in-fact must jointly exercise
the powers granted.