This is a download of legal forms for:

DAVENPORT’S MINNESOTA WILLS AND ESTATE PLANNING LEGAL FORMS

See book for instructions on filling out forms.

This download has forms in Word format for people to either 1) print out and hand-write in words to complete and then sign, or2) first open in any word processing program to type in some words, then print to maybe hand-write in more words, and then sign.

BOOK HAS 11 FORMS BUT MOST PEOPLE ONLY USE A FEW FORMS

Form 1. Last Will And Testament (With Guardians) (lets one give orders to on deathgift property and money, pick person as executor to do things after death, say less costlyprocedures can be used, and in case needed pick guardians for minors and their property);

Form 2. Last Will And Testament (No Guardians) (this is a Will with no Guardiansparagraph for those without a child under 18 and not giving major things to anyone under 18);

Form 3. Self-Proving Affidavit (often done with a Will to help the later process after adeath of proving a Will was signed correctly, and this makes it more likely a Will is followed);

Form 4. Tangible Personal Property List (lets people easily write down outside a Willwanted gifts of “tangible personal property” like clothes, furniture, tools, cars, and jewelry);

Form 5. Codicil (lets one make changes to an existing Will, but most just do a new Will);

Form 6. Health Care Directive (lets person in case they can’t later control own healthcare name a “Health Care Agent”, and also if wanted give health care and other instructions);

Form 7. P.O.L.S.T. (Do Not Resuscitate) (this “Provider Orders for Life SustainingTreatment” form is often called a “Do Not Resuscitate” form and lets a person say paramedicsand others should not to try restart the heart or breathing (C.P.R.) or try some other actions);

Form 8. Statutory Short Form Power of Attorney (lets power over one’s money,property, and more be shared with someone like spouse or trusted friend to let them do things);Form 9. Power Of Attorney Over Child (lets parent give power over a child to someoneso they can help when child is away from parents, like with health care or school issues);

Form 10. Standby Guardian (lets parent arrange to have power over a child quickly go tosomeone on a parent’s death or severe illness, but most just name a guardian in a Will);

Form 11. Final Wishes (lets person give orders that involve their body after death likefuneral, burial, ceremonies, and smaller details, and maybe name person to control this).

FORM 1:LAST WILL AND TESTAMENT (WITH GUARDIANS)

LAST WILL AND TESTAMENT..I, ______________________ a resident of _____________ County, Minnesota, hereby make, publish, and declare this as my Last Will and Testament (called here my "Will"), and I hereby revoke any Wills and Codicils earlier made by me.

1. GIFTS. I give the following gifts which are specific gifts except any gifts of money amounts are general gifts:

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ___________________________________________ if they survive me; and

I give ________________________________________________________ to ______________________________________________ if they survive me.

2. TANGIBLE PERSONAL PROPERTY LIST. I may leave a list or other writing giving tangible personal property as allowed by Minnesota or other law, and I hereby authorize all such lists and make the gifts described. But gifts in a writing not found by 60 days after my death shall abate and be of no effect.

3. RESIDUE. I give all my property and estate remaining and not given or used by other Will provisions or other ways, whether now owned or later acquired, wherever located, and of any kind and nature including personal, real, and mixed property (all of which is called the “residue” in this Will), as follows: to _______________________________________________ if they survive me, but if they all do not survive me then I give the just described property to ________________________________ or their lineal descendants per stirpes.

4. ADMINISTRATION. I name and appoint ____________________________ as personal representative of my Will and estate, also called here my “executor”.

5. GUARDIANS. If any of my children have not reached age 18 I name and appoint ______________________________ to be guardian of the person of such children. I also name and appoint _______________________________ as conservator of the property and estate of such children or any other persons under age 18 who receive or possess property.

6. MISCELLANEOUS. The following applies to this Will and generally. Plural, singular, or gender meaning of words and phrases do not limit any Will provision, and “they” means one or several persons or entities. Informal and unsupervised administration and probate of my Will and estate is requested. Any personal representative, guardian of any type, and conservator serving under this Will or otherwise shall serve without bond, surety, or other security. A gift to multiple beneficiaries shall be sold by the personal representative and the proceeds distributed unless beneficiaries agree on how to use or sell it. For gifts to multiple beneficiaries a non-surviving beneficiary’s share goes to other beneficiaries in proportion to the share they are taking, including for the residue or if a gift requires survival, but not if an alternate beneficiary is provided. No unfilled Will part is a mistake and parts about the residue may be left blank. Priority of Will gifts of the same type is based on the order they appear here. “Give” and “gift” means the same as devise, bequest, grant, legacy or similar. “Survive” or “surviving” means to not stop living before 60 days after my death, and if in a gift it is an absolute condition and anti-lapse laws shall have no effect. Any personal representative, guardian of any type, and conservator is given as much power, authority, and discretion that may be given by law, including power to with no liability for change in value sell, lease, assign, mortgage, invest,

exchange, and transfer in any way any property, settle claims for and against the estate or any person, and have power of sale over real property, with no need for act of a court at any time or need for any filing or inventory or other thing. Any personal representative may and has power to at any time pay debts of mine or my estate that the personal representative in his or her sole and absolute discretion finds are valid including timely and fair, including debts of a last illness or funeral or burial or any similar things, all with no limit on amount, no need forfiling or inventory or similar, and no need for court action at any time. For gifts or other property going to minors my personal representative without act of any court has discretion and power to transfer property to: the minor, a conservator named by Will or a court, or a custodian under the Minnesota Uniform Transfers to Minors Act or similar law. For minors getting gifts in this Will or other transfers the person named conservator in this Will is nominated and named as custodian under the Minnesota Uniform Transfers to Minors Act or similar law, or if they fail to serve any personal representative may name a custodian. The residue includes lapsed or failed gifts, insurance paid to the estate, and property testator had a power of appointment or testamentary disposition over.

TESTATOR . . I, the Testator, sign, publish, and declare that I sign and execute this instrument as my Last Will and Testament, that I sign it willingly as a free and voluntary act for the purposes expressed therein, and that I am at least 18 years of age and of sound mind and under no constraint or undue influence, this __ day of ________________, 20__.

________________________________ Testator

WITNESSES .. We, the undersigned, declare in our presence the foregoing instrument was willingly published, declared, and signed by the above-named Testator as his or her Last Will and Testament, that to the best of our knowledge the Testator is at least 18 years of age and of sound mind and under no constraint or undue influence, that each of us is at least 18 years old, and that in the presence and hearing of Testator and each other we hereby sign our names as witnesses.

____________________ ________________________________________Witness Address____________________ ________________________________________

Witness Address

FORM 2:LAST WILL AND TESTAMENT (NO GUARDIANS)

LAST WILL AND TESTAMENT..I, ______________________ a resident of _____________ County, Minnesota, hereby make, publish, and declare this as my Last Will and Testament (called here my "Will"), and I hereby revoke any Wills and Codicils earlier made by me.

1. GIFTS. I give the following gifts which are specific gifts except any gifts of money amounts are general gifts:

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ______________________________________________ if they survive me;

I give ________________________________________________________ to ___________________________________________ if they survive me; and

I give ________________________________________________________ to ______________________________________________ if they survive me.

2. TANGIBLE PERSONAL PROPERTY LIST. I may leave a list or other writing giving tangible personal property as allowed by Minnesota or other law, and I hereby authorize all such lists and make the gifts described. But gifts in a writing not found by 60 days after my death shall abate and be of no effect.

3. RESIDUE. I give all my property and estate remaining and not given or used by other Will provisions or other ways, whether now owned or later acquired, wherever located, and of any kind and nature including personal, real, and mixed property (all of which is called the “residue” in this Will), as follows: to _______________________________________________ if they survive me, but if they all do not survive me then I give the just described property to ________________________________ or their lineal descendants per stirpes.

4. ADMINISTRATION. I name and appoint ____________________________ as personal representative of my Will and estate, also called here my “executor”.

5. MISCELLANEOUS. The following applies to this Will and generally. Plural, singular, or gender meaning of words and phrases do not limit any Will provision, and “they” means one or several persons or entities. Informal and unsupervised administration and probate of my Will and estate is requested. Any personal representative, guardian of any type, and conservator serving under this Will or otherwise shall serve without bond, surety, or other security. A gift to multiple beneficiaries shall be sold by the personal representative and the proceeds distributed unless beneficiaries agree on how to use or sell it. For gifts to multiple beneficiaries a non-surviving beneficiary’s share goes to other beneficiaries in proportion to the share they are taking, including for the residue or if a gift requires survival, but not if an alternate beneficiary is provided. No unfilled Will part is a mistake and parts about the residue may be left blank. Priority of Will gifts of the same type is based on the order they appear here. “Give” and “gift” means the same as devise, bequest, grant, legacy or similar. “Survive” or “surviving” means to not stop living before 60 days after my death, and if in a gift it is an absolute condition and anti-lapse laws shall have no effect. Any personal representative, guardian of any type, and conservator is given as much power, authority, and discretion that may be given by law, including power to with no liability for change in value sell, lease, assign, mortgage, invest, exchange, and transfer in any way any property, settle claims for and against the estate or any person, and have power of sale over real property, with no need for act of a court at any time or need for any filing or inventory or other thing. Any personal representative may and has power to at any time pay debts of mine or my estate that the personal representative in his or her sole and absolute discretion finds are valid including timely and fair, including debts of a last illness

or funeral or burial or any similar things, all with no limit on amount, no need forfiling or inventory or similar, and no need for court action at any time. For gifts or other property going to minors my personal representative without act of any court has discretion and power to transfer property to: the minor, a conservator named by Will or a court, or a custodian under the Minnesota Uniform Transfers to Minors Act or similar law. For minors getting gifts in this Will or other transfers the person named conservator in this Will is nominated and named as custodian under the Minnesota Uniform Transfers to Minors Act or similar law, or if they fail to serve any personal representative may name a custodian. The residue includes lapsed or failed gifts, insurance paid to the estate, and property testator had a power of appointment or testamentary disposition over.

TESTATOR . .. I, the Testator, sign, publish, and declare that I sign and execute this instrument as my Last Will and Testament, that I sign it willingly as a free and voluntary act for the purposes expressed therein, and that I am at least 18 years of age and of sound mind and under no constraint or undue influence, this __ day of ________________, 20__.

________________________________ Testator

WITNESSES ... We, the undersigned, declare in our presence the foregoing instrument was willingly published, declared, and signed by the above-named Testator as his or her Last Will and Testament, that to the best of our knowledge the Testator is at least 18 years of age and of sound mind and under no constraint or undue influence, that each of us is at least 18 years old, and that in the presence and hearing of Testator and each other we hereby sign our names as witnesses.

____________________ ________________________________________Witness Address

____________________ ________________________________________Witness Address

FORM 3:SELF-PROVING AFFIDAVIT

SELF-PROVING AFFIDAVIT(Minn. Stat. s 524.2-504)

State of _____________________

County of ___________________

We, _________________________, _________________________, and _________________________, the testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as the testator's will and that the testator had signed willingly (or willingly directed another to sign for the testator), and that the testator executed it as the testator's free and voluntary act for the purposes therein expressed, and each of the witnesses, in the presence and hearing of the testator, signed the will as witness and that to the best of the witness' knowledge the testator was at the time 18 years of age or older, of sound mind, and under no constraint or undue influence.

_____________________________ Testator

_____________________________ Witness

_____________________________ Witness

Subscribed, sworn to, and acknowledged before me by _________________________, the testator, and subscribed and sworn to before me by__________________________, and _______________________, witnesses, this __ day of ________________, 20__.

(Seal) (Signed) ___________________________

____________________________________

(Official capacity of officer)

FORM 4:TANGIBLE PERSONAL PROPERTY LIST

TANGIBLE PERSONAL PROPERTY LIST ... I wish this to be a separate writing giving tangible personal property as allowed by Minnesota Statute s 524.2-513 or other law. I know property used in a trade or business, money or coin, real property, and non-tangible property cannot be given here. I give property listed below to the beneficiary named to it but only if the recipient survives me as my Will defines and if no specific gift in my Will gives the property. This writing has no effect if not found by 60 days after my death. PROPERTY ITEMS NAMES OF BENEFICIARIES _________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

_________________________________________ ___________________________

DATE: _______________ SIGNED:_______________________________

FORM 5:CODICIL

C O D I C I LI, _______________________, a resident of ___________ County, Minnesota, declare this to be a Codicil to my Will dated _______________.

FIRST: I hereby do revoke the part of my Will that reads as follows: ______________________________________________________________________________________________________________________________ ____________________________________________________________ .

SECOND: I hereby do add the following part to my Will: ______________________________________________________________________________________________________________________________ _____________________________________________________________.

THIRD: In all other respects I hereby do confirm and republish the above-described Will.

TESTATOR . . I, the Testator, sign, publish, and declare I sign and execute this instrument as my Codicil, that I sign it willingly as a free and voluntary act for the purposes expressed therein, and that I am at least 18 years of age and of sound mind and under no constraint or undue influence, this __ day of ____________, 20__.

________________________ Testator

WITNESSES .. We, the undersigned, declare in our presence the foregoing instrument was willingly published, declared, and signed by the above-named Testator as his or her Codicil, that to the best of our knowledge the Testator is at least 18 years of age and of sound mind and under no constraint or undue influence, that each of us is at least 18 years old, and that in the presence and hearing of Testator and each other we hereby sign our names as witnesses.

____________________ ________________________________________Witness Address

____________________ ________________________________________Witness Address

FORM 6:HEALTH CARE DIRECTIVE

HEALTH CARE DIRECTIVE(Minn. Stat. s 45C.16)

I,________________________________, understand this document allows me to do ONE OR BOTH of the following:

PART I: Name another person (called the health care agent) to make health care decisions for me if I am unable to decide or speak for myself. My health care agent must make health care decisions for me based on the instructions I provide in this document (Part II), if any, the wishes I have made known to him or her, or must act in my best interest if I have not made my health care wishes known. AND/OR PART II: Give health care instructions to guide others making health care decisions for me. If I have named a health care agent, these instructions are to be used by the agent. These instructions may also be used by my health care providers, others assisting with my health care and my family, in the event I cannot make decisions for myself.

PART I: APPOINTMENT OF HEALTH CARE AGENT I revoke all living wills, Durable Powers of Attorney for Health Care, or other written advance health care directives I have signed in the past. This is who I want to make health care decisions for me if I am unable to decide or speak for myself (I know I can change my agent or alternate agent at any time and I know I do not have to appoint an agent or an alternate agent.) NOTE: If you appoint an agent, you should discuss this health care directive with your agent and give your agent a copy. If you do not wish to appoint an agent, you may leave Part I blank and go to Part II.

When I am unable to decide or speak for myself, I trust and appoint ___________________ ___________ to make health care decisions for me. This person is called my health care agent. Relationship of my health care agent to me: ________________________________Telephone number of my health care agent: ________________________________Address of my health care agent: _________________________________________

(OPTIONAL) APPOINTMENT OF ALTERNATE HEALTH CARE AGENT: If my health care agent is not reasonably available, I trust and appoint __________________ ________________________ to be my health care agent instead.Relationship of my health care agent to me: ________________________________ Telephone number of my health care agent: ________________________________ Address of my health care agent:: ________________________________________

THIS IS WHAT I WANT MY HEALTH CARE AGENT TO BE ABLE TO DO IF I AM UNABLE TO DECIDE OR SPEAK FOR MYSELF

(I know I can change these choices) My health care agent is automatically given the powers listed below in (A) through (D). My health care agent must follow my health care instructions in this document or any other instructions I have given to my agent. If I have not given health care instructions, then my agent must act in my best interest.

Whenever I am unable to decide or speak for myself, my health care agent has the power to: (A) Make any health care decision for me. This includes the power to give, refuse, or withdraw consent to any care, treatment, service, or procedures. This includes deciding whether to stop or not start health care that is keeping me or might keep me alive, and deciding about intrusive mental health treatment. (B) Choose my health care providers. (C) Choose where I live and receive care and support when those choices relate to my health care needs. (D) Review my medical records and have the same rights that I would have to give my medical records to other people. If I DO NOT want my health care agent to have a power listed above in (A) through (D) OR if I want to LIMIT any power in (A) through (D), I MUST say that here: ____________________________________________________________________________ _____________________________________________________________________________________________________________________________________________

My health care agent is NOT automatically given the powers listed below in (1) through (4). If I WANT my agent to have any of these powers I must INITIAL the line in front of the power then my agent WILL HAVE that power. _____ (1) To decide whether to donate any parts of my body, including organs, tissues, and eyes, when I die. _____ (2) To decide what will happen with my body when I die (burial, cremation). _____ (3) If I am pregnant determine whether to continue the pregnancy to delivery based on my agent's understanding of my values, preferences and instructions._____ (4) Continue as my health care agent even if a divorce of our marriage or domestic partnership is in process or completed

If I want to say anything more about my health care agent's powers or limits on the powers, I can say it here: _______________________________________________________ ____________________________________________________________________________ __________________________________________________________________

PART II: HEALTH CARE INSTRUCTIONSNOTE: Complete this Part II if you wish to give health care instructions. If you appointed an agent in Part I, completing this Part II is optional but would be very helpful to your agent. However, if you chose not to appoint an agent in Part I, you MUST complete some or all of this Part II if you wish to make a valid health care directive. These are instructions for my health care when I am unable to decide or speak for myself. These instructions must be followed (so long as they address my needs). THESE ARE MY BELIEFS AND VALUES ABOUT MY HEALTH CARE. I want you to know these things about me to help you make decisions about my health care: My goals for my health care: ____________________________________________________ _____________________________________________________________________________

_________________________________________________________________

My fears about my health care: __________________________________________________ ______________________________________________________________________________________________________________________________________________My spiritual or religious beliefs and traditions: ______________________________________ ______________________________________________________________________________________________________________________________________________My beliefs about when life would be no longer worth living: ___________________________ ______________________________________________________________________________________________________________________________________________My thoughts about how my medical condition might affect my family: ___________________ ______________________________________________________________________________________________________________________________________________(For a woman of childbearing age) My thoughts about how my health care should be handled in the event I am pregnant: ______________________________________________________ ___________________________________________________________________

THIS IS WHAT I WANT AND DO NOT WANT FOR MY HEALTH CARE (I know I can change these choices or leave any of them blank) Many medical treatments may be used to try to improve my medical condition or to prolong my life. Examples include artificial breathing by a machine connected to a tube in the lungs, artificial feeding or fluids through tubes, attempts to start a stopped heart, surgeries, dialysis, antibiotics, and blood transfusions. Most medical treatments can be tried for a while and then stopped if they do not help. I have these views about my health care in these situations:

(NOTE: You can discuss general feelings, specific treatments or leave any of them blank) If I had a reasonable chance of recovery, and were temporarily unable to decide or speak for myself, I would want: _______________________________________________________ _______________________________________________________________________________________________________________________________________________ If I were dying and unable to decide or speak for myself, I would want: ________________ _______________________________________________________________________________________________________________________________________________ If I were permanently unconscious and unable to decide or speak for myself, I would want: ____________________________________________________________________________ _______________________________________________________________________________________________________________________________________________ If I were completely dependent on others for my care and unable to decide or speak for myself, I would want: _________________________________________________________ _______________________________________________________________________________________________________________________________________________ In all circumstances, my doctors will try to keep me comfortable and reduce my pain. This is how I feel about pain relief if it would affect my alertness or if it could shorten my life: ____________________________________________________________________________ ___________________________________________________________________

There are other things that I want or don’t want for my health care, if possible: Who I would like to be my doctor: _____________________________________________ ________________________________________________________________________________________________________________________________________________________ Where I would like to live to receive health care: __________________________________ _______________________________________________________________________________________________________________________________________________ Where I would like to die and other wishes I have about dying: ______________________ ___________________________________________________________________ My wishes about donating parts of my body when I die: ____________________________ _______________________________________________________________________________________________________________________________________________ My wishes about what happens to my body when I die (cremation, burial): _____________ _______________________________________________________________________________________________________________________________________________ Any other things: ___________________________________________________________ ____________________________________________________________________________ ___________________________________________________________________

PART III: MAKING THE DOCUMENT LEGAL This document must be signed by me. It also must either be verified by a notary public (Option 1) OR witnessed by two witnesses (Option 2). It must be dated when it is verified or witnessed. I am thinking clearly, I agree with everything that is written in this document, and I have made this document willingly.

My Signature _____________________________________ Date signed: _______________________ Date of birth: _______________________ Address: _______________________________________________________

If I cannot sign my name, I can ask someone to sign this document for me. _____________________________________ Signature of the person who I asked to sign this document for me. _____________________________________ Printed name of the person who I asked to sign this document for me.

Option 1: Notary Public

This document was signed or acknowledged before me this ___ day of ________________, 20__ by the above-named principal. I am not named as a health care agent or alternate health care agent in this document. Subscribed and sworn to before me this __ day of ___________________, 20___.

______________________________

Option 2: Two Witnesses Two witnesses must sign. Only one of the two witnesses can be a health care provider or an employee of a health care provider giving direct care to me on the day I sign this document.

Witness One: (i) In my presence on __________________ (date), _________________________ (name) acknowledged his/her signature on this document or acknowledged that he/she authorized the person signing this document to sign on his/her behalf. (ii) I am at least 18 years of age. (iii) I am not named as a health care agent or an alternate health care agent in this document. (iv) If I am a health care provider or an employee of a health care provider giving direct care to the person listed above in (A), I must initial this box: [ ]

I certify that the information in (i) through (iv) is true and correct.

_______________________ __________________________________________________(Signature of Witness One) (Address)

Witness Two: (i) In my presence on __________________ (date), _________________________ (name) acknowledged his/her signature on this document or acknowledged that he/she authorized the person signing this document to sign on his/her behalf. (ii) I am at least 18 years of age. (iii) I am not named as a health care agent or an alternate health care agent in this document. (iv) If I am a health care provider or an employee of a health care provider giving direct care to the person listed above in (A), I must initial this box: [ ]

I certify that the information in (i) through (iv) is true and correct.

_______________________ __________________________________________________(Signature of Witness Two) (Address)

REMINDER: Keep this document with your personal papers in a safe place (not in a safe deposit box). Give signed copies to your doctors, family, close friends, health care agent, and alternate health care agent. Make sure your doctor is willing to follow your wishes. This document should be part of your medical record at your physician's office and at the hospital, home care agency, hospice, or nursing facility where you receive your care.

FORM 7:P.O.L.S.T. (DO NOT RESUSCITATE)

FORM 8:STATUTORY SHORT FORM POWER OF ATTORNEY

STATUTORY SHORT FORM POWER OF ATTORNEYMINNESOTA STATUTES, SECTION 523.23 .

Before completing and signing this form, the principal must read and initial the IMPORTANT NOTICE TO 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 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(Name and Address) (Optional) To act if any named attorney-in-fact

dies, resigns, or is otherwise unable to serve._________________________________ (Name and Address)_________________________________ First Successor

_________________________________ _________________________________ __________________________________________________________________ Second Successor

__________________________________________________________________

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 statements:

______ Each attorney-in-fact may independently exercise the powers granted.

______ All attorneys-in-fact EXPIRATION DATE (Optional)must jointly exercise the _____________________________________powers granted. Use Specific Month Day Year Only

I, (the above-named Principal) hereby appoint the above named Attorney(s)-in-Fact to act as my attorney(s)-in-fact:

FIRST: To act for me in any way that I could act with respect to the following matters, as each of them is defined in Minnesota Statutes, section 523.24:

(To grant to the attorney-in-fact any of the following powers, make a check or "x" on the line in front of each power being granted. You may, but need not, cross out each power not granted. Failure to make a check or "x" on the line in front of the power will have the effect of deleting the power unless the line in front of the power of (N) is checked or x-ed.)_____ (A) real property transactions;

I choose to limit this power to real property in __________County, Minnesota, described as follows:

(Use legal description. Do not use street address.)_______________________________________________________________________________________________________________________________________(If more space is needed, continue on the back or on an attachment.)

_____ (B) tangible personal property transactions;_____ (C) bond, share, and commodity transactions;_____ (D) banking transactions;_____ (E) business operating transactions;_____ (F) insurance transactions;_____ (G) beneficiary transactions;_____ (H) gift transactions;_____ (I) fiduciary transactions;_____ (J) claims and litigation;_____ (K) family maintenance_____ (L) benefits from military service;_____ (M) records, reports, and statements;_____ (N) all of the powers listed in (A) through (M) above and all other matters, other than health

care decisions under a health care directive that complies with Minnesota Statutes, chapter 145C.

SECOND: (You must indicate below whether or not this power of attorney will be effective if you become incapacitated or incompetent. Make a check or "x" on the line in front of the statement that expresses your intent.)

_____ This power of attorney shall continue to be effective if I become incapacitated or incompetent.

_____ This power of attorney shall not be effective if I become incapacitated or incompetent.

THIRD: My attorney(s)-in-fact MAY NOT make gifts to the attorney(s)-in-fact, or anyone the attorney(s)-in-fact are legally obligated to support, UNLESS I have made a check or an "x" on the line in front of the second statement below and I have written in the name(s) of the attorney(s)-in-fact. The second option allows you to limit the gifting power to only the attorney(s)-in-fact you name in the statement.

Minnesota Statutes, section 523.24, subdivision 8, clause (2), limits the annual gift(s) made to my attorney(s)-in-fact, or to anyone the attorney(s)-in-fact are legally obligated to support, to an amount, in the aggregate, that does not exceed the federal annual gift tax exclusion amount in the year of the gift.

_____ I do not authorize any of my attorney(s)-in-fact to make gifts to themselves or to anyone the attorney(s)-in-fact have a legal obligation to support.

_____ I authorize ______________________________________________(write in name(s)), as my attorney(s)-in-fact, to make gifts to themselves or to anyone the attorney(s)-in-fact have a legal obligation to support.

FOURTH: (You may indicate below whether or not the attorney-in-fact is required to make an accounting. Make a check or "x" on the line in front of the statement that expresses your intent.)

My attorney-in-fact need not render an accounting unless I request it or the accounting is otherwise required by Minnesota Statutes, section 523.21.

My attorney-in-fact must render ________________________________ (Monthly, Quarterly, Annual)accountings to me or __________________________________________ (Name and Address)during my lifetime, and a final accounting to the personal representative of my estate, if any is appointed, after my death.

In Witness Whereof I have hereunto signed my name this __ day of __________________, 20__,

_________________________ (Signature of Principal)

(Acknowledgment of Principal)

STATE OF MINNESOTA ) ) ss.

COUNTY OF _________________ )

The foregoing instrument was acknowledged before me this ___ day of __________________, 20__,by _______________________________ (Insert Name of Principal)

____________________________ (Signature of Notary Public or other Official)

Acknowledgment of notice to attorney(s)-in-fact and specimen signature of attorney(s)-in-fact.

By signing below, I acknowledge I have read and understand the IMPORTANT NOTICE TO ATTORNEY(S)-IN-FACT required by Minnesota Statutes, section 523.23, and understand and accept the scope of any limitations to the powers and duties delegated to me by this instrument.

(Notarization not required)______________________________________

Specimen Signature of Attorney(s)-in-Fact

(Notarization not required)________________________________________________________________________

This instrument was drafted by: ____________________________________________________________________________________________________________

IMPORTANT NOTICE TO THE PRINCIPALREAD THIS NOTICE CAREFULLY. The power of attorney form that you will be signing is a legal document. It is governed by Minnesota Statutes, chapter 523. If there is anything about this form that you do not understand, you should seek legal advice.

PURPOSE: The purpose of the power of attorney is for you, the principal, to give broad and sweeping powers to your attorney(s)-in-fact, who is the person you designate to handle your affairs. Any action taken by your attorney(s)-in-fact pursuant to the powers you designate in this power of attorney form binds you, your heirs and assigns, and the representative of your estate in the same manner as though you took the action yourself.

POWERS GIVEN: You will be granting the attorney(s)-in-fact power to enter into transactions relating to any of your real or personal property, even without your consent or any advance notice to you. The powers granted to the attorney(s)-in-fact are broad and not supervised. THIS POWER OF ATTORNEY DOES NOT GRANT ANY POWERS TO MAKE HEALTH CARE DECISIONS FOR YOU. TO GIVE SOMEONE THOSE POWERS, YOU MUST USE A HEALTH CARE DIRECTIVE THAT COMPLIES WITH MINNESOTA STATUTES, CHAPTER 145C.

DUTIES OF YOUR ATTORNEY(S)-IN-FACT: Your attorney(s)-in-fact must keep complete records of all transactions entered into on your behalf. You may request that your attorney(s)-in-fact provide you or someone else that you designate a periodic accounting, which is a written statement that gives reasonable notice of all transactions entered into on your behalf. Your attorney(s)-in-fact must also render an accounting if the attorney-in-fact reimburses himself or herself for any expenditure they made on behalf of you.

An attorney-in-fact is personally liable to any person, including you, who is injured by an action taken by an attorney-in-fact in bad faith under the power of attorney or by an attorney-in-fact's failure to account when the attorney-in-fact has a duty to account under this section. The attorney(s)-in-fact must act with your interests utmost in mind.

TERMINATION: If you choose, your attorney(s)-in-fact may exercise these powers throughout your lifetime, both before and after you become incapacitated. However, a court can take away the powers of your attorney(s)-in-fact because of improper acts. You may also revoke this power of attorney if you wish. This power of attorney is automatically terminated if the power is granted to your spouse and proceedings are commenced for dissolution, legal separation, or annulment of your marriage.

This power of attorney authorizes, but does not require, the attorney(s)-in-fact to act for you. You are not required to sign this power of attorney, but it will not take effect without your signature. You should not sign this power of attorney if you do not understand everything in it, and what your attorney(s)-in-fact will be able to do if you do sign it.

Please place your initials on the following line indicating you have read this IMPORTANT NOTICE TO THE PRINCIPAL: ____________

IMPORTANT NOTICE TO THE ATTORNEY(S)-IN-FACT

You have been nominated by the principal to act as an attorney-in-fact. You are under no duty to exercise the authority granted by the power of attorney. However, when you do exercise any power conferred by the power of attorney, you must:

(1) act with the interests of the principal utmost in mind;

(2) exercise the power in the same manner as an ordinarily prudent person of discretion and intelligence would exercise in the management of the person's own affairs;

(3) render accountings as directed by the principal or whenever you reimburse yourself for expenditures made on behalf of the principal;

(4) act in good faith for the best interest of the principal, using due care, competence, and diligence;

(5) cease acting on behalf of the principal if you learn of any event that terminates this power of attorney or terminates your authority under this power of attorney, such as revocation by the principal of the power of attorney, the death of the principal, or the commencement of proceedings for dissolution, separation, or annulment of your marriage to the principal;

(6) disclose your identity as an attorney-in-fact whenever you act for the principal by signing in substantially the following manner:

Signature by a person as "attorney-in-fact for (name of the principal)" or "(name of the principal) by (name of the attorney-in-fact) the principal's attorney-in-fact";

(7) acknowledge you have read and understood this IMPORTANT NOTICE TO THE ATTORNEY(S)-IN-FACT by signing the power of attorney form.

You are personally liable to any person, including the principal, who is injured by an action taken by you in bad faith under the power of attorney or by your failure to account when the duty to account has arisen.

The meaning of the powers granted to you is contained in Minnesota Statutes, chapter 523. If there is anything about this document or your duties that you do not understand, you should seek legal advice.

FORM 9:POWER OF ATTORNEY OVER CHILD

POWER OF ATTORNEY OVER CHILD. 1. I, _________________________ am the parent of ____________________________, born ______________________, and I meet requirements to make the grants of power and authority contained herein and under Minn. Stat. § 524.5-211.

2. I hereby name and appoint _______________________________ residing at ______________________________________________________, to be my true and lawful Attorney-in-Fact for me and in my name and place for the above-named child and to have the power and authority to do anything and all I could do if personally present, including for all care, custody, and property of the child.

3. Without limiting any grant of power and authority I specifically grant and give the above-named Attorney-in-Fact full power and authority in matters involving the child and: a) schooling including choice of schools and enrollment, classes, and all activities; b) money, property, benefits, or insurance owned by or involving the above-named child; c) custody and care including housing, control of schedule, and discipline; and d) health care including permission and consent to medical and/or dental care without delay and without contacting anyone but the Attorney-in-Fact, access and review of medical and personal records, transport including an ambulance, admission to any hospital or other facility, use of drugs and medications including anesthesia, surgery, and any other minor or major care.

4. This document is effective when signed and is valid for a period of _________________ (up to one year) following the date of my signature.

I hereby grant my Attorney-in-Fact full power and authority to execute all instruments, and power and authority to do every act and thing necessary or helpful in exercising any of the powers given under this Power of Attorney, but no power over marriage or adoption is given.

Revocation is not effective until parties get actual notice, copies of this document may be relied upon, and I agree to indemnify any party for claims related to reliance on this document.

I understand I am obligated by Minn. Stat. § 524.5-211 to mail or give a copy of this document to any other parent within 30 days of its execution under certain circumstances.

IN TESTIMONY WHEREOF, I have hereunto set my hand this ___ day of _________________, 20___.

__________________________________Signature of Parent

Subscribed and sworn to before me this ____ day of _____________, 20___.

Notary Public ________________________

I hereby accept the foregoing Power Of Attorney Over Child for the child named ___________________________ . Signature of Attorney-in-Fact _____________________________

FORM 10:STANDBY GUARDIAN

STANDBY GUARDIAN(Minn. Stat. s 257B.04) …

I ___________________________________ (insert name of designator) do hereby appoint _____________________________________________________________ (insert name, address, and telephone number of standby or temporary custodian) as the standby or temporary custodian of ____________________________________ (insert names of children) to take effect upon the occurrence of the following triggering event or events: ______________________________________________ __________________________________ (insert specific triggering events).

I am the ___________________ (insert designator's relationship to children) of ___________________________________________________________________(insert names of children).

_____________________________ (insert name of child’s other parent) is the other parent of ____________________________________________________________(insert names of children). The other parent's address is: ______________________ ________________________________________________________.

(check all that apply):___The other parent died on ________________ (insert date of death).___The other parent's parental rights were terminated on (insert date).___The other parent's whereabouts are unknown. I understand that all living parents whose rights have not been terminated must be given notice of this designation pursuant to the Minnesota Rules of Civil Procedure or a petition to approve this designation may not be granted by the court.___The other parent is unwilling and unable to make and carry out day-to-day child-care decisions concerning the children.___The other parent consents to this designation and signs this form below.

By this designation I am granting __________________________________ (insert name of standby or temporary custodian) the authority to act for 30 days following the occurrence of the triggering event as a co-custodian with me, or in the event of my death, as custodian of my children.

A temporary custodian appointment ends upon the death of the designator.

(Optional) I hereby nominate ____________________________________________ ______________________________________________ (insert name, address, and telephone number of alternate standby custodian) as the alternate standby custodian to assume the duties of the standby custodian named above if the standby custodian is unable or unwilling to act as a standby custodian.

If I have indicated more than one triggering event, it is my intent that the triggering event which occurs first shall take precedence. If I have indicated "my death" as the triggering event, it is my intent that the person named in the designation to be standby custodian for my children in the event of my death shall be appointed as guardian of my children under Minnesota Statutes, sections 524.5-201 to 524.5-317, upon my death.

It is my intention to retain full parental rights to the extent consistent with my condition and to retain the authority to revoke the appointment of a standby or temporary custodian if I so choose.

This designation is made after careful reflection, while I am of sound mind.

__________________ _______________________________(Date) Designator's Signature)______________________________ _______________________________ (Witness' Signature) (Witness' Signature)______________________________ _______________________________ (Address) (Address)

IF APPLICABLE: I _____________________________________ (insert name of other parent) hereby consent to this designation._________________ _____________________________________(Date) (Signature of Other Parent)___________________________________________________________________ (Address of other parent)

I, ___________________________________ (insert name of standby or temporary custodian), hereby accept my nomination as standby or temporary custodian of ______________________________________________ (insert children's names). I understand that my rights and responsibilities toward the children named above will become effective upon the occurrence of the above-stated triggering event or events. I further understand that in order to continue caring for the children, I must file a petition with the court within 30 days of the occurrence of the triggering event._________________ _____________________________________(Date) (Signature of Standby or Temporary Custodian)

FORM 11:FINAL WISHES

FINAL WISHES..I, ______________________________ (name of person making this document) as allowed by law including Minn. Stat. s 149A.80, do hereby order the following be done involving my body and its final disposition and all related things.

1. Final place and details for handling, preparing, and moving body:______________________ _____________________________________________________________________________________________________________________________________________________

2. Funeral, burial,wake, visitation, viewing, religious ceremony, and other proceedings: _____________________________________________________________________________ _________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 3. Other related matters (like readings or things to discuss, persons to use, songs, foods, items to purchase, embalming, casket or containers, decorations, tombstones, or other): ____________________________________________________________________________ _________________________________________________________________________________________________________________________________________________________________________________________________________________________________

4. Attorneys, accountants, friends and others to inform of death:________________________ _________________________________________________________________________

DESIGNATION OF PERSON (OPTIONAL)In accord with Minnesota Statute s 149A.80, I designate the following person to have the right to control my body after death as well as its final disposition, rather than the family member designated by Minnesota law. I understand whoever has this right must follow any valid orders about my body and its final disposition I have given. (Name and contact information for this person): ____________________________________________________________________________

SIGNATURE OF PERSON DOING FORMSIGNED:____________________________ DATED:___________________

SIGNATURE OF WITNESSESStatement: I personally witnessed signing of this document by the above-named person, and I certify that I am not the person named to control the body after death and its final disposition.Witness: ___________________________ Witness: _____________________________