Missouri Limited (Special) Power of Attorney Form

The Missouri limited (special) power of attorney form is used when transferring the personal authority of an individual, the “Principal”, to an Attorney-In-Fact, in order to delegate specific responsibilities or duties which the Principal may be unable to perform. Unlike a general POA form, the limited (special) form may contain instructions detailing what shall be done in the event of financial issues or the absence (military leave, travel, incarceration) of the Principal. An Attorney-In-Fact shall execute the powers as described in the Principal’s instructions, doing so in good faith and in compliance with sections 404.712 and 404.714 of the Missouri Revised Statutes.

How to Write

Step 1 – Download the Document  – The Principal shall read all of the following Titled Sections before they proceed:

  • Notice
  • Incapacitation
  • Revocation
  • Witness and Notary
  • Terms and Conditions
  • Third Parties
  • Compensation
  • Disclosure

Step 2 – Enter the Principal’s Information –

  • Name the Principal
  • Principal’s Address
  • City
  • State
  • AND
  • Agent’s name
  • Agent’s physical Address
  • City
  • State
  • AND
  • The name of any Successor Agent
  • Successor’s Physical Address
  • City
  • State

Step 3 – Signatures – Must be reserved to be signed before a state licensed Notary Public:

  • Provide the Principal’s Signature
  • Date pf the Principal’s signature in dd/mm/yyyy format
  • AND
  • Agent’s Printed Name
  • Enter the Agent’s Signature
  • Date of the Agent’s signature in mm/dd/yyyy format
  • AND
  • Alternate/Successor Agent’s Printed Name
  • Enter the Alternate Successor’s Signature
  • Date of the Successor’s signature in mm/dd/yyyy format

Step 4 – Notarization –

Once the Notary will witness all signatures. The notary will then enter all of the requirements to acknowledge the document, also affixing the official seal.

Step 5 – Acknowledgement and Acceptance of Agents – Agent’s must review the acknowledgements– Provide the following:

  • Printed name of the Agent(s)
  • Agent (s) signatures(s)
  • Date(s) of signatures in mm/dd/yyyy format
  • AND

The Witnesses must review the Witness Attestation statements (respectively) – Then submit the following:

  • Printed names of the Witnesses
  • Signatures of the Witnesses