North Dakota Limited (Special) Power of Attorney Form

The North Dakota limited (special) power of attorney form is used to permit someone the authority to handle specific responsibilities for an individual while they are away on business, travel, or when otherwise incapable of such. The person to whom authority is permitted is referred to as the “Agent”; an Agent acting on someone else’s behalf will be able to operate within the guidelines established in the form only. Therefore, the Agent’s authority is limited and may be terminated after a certain length of time or once a specific tasks has been accomplished. Each limited (special) power of attorney form must be signed by the Principal in front of a Notary Public.

How to Write

Step 1 – Download the Document  – The Principal should read the following:

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

Step 2 – Principal and Agent(s) Information  –

  • Principal’s Name
  • Principal’s Address
  • City
  • State
  • AND
  • Agent’s name
  • Agent’s Address
  • City
  • State
  • AND
  • Provide the name of the Successor Agent (Optional)
  • Successor Agent’s Address
  • City
  • State

Step 3 – Signatures – All parties must sign before a Notary Public:

  • The Principal’s printed name
  • The date the Principal’s signature in dd/mm/yyyy format
  • AND
  • Agent’s printed name
  • Enter the Agent’s Signature
  • Date the Agent’s signature in mm/dd/yyyy format
  • AND
  • Successor Agent’s printed name
  • Successor Agent’s signature
  • Date the Successor’s signature in mm/dd/yyyy format

Step 4 – Notarization –

Once the Notary witnesses 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 Agents
  • Agent’s respective signatures
  • Dates of signatures in mm/dd/yyyy format
  • AND

The Witnesses must first review the Witness Attestation and enter the following:

  • Printed names of the Witnesses
  • Signatures of the Witnesses