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Montana Code Annotated 2011, Statutory Form Power of Attorney §72-31-353 Montana Statutory Form Power of Attorney 1 of 3 DESIGNATION OF AGENT I (Name of Principal) name the following person as my agent: Name of Agent: Agent’s Address: Agent’s Telephone Number: DESIGNATION OF SUCCESSOR AGENT(S) (OPTIONAL) If my agent is unable or unwilling to act for me, I name as my successor agent: Name of Successor Agent: Successor Agent’s Address: Successor Agent’s Telephone Number: If my successor agent is unable or unwilling to act for me, I name as my second successor agent: Name of Second Successor Agent: Second Successor Agent’s Address: Second Successor Agent’s Telephone Number: GRANT OF GENERAL AUTHORITY I grant my agent and any successor agent general authority to act for me with respect to the following subjects as defined in the Uniform Power of Attorney Act, Title 72, chapter 31, part 3: INITIAL each subject you want to include in the agent s general authority..