457.430 Agent’s certification.

218 words·~1 min read·/ky/chapter-457/457-430

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

The following optional form may be used by an agent to certify facts concerning a power of attorney:

AGENT’S CERTIFICATION AS TO THE VALIDITY OF POWER OF ATTORNEY

AND AGENT’S AUTHORITY State of _____________________________ County of ___________________________ I, _____________________________________________(Name of Agent), certify under penalty of perjury that __________________________________________(Name of Principal) granted me authority as an agent or successor agent in a power of attorney dated ________________________. I further certify that to my knowledge:

(1)The Principal is alive and has not revoked the Power of Attorney or my authority to

act under the Power of Attorney and the Power of Attorney and my authority to act

under the Power of Attorney have not terminated;

(2)If the Power of Attorney was drafted to become effective upon the happening of an

event or contingency, the event or contingency has occurred;

(3)If I was named as a successor agent, the prior agent is no longer able or willing to

serve; and (4)_____________________________________________________________________

___________________________________________________________________

_______________________________________________________-------------___

(Insert other relevant statements)

SIGNATURE AND ACKNOWLEDGMENT

___________________________________________ _______________ Agent’s Signature Date

____________________________________________ Agent’s Name Printed

____________________________________________

____________________________________________ Agent’s Address

____________________________________________ Agent’s Telephone Number This document was acknowledged before me on __________________________,

(Date)by______________________________________.

(Name of Agent)

____________________________________________ (Seal, if any) Signature of Notary My commission expires: ________________________ This document prepared by:

_________________________________________________________________