§58-3042. Agent's certification.

234 words·~1 min read·/ok/title-58-probate-procedure/58-3042·

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: _________________________________________ Added by Laws 2021, c. 332, § 42, eff. Nov. 1, 2021.