Ratification of Power of Attorney Form
STATE OF _________________
COUNTY OF ________________
_____________________, having been sworn or affirmed to tell the truth, states:
WHEREAS, on ____________, ___________________ executed a power of attorney naming myself as their attorney in fact, and,
WHEREAS, on _______________ I began to act under that power, and,
WHEREAS, ________________ is requesting verification that the power is still in force and effect,
________________________, having personal knowledge of the facts and circumstances herein, certify that the power of attorney referred to herein is still in full force and effect and that I am not aware of any event which would result in the power of attorney lapsing having taken effect.
Sworn to and subscribed before me on ___________________, 199___.
My Commission Expires: