AFFIDAVIT OF PRINCIPAL THAT POWER OF ATTORNEY REMAINS IN FULL FORCE
STATE OF _____________________
COUNTY OF ___________________
PERSONALLY appeared before me,_____________________________, hereinafter “Principal”, who being duly sworn by me states upon his or her oath and personal knowledge the following:
- Principal resides in ______________ County. The Principal signed a written Power of Attorney on ____________________, 20___ , appointing _______________________ as his/her attorney-in-fact, hereinafter “Agent”. (A true copy of the power of attorney is attached hereto and incorporated herein.)
2. As Principal I hereby certify that the Power of Attorney referenced above remains in full force and has not been revoked, amended or cancelled by me, or by operation of law.
- Since the date of execution of the Power of Attorney, all actions of my Agent pursuant to the power of attorney are fully recognized by me as binding.
- My Agent remains empowered to act pursuant to the power of attorney and said agent has not been removed as my attorney-in-fact.
DATED this the ____ day of ___________, 20___ .
Principal
____________________________________
___________________________________
____________________
Witness
Print Name: ________________________
__________________________________
Witness
Print Name: ________________________
Sworn to and subscribed before me on this the ____ day of ___________, 20__ .
_____________________________
Notary Public
My Commission Expires:________________________
State Specific Power of Attorney Forms
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