Colorado § 15-14-742 Certification

Colorado Statutes

§ 15-14-742 — Certification

Colorado·Title 15 Probate,·Art. Persons Under Disability - Protection

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 t

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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 signature Date

_______________________

Agent's name printed

_______________________

Agent's address