§ 3-9-302 — Agent's certification

Wyoming § 3-9-302

• Jurisdiction: Wyoming
• Title 03: Guardian and Ward
• Ch. 9: UNIFORM POWER OF ATTORNEY ACT
• Art. 3: STATUTORY FORMS

Text

(a) 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 (Date).
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: