Utah Code 75A-2-302. Agent’s certification
The following optional form may be used by an agent to certify facts concerning a power of attorney.
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:
Terms Used In Utah Code 75A-2-302
- Agent: includes an original agent, coagent, successor agent, and person to which an agent's authority is delegated. See Utah Code 75A-2-102
- Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
- Power of attorney: means a writing or other record that grants authority to an agent to act in the place of the principal, whether or not the term power of attorney is used. See Utah Code 75A-2-102
- Principal: means an individual who grants authority to an agent in a power of attorney. See Utah Code 75A-2-102
(Insert other relevant statements)
____________________________________________ __________
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:
_________________________________________________________________