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.

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;

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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

(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: ________________________

This document prepared by:

_________________________________________________________________

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