Colorado Revised Statutes Title 15. Probate, Trusts, and Fiduciaries § 15-14-742. 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;

(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

________________________________________

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:

______________________________________________________________________________


FindLaw Codes are provided courtesy of Thomson Reuters Westlaw, the industry-leading online legal research system. For more detailed codes research information, including annotations and citations, please visit Westlaw.

FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.