West Virginia Code Chapter 39B. Uniform Power of Attorney Act § 39B-3-102. Agent's certification
Current as of January 01, 2020 | Updated by FindLaw Staff
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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
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___________________________________________________________________________________________________ |
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___________________________________________________________________________________________________ |
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___________________________________________________________________________________________________ |
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(Insert other relevant statements) |
SIGNATURE AND ACKNOWLEDGMENT
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___________________________________________________________________________________________________ |
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Agent's Signature |
Date |
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Agent's Name Printed_______________________________________________________________________________ |
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Agent's Address____________________________________________________________________________________ |
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Agent's Telephone Number___________________________________________________________________________ |
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This document was acknowledged before me on |
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_______________, |
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(Date)
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by ____________________________________________________________________. |
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(Name of Agent)
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____________________________________________________________(Seal, if any) |
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Signature of Notary |
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My commission expires:_____________________________________________________________________________ |
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[This document prepared by:_______________________________________________________________________] |
Cite this article: FindLaw.com - West Virginia Code Chapter 39B. Uniform Power of Attorney Act § 39B-3-102. Agent's certification - last updated January 01, 2020 | https://codes.findlaw.com/wv/chapter-39b-uniform-power-of-attorney-act/wv-code-sect-39b-3-102.html
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