2012 Connecticut General Statutes
Title 45a - Probate Courts and Procedure
Chapter 802h - Protected Persons and Their Property
Section 45a-624c - Written statement that designation of standby guardian in full force and effect.

The written statement referred to in section 45a-624 shall be in substantially the following form:

STATEMENT THAT DESIGNATION OF A STANDBY GUARDIAN
IS IN FULL FORCE AND EFFECT

STATE OF	}
	}   SS:
COUNTY OF	}

I, .... of ...., state under penalty of false statement:

THAT ...., of ...., as principal, did on ...., 20.., appoint me as standby guardian dated ...., 20.., to execute a statement that a specified contingency had occurred;

THAT specified contingency was: ....

THAT specified contingency has occurred.

IN WITNESS WHEREOF, I have hereunto set my hand and seal under penalty of false statement.

….
Witness
….	…. L.S.
Witness

(P.A. 94-207, S. 3; P.A. 99-84, S. 26.)

History: P.A. 99-84 substituted “statement” for “affidavit” and added “under penalty of false statement” and deleted the attestation clause for Commissioners of the Superior Court and Notaries Public; (Revisor’s note: In 2001 the references in this section to the date “19..” were changed editorially by the Revisors to “20..” to reflect the new millennium).