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2017 Utah Code
Title 75 - Utah Uniform Probate Code
Chapter 9 - Uniform Power of Attorney Act
Part 3 - Statutory Forms
Section 302 - Agent's certification.
Universal Citation: UT Code § 75-9-302 (2017)
Effective 5/10/2016
75-9-302. 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:
Enacted by Chapter 256, 2016 General Session
75-9-302. 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;
- (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:
_________________________________________________________________
Enacted by Chapter 256, 2016 General Session
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