2022 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 (2022)
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:
  • (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
Disclaimer: These codes may not be the most recent version. Utah may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.