Affidavit Of Principal'S Competence At Time Of Granting Power Of Attorney

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AFFIDAVIT OF PRINCIPAL’S COMPETENCE
AT TIME OF GRANTING POWER OF ATTORNEY
Affiant Name
______________________________
Affiant Address
______________________________
______________________________
I, Affiant, being first duly sworn, under penalty of perjury, and upon personal knowledge of the facts
and circumstances recited herein, declare that the following statements are true:
1. I am personally aware of the Power of Attorney dated __________, signed by
___________________, Principal, appointing ____________________ as agent and attorney in fact.
2. Based on my personal observations, I state with certainty that the Principal was alive and present
on the signing date.
3. Based on my personal observations, to the best of my knowledge and belief, the Principal was
under no mental disability or impairment, and was of sound mind, with adequate understanding,
reasoning, decision making ability, and awareness of the purpose and desired results of the
Power of Attorney, and approved the choice of the agent and attorney in fact.
Affiant Signature
______________________________
Date _______________
State of _______________
County of _______________
Subscribed and sworn to, or affirmed, before me this _____ day of _______________, 20____,
by Affiant ______________________________.
(Notary Seal)
_________________________
_____________________
Notary Public Signature
My commission expires:

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