Affidavit That Power Of Attorney Is In Full Force

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AFFIDAVIT THAT POWER OF ATTORNEY IS IN FULL FORCE
STATE OF NEW YORK
)
COUNTY OF
)
ss:
, being duly sworn, deposes and says:
1. That
, as principal did, in writing, appoint me [his/her] true and lawful
attorney(s)-in-fact, and that annexed hereto is said power of attorney.
2. That, as attorney-in-fact of said principal and under and by virtue of the said power of
attorney, I have this day executed the following described instrument(s):
3. That the said principal is now alive and has not, at any time revoked or repudiated the
said power of attorney; and that I have no actual knowledge or actual notice of
revocation or termination of the aforesaid power of attorney by death of said principal or
otherwise, or notice of any facts indicating the same; and that the said power of attorney
still is in full force and effect.
4. That I make this affidavit to induce
to accept delivery of the above-described
instrument(s), as executed by me in my capacity as the attorney-in-fact, with the full
knowledge that they will rely upon the truthfulness of this affidavit in accepting my
execution and delivery of the above-mentioned instrument(s) and in paying a good and
valuable consideration therefore.
____________________________________
Sworn to before me this
day of
,
.
____________________________________
Notary Public

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