Ratification of Power of Attorney
STATE OF _________________ COUNTY OF ________________
_____________________, having been sworn or affirmed to tell the truth, states: WHEREAS, on ____________, ___________________ executed a power of attorney naming myself as their attorney in fact, and, WHEREAS, on _______________ I began to act under that power, and, WHEREAS, ________________ is requesting verification that the power is still in force and effect, ________________________, having personal knowledge of the facts and circumstances herein, certify that the power of attorney referred to herein is still in full force and effect and that I am not aware of any event which would result in the power of attorney lapsing having taken effect. Dated: ________________________________________
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Sworn to and subscribed before me on ___________________, 199___.
_______________________________________________________ Notary Public My Commission Expires: