BANK OF AMERICA, N.A. (THE “BANK”)
Affidavit and Indemnity Agreement
By Attorney in Fact
The undersigned, being first duly sworn, deposes and says that:
I am the Attorney-In-Fact for (the “Principal”),
and I am acting in good faith under the Power of Attorney pursuant to the authority given to me as Attorney-In-Fact. A true and accurate copy of the original
Power of Attorney is attached hereto. I hereby request the Bank of America, N.A. transact the following business:
All Banking Transactions (please mark through this language and substitute other description, if more appropriate)
I represent that the Principal is alive and has not revoked or repudiated the Power of Attorney and that the Power of Attorney still is in full force and effect.
I am qualified to act as the Principal’s Attorney-In-Fact.
I have no actual knowledge or notice of revocation or termination of the Power of Attorney partially or impartially, for any reason, including by the
Principal’s death or by the qualification of a guardian of the estate of the Principal or, if the Principal is my spouse, that a decree of annulment or dissolution
of marriage has been entered.
A petition to determine the incapacity or appointment of a Guardian for the Principal is not pending.
Choose one and initial if applicable:
If the Power if Attorney is not durable and the Principal is not disabled or incapacitated.
If the Power of Attorney is durable and the Principal is disabled or incapacitated.
I do hereby, for myself and for my heirs and personal representative, agree to hold harmless and indemnify Bank of America, N.A. from all actions, suits,
claims, liabilities, damages, expenses, taxes, costs, assessments, and fees (including attorneys’ fees) or any other action which may arise directly or indirectly
by reason of Bank of America, N/A.’s reliance upon the aforementioned Power of Attorney or upon the representations made in this Affidavit and Indemnity
I make the affidavit for the purpose of inducing Bank of America, N.A. to accept delivery of the above-described instrument, as executed by me in my
capacity as Attorney-In-Fact for the Principal.
Executed this day of , .
Individually and as Attorney in Fact
On the day of, before me personally appeared, known to me (or satisfactory proven) to be the person who subscribed to the within
document and acknowledged to me that he/she executed the same for the purposes stated therein.
Signer is personally known to me.
Signer has produced the following identification:
In witness thereof I have set my hand and official seal.
Signature of Notary Public in and for
(SEAL) County of
Typed or Printed Name
Return to: BANK OF AMERICA Title/ Rank/ Serial Number (If Applicable)
TX7-550-01-01 My Commission Expires:
1422 E GRAYSON ST
SAN ANTONIO TX 78208