O.C.G.A. § 10-6B-71
Optional form for agent certification of facts
Redline — February 1, 2022 → current.View current text →
Current — July 1, 2022
As of February 1, 2022
The following optional form may be used by an agent to certify facts concerning a power of attorney.
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 Georgia
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 were named as a successor agent, the prior agent is no longer able or willing to serve; and
(4) _________ _______________ _________ Agent’s signature Date _______________ Agent’s name printed _______________ Agent’s address _______________ Agent’s telephone number _______________ Agent’s e-mail address This document was signed or acknowledged in my presence on _______________, by _______________. (Date) (Name of agent) _______________ (Seal) Signature of notary My commission expires: _______________ This document prepared by: _______________.”
(Insert other relevant statements)
SIGNATURE AND ACKNOWLEDGMENT
‘‘AGENT’S CERTIFICATION AS TO THE VALIDITY OFPOWER OF ATTORNEY AND AGENT’S AUTHORITY State of Georgia 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 were 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 Agent’s e-mail address This document was signed in my presence on, by (Date) (Name of agent) (Seal) Signature of notary My commission expires: This document prepared by:.”
Current official text: Official Code of Georgia Annotated (LexisNexis). Digitized from the Internet Archive scan of the OCGA. Reproduced from public-domain Georgia statutes; confirm against the official source for the current text. Not legal advice.