Effective: March 22, 2012 Latest Legislation: Senate Bill 117 - 129th General Assembly 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 Ohio 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 was named as a successor agent, the prior agent is no longer able or willing to serve; (4)_______________________________________________________________________________________________________________________________________________________________________________________ (Insert other relevant statements). SIGNATURE AND ACKNOWLEDGMENT ___________________________________ Agent's Signature ___________________________________ Date ________________________________________________________________ Agent's Name Printed ________________________________________________________________ Agent's Address ________________________________________________________________ Agent's Telephone Number State of Ohio County of __________________________ This document was acknowledged before me on______________________,(Date) by _______________________ (Name of Agent). ________________________________ Signature of Notary My commission expires: _________________________________ This document prepared by: _________________________________ _________________________________
‹ Prev All Ohio sections Next ›
Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.