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: ________________________________________

________________________________________________________

Sworn to and subscribed before me on ___________________, 199___.

_______________________________________________________
Notary Public

My Commission Expires:

Ratification of Power of Attorney
Review List

This review list is provided to inform you about this document in question and assist you in its preparation. This document seeks to affirm and ratify the continuing appointment as Power of Attorney. This is a wise choice for someone caught up in an ambiguous or troubled situation who has a Power of Attorney. To avoid later blame, getting a ratification is a smart move.

1. Make multiple copies. Give each party with an interest in the matter a copy.

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