Sample Affidavit That Power of Attorney is in Full Force

AFFIDAVIT THAT POWER OF ATTORNEY IS IN FULL FORCE
(sign before a Notary Public)


STATE OF _______________________
ss:
COUNTY OF _______________________ ss:

[Name], being duly sworn, deposes and says:

1. The Principal within did, in writing, appoint me as the Principal’s true and lawful ATTORNEY(S)-IN-FACT in the within Power of Attorney.
2. I have no actual knowledge or actual notice of revocation or termination of the Power of Attorney by death or otherwise, or knowledge of any facts indicating the same. I further represent that the Principal is alive, has not revoked or repudiated the Power of Attorney and the Power of Attorney still is in full force and effect.
3. I make this affidavit for the purpose of inducing


to accept delivery of the following Instrument(s) as executed by me in my capacity as the ATTORNEY(S)-IN-FACT, with full knowledge that this affidavit will be relied upon in accepting the execution and delivery of the Instrument(s) and in paying good and valuable consideration therefor:

____________________________________

Sworn to before me on this ____ day
of ___________ 2001


_______________________________________
Notary Public

My commission expires: