Optional form for agent certification of facts

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) 1116 10-6B-71 (Insert other relevant statements) SIGNATURE AND ACKNOWLEDGMENT Agent’s signature Date Agent’s name printed Agent’s address Agent’s telephone number Agent’s email 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: . History. Code 1981, § 10-6B-71, enacted by Ga. L. 2017, p. 435, § 2-1/HB 221; Ga. L. 2018, p. 520, § 20/HB 897; Ga. L. 2024, p. 1052, § 2(57)/SB 448, effective July 1, 2024. Amendments. The 2024 amendment, effective July 1, 2024, part of an Act to revise, modernize, and correct the Code, substituted “email” for “e-mail” in this Code section. ARTICLE 4 OTHER STATUTORY PROVISIONS 10-6B-80. Construction with federal Electronic Signatures in Global and National Commerce Act. This chapter modifies, limits, and supersedes the federal Electronic Signatures in Global and National Commerce Act, 15 U.S.C. Section 7001 et seq., but shall not modify, limit, or supersede Section 101(c) of that act, 15 U.S.C. Section 7001(c), or authorize electronic delivery of 1117 10-6B-81 any of the notices described in Section 103(b) of that act, 15 U.S.C. Section 7003(b). History. Code 1981, § 10-6B-80, enacted by Ga. L. 2017, p. 435, § 2-1/HB 221. 10-6B-81. Application of Chapter 6B.