Affidavit Of Attorney In Fact (POA)

STATE OF NEW YORKSURROGATE222S COURT : COUNTY OF In the Matter of the Estate of AFFIDAVIT OF ATTORNEY IN FACT , PURSUANT TO RULE 207.48(a)(2) Deceased. , being duly sworn, deposes and says that: 1) , hereinafter referred to as the grantor, did execute a powerof attorney on appointing me his/her true and lawful attorney in fact. Following the execution of the document, the grantor expressed his/her desire that I act onhis/her behalf and I obtained the original instrument from the grantor. 2)The instrument was executed under the supervision of , Esq.,attorney for the grantor. OR No attorney assisted the grantor with execution of the instrument. Strike out the section that does not apply. 3) The grantor222s current mailing address is , and thegrantor222s relationship to the decedent is , thus the grantor222s interest in the above referenced estate is as a distributee OR beneficiary. (Strike out theinterest that does not apply). 4)As the attorney in fact under the instrument above described I have executed a in connection with the above referenced estate proceeding. Upon information and belief, at thetime of executing this document, the power of attorney is in full force and effect as the principalis alive and I have no knowledge or notice that the power of attorney has been revoked orterminated by the principal. 5) I make this affidavit for the purpose of inducing the Court to accept the currentlybeing submitted on behalf of the grantor in my capacity of attorney in fact under the power ofattorney dated . I have provided the Court with the original or a certified copy ofsaid power of attorney, as well as the fee to record the instrument. 6)I will be receiving no compensation for my services as attorney in fact. OR I will be receivingcompensation for my services as described in the attached agreement/explanation. Pleasestrike out any section that does not apply. Dated Subscribed and sworn to before meSignature of Attorney in Factthis day of Notary Public American LegalNet, Inc. www.FormsWorkFlow.com