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Affidavit By Attorney-In-Fact
STATE OF ----------)
COUNTY OF ---------)
[Name in capital letters] (Affiant), being duly sworn, says:
1. I reside at [address, city, state of Affiant].
2. I am Attorney-in-Fact for [name of principal] under power of attorney executed by [principal], dated [date]. As of the date of this Affidavit, [principal] is alive and well, and has agreed to the terms of [description of contract, e.g., sale of real estate property, goods and chattel, etc.].
3. This Affidavit is made for the purpose of inducing [name] to [description of purpose, e.g., to induce a party to accept a conveyance, a bank to provide a loan].
*** If Required By FederaL or State Law ***
This Section for Notary:
State of _________
County of ________ [COUNTY]
On [DATE] before me, [NAME OF NOTARY], notary, personally appeared [NAME OF PERSON(S) INVOLVED], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
Witness my hand and official seal.
My commission expires: _____