AFFIDAVIT THAT POWER OF ATTORNEYIS IN FULL FORCE AND EFFECT
STATE OF | } | ss: |
COUNTY OF | ||
I, .... of ...., being duly sworn, depose and say: |
THAT ...., of ...., as principal, did on ...., 20.., appoint me in a power of attorney dated ...., 20.., to execute an affidavit that a specified contingency had occurred;
THAT specified contingency was: ....
THAT specified contingency has occurred.
IN WITNESS WHEREOF, I have hereunto set my hand and seal.
.... L.S.
....Witness
....Witness
Subscribed and sworn to before me this .... day of ...., 20...
....Commissioner of the Superior Court
Notary Public
My commission expires: ....
Conn. Gen. Stat. § 1-350h
( P.A. 15-240, S. 9; P.A. 16-40, S. 9.)