AGENT'S CERTIFICATION AND ACCEPTANCE OF AUTHORITY
I,.......... (insert name of agent), certify that the attached is a true copy of a power of attorney naming the undersigned as agent or successor agent for.............
(insert name of principal).
I certify that to the best of my knowledge the principal had the capacity to execute the power of attorney, is alive, and has not revoked the power of attorney; that my powers as agent have not been altered or terminated; and that the power of attorney remains in full force and effect.
I accept appointment as agent under this power of attorney.
This certification and acceptance is made under penalty of perjury.*
Dated:............
.......................
(Agent's Signature)
.......................
(Print Agent's Name)
.......................
(Agent's Address)
*(NOTE: Perjury is defined in Section 32-2 of the Criminal Code of 2012, and is a Class 3 felony.)
755 ILCS 45/2-8