OPTIONAL SIGNATURE OF AGENT
I HAVE READ AND ACCEPT THE DUTIES AND LIABILITIES OF THE AGENT AS SPECIFIED IN THIS POWER OF ATTORNEY.
Agent’s signature .... Date ....
(APPENDIX FOLLOWS)
244.61 AnnotationOffering Clarity and Guidance: New Uniform Power of Attorney for Finances and Property. Collins, Hatch, & Wilcox. Wis. Law. June 2010.
244.62244.62 Agent’s certification. The following optional form may be used by an agent to certify facts concerning a power of attorney for finances and property: AGENT’S CERTIFICATION AS TO THE VALIDITY OF POWER OF ATTORNEY FOR FINANCES AND
PROPERTY AND AGENT’S AUTHORITY
State of ....
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 was named as a successor agent, the prior agent is no longer able or willing to serve.
(4) .... (insert other relevant statements).
SIGNATURE AND ACKNOWLEDGMENT
Agent’s signature .... Date ....
Agent’s name printed ....
Agent’s address ....
Agent’s telephone number ....
This document was acknowledged before me on .... (date), by .... (name of agent).
(Seal, if any)
Signature of notary ....
My commission expires: ....
This document prepared by: ....
244.62 HistoryHistory: 2009 a. 319. 244.63244.63 Distribution of forms. The department of health services shall prepare and provide copies of the Wisconsin statutory form power of attorney for finances and property for distribution in quantities to financial institutions, health care professionals, hospitals, nursing homes, multipurpose senior centers, county clerks and local bar associations and individually to private persons. The department of health services may charge a reasonable fee for the cost of preparation and distribution of the forms. 244.63 HistoryHistory: 2009 a. 319. 244.64244.64 Relation to power of attorney for health care. The execution of a Wisconsin statutory form power of attorney for finances and property under this chapter does not confer on the agent any of the powers or duties conferred on a health care agent by the power of attorney for health care under ch. 155. 244.64 HistoryHistory: 2009 a. 319.
