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15If there is anything about this document or your duties
16that you do not understand, you should seek legal advice.
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OPTIONAL SIGNATURE OF AGENT
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I HAVE READ AND ACCEPT THE DUTIES AND LIABILITIES OF THE
19AGENT AS SPECIFIED IN THIS POWER OF ATTORNEY.
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Agent's signature .... Date ....
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(APPENDIX FOLLOWS)
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22244.62 Agent's certification. The following optional form may be used by an
23agent to certify facts concerning a power of attorney for finances and property:
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1AGENT'S CERTIFICATION AS TO THE VALIDITY OF POWER
2
OF ATTORNEY
for finances and property AND AGENT'S
3AUTHORITY
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State of ....
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County of ....
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I, .... (name of agent), certify under penalty of perjury that .... (name of principal)
7granted me authority as an agent or successor agent in a power of attorney dated .....
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I further certify that to my knowledge:
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(1) The principal is alive and has not revoked the power of attorney or my
10authority to act under the power of attorney, and the power of attorney and my
11authority to act under the power of attorney have not terminated.
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(2) If the power of attorney was drafted to become effective upon the happening
13of an event or contingency, the event or contingency has occurred.
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(3) If I was named as a successor agent, the prior agent is no longer able or
15willing to serve.
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(4) .... (insert other relevant statements).
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SIGNATURE AND ACKNOWLEDGMENT
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Agent's signature .... Date ....
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Agent's name printed ....
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Agent's address ....
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Agent's telephone number ....
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This document was acknowledged before me on .... (date), by .... (name of agent).
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(Seal, if any)
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Signature of notary ....
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My commission expires: ....
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1This document prepared by: ....
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2244.63 Distribution of forms. The department of health and family services
3shall prepare and provide copies of the Wisconsin statutory form power of attorney
4for finances and property for distribution in quantities to financial institutions,
5health care professionals, hospitals, nursing homes, multipurpose senior centers,
6county clerks and local bar associations and individually to private persons. The
7department of health and family services may charge a reasonable fee for the cost
8of preparation and distribution of the forms.
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9244.64 Relation to power of attorney for health care. The execution of
10a Wisconsin statutory form power of attorney for finances and property under this
11chapter does not confer on the agent any of the powers or duties conferred on a health
12care agent by the power of attorney for health care under ch. 155.
SB529, s. 17
13Section
17. 854.08 (5) (a) of the statutes is amended to read:
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854.08
(5) (a) In this subsection, "agent" means an agent under a durable power
15of attorney, as defined in s.
243.07 (1) (a) 244.02 (3).
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(1) This act takes effect on the first day of the 4th month beginning after
18publication.
