<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 59-12-42 - Statutory form--Agent's certification.</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2078728Normal { text-indent: 0.50in; text-align: justify; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2078728SENU { font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2078728CL { font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2078728DefaultParagraphFont { font-style: normal; font-weight: normal; margin: 0; padding: 0; } a.s2078728000000 { text-decoration: none; } span.s2078728000001 { font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2078728NoIndent { text-indent: 0.00in; text-align: justify; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2078728DefaultParagraphFont-000002 { font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2078728SCL { font-style: normal; font-weight: normal; margin: 0; padding: 0; } body { text-decoration-skip-ink: none; } </style></head><body><div><p dir="ltr" class="s2078728Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=59-12-42"><span class="s2078728SENU">59-12-42</span></a><span xml:space="preserve" class="s2078728SENU">. </span><span class="s2078728CL">Statutory form--Agent's certification.</span></p><p dir="ltr" class="s2078728Normal"><span xml:space="preserve" class="s2078728DefaultParagraphFont">The following optional form may be used by an agent to certify facts concerning a power of attorney. The provisions of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=43-28-23"><span class="s2078728DefaultParagraphFont">43-28-23</span></a><span xml:space="preserve" class="s2078728DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=7-9-1"><span class="s2078728DefaultParagraphFont">7-9-1</span></a><span xml:space="preserve" class="s2078728DefaultParagraphFont"> apply to any power of attorney that is to be recorded with the register of deeds.</span></p><p dir="ltr" class="s2078728Normal"><a id="_pagenumber35" class="s2078728000000"></a><span class="s2078728DefaultParagraphFont">AGENT'S CERTIFICATION AS TO THE VALIDITY OF POWER OF ATTORNEY AND AGENT'S AUTHORITY</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">State of ______________________)</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">)SS. AFFIDAVIT</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">County of_____________________)</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">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 _____________________, 2____.</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">I further certify that to my knowledge:</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">(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;</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">(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;</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">(3)    If I was named as a successor agent, the prior agent is no longer able or willing to serve; and</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">(4)_____________________________________________________________________________________________________________________________________________________________________________________________________</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">(Insert other relevant statements)</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">SIGNATURE AND ACKNOWLEDGMENT</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">___________________________________________________________, 2____</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">Agent's Signature              Date</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">____________________________________________</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">Agent's Name Printed</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">Agent's Address____________________________________________</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">Agent's Telephone Number____________________________________________</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">State of ____________________________ )</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">)SS.</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">County of___________________________)</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">This Agent's Certification as to the Validity of Power of Attorney and Agent's Authority document was acknowledged before me on _____________________, 2_____ by ___________________________________. (Date) (Name of Agent)</span></p><p dir="ltr" class="s2078728Normal"><a id="_pagenumber36" class="s2078728000000"></a><span class="s2078728DefaultParagraphFont">____________________________________________(Seal)</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">Signature of Notary Public</span></p><p dir="ltr" class="s2078728Normal"><span class="s2078728DefaultParagraphFont">My commission expires:</span></p><p dir="ltr" class="s2078728Normal"><span xml:space="preserve" class="s2078728000001"> </span></p><p dir="ltr" class="s2078728NoIndent"><span xml:space="preserve" class="s2078728DefaultParagraphFont-000002">Source: </span><span class="s2078728SCL">SL 2020, ch 214, § 42.</span></p></div></body></html>