Affidavit by Attesting Witness of execution of Power-of-attorney

 

Before the special Judicial Magistrate at ___________

 

I, [deponent(s) name, address and description], make oath and say as follows:

I was present on the_________ day of ________ and did see [donor] the donor of the power of attorney dated the __________ day of ________ now produced and shown to me marked .A. duly sign, seal and as his act and deed deliver the said power of attorney and that the name or signature __________ (to agree with signature on deed) set out and subscribed thereto as the signature of the said donor who executed the same as aforesaid is in the proper handwriting of the said donor and that the signature ________ (to agree with witness(s) signature on deed) set and subscribed thereto as the witness attesting the due execution thereof by the said donor is in my proper handwriting.

 

SWORN AT

Date

[Signature of deponent]

 

Before me

 

[Signature of Special Judicial Magistrate at...]