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Acceptance And Power Of Attorney (Person Only) Form. This is a New Jersey form and can be use in Salem Local County.
Tags: Acceptance And Power Of Attorney (Person Only), J4, New Jersey Local County, Salem
State of New Jersey
Docket No.: ________________
Salem County Surrogate’s Court
In the matter of the Guardianship of
____________________________________________________, a Minor
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AKA: ______________________________________________
ACCEPTANCE AND
POWER OF ATTORNEY
I, ________________________ about to be appointed by a judgment of the Surrogate of the County of Salem Guardian of the person
only of the above-named minor do hereby declare my acceptance of said Guardianship.
Signature
Dated: ______/______/20___
Signed in the presence of:
Witness Signature (Attorney or Notary)
KNOW ALL MEN BY THESE PRESENTS, that I, _________________________ residing at ______________________________
___________________________________, pursuant to the provisions of Revised Statutes 3B:14-47 do hereby make, constitute and
appoint Nicki A. Burke, Surrogate of the County of Salem, in the State of New Jersey, and their successors in office, my true and
lawful attorney upon whom may be served any and all process affecting the aforesaid estate, or any interest therein, whereof I am the
Guardian.
And I do further agree that any process against the aforesaid estate, so served, shall be of the same force and effect as if duly served
upon me within this State.
In Witness Whereof, I have hereunto set my hand and seal this ____/____/20__
__________________________________
Signature
Signed, sealed and delivered in the presence of:
Attorney or Notary Public of the State of New Jersey
STATE OF NEW JERSEY
COUNTY OF SALEM
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SS.
BE IT REMEMBERED, that on this, ____/____/20__, before me, the subscriber, a Notary Public of New Jersey, personally appeared
____________________________, who I am satisfied is the person named in the foregoing power of attorney, and I having first made
known to them the contents thereof, they did thereupon acknowledge that they signed, sealed and delivered the said power of attorney
as their voluntary act and deed, for the uses and purposes therein expressed.
______________________________________________
Attorney or Notary Public of the State of New Jersey
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