STATE OF COUNTY OF ss: , being duly sworn, deposes and says as follows: 1. This affidavit is made in connection with the , in , New York to . 2. I am the agent named in the Power of Attorney (hereafter "Power of Attorney") made by , as principal (the "Principal"), dated . 3. I do not have actual notice that the Power of Attorney has been modified in any way that would affect my ability to authorize or engage in the present transaction for which the Power of Attorney is being used, or notice of any facts indicating that the Power of Attorney has been so modified. 4. I do not have actual notice of the termination or revocation of the Power of Attorney, or notice of any facts indicating that the Power of Attorney has been terminated or revoked, and the Power of Attorney remains in full force and effect. 5. If the Principal has been my spouse, we are not divorced and our marriage has not been annulled. 6. If I am a successor agent, the prior agent is no longer able or willing to serve. ____________________________________ Sworn to before me this of 2 day ____________________________ Notary Public NOTE: If multiple agents are appointed, an affidavit is to be executed by each agent. American LegalNet, Inc. www.FormsWorkFlow.com