Home > Legal > Legal > Power of Attorney Template > Alberta Power of Attorney Form > Alberta Power of Attorney Template

Alberta Power of Attorney Form

At Speedy Template, You can download Alberta Power of Attorney Form . There are a few ways to find the forms or templates you need. You can choose forms in your state, use search feature to find the related forms. At the end of each page, there is "Download" button for the forms you are looking form if the forms don't display properly on the page, the Word or Excel or PDF files should give you a better reivew of the page.

Alberta Power of Attorney Form Page 2
Alberta Power of Attorney Form
CCIR-1: Appendix VII (01/2000)
Page 2
Canadian Council of Insurance Regulators
Affidavit of Execution
Appendix VII
IN THE MATTER OF THE
(Legislation)
AND THE APPOINTMENT OF A CHIEF AGENT THEREUNDER BY
Name of appointing insurer
TO WIT :
I,
Full name of witness
of the of
Status of municipality Name of municipality
in the of
County, etc., or district Name of county, etc., or district
in
Name of province or state and country
Occupation
MAKE OATH AND SAY THAT :
1. I was personally present and did see the annexed power of attorney duly signed by
and
Full name of signing officer
Full name of signing officer
and did witness the application of the corporate seal of the appointing insurer thereto.
2. I know the said signing officers and they are the
Description of office
Description of office
respectively of the said corporation (or « company »).
3. I am the subscribing witness to the said Power of Attorney.
SWORN at the
of
in the
Signature of witness
of
this day of 19
NOTE :
To be signed by the party witnessing the signatures
on preceding page and affidavit of such party to be
taken before a person authorized to administer
oaths.
A commissioner or notary public
Alberta Power of Attorney Form