The written statement referred to in section 45a-624 shall be in substantially the following form:
STATEMENT THAT DESIGNATION OF A STANDBY GUARDIAN
IS IN FULL FORCE AND EFFECT
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I, .... of ...., state under penalty of false statement:
THAT ...., of ...., as principal, did on ...., 20.., appoint me as standby guardian dated ...., 20.., to execute a statement that a specified contingency had occurred;
THAT specified contingency was: ....
THAT specified contingency has occurred.
IN WITNESS WHEREOF, I have hereunto set my hand and seal under penalty of false statement.
| .... | |
| Witness | |
| .... | .... L.S. |
| Witness |
(P.A. 94-207, S. 3; P.A. 99-84, S. 26.)
History: P.A. 99-84 substituted “statement” for “affidavit” and added “under penalty of false statement” and deleted the attestation clause for Commissioners of the Superior Court and Notaries Public; (Revisor's note: In 2001 the references in this section to the date “19..” were changed editorially by the Revisors to “20..” to reflect the new millennium).