REVOCATION OF POWER OF ATTORNEY
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Revocation of Power of Attorney Sample

The revocation of power of attorney form is used to terminate the authority given to the other person (attorney-in-fact) in the original document.

REASONS TO REVOKE A POWER OF ATTORNEY:

  • You wish to terminate the POA before the specific end date of a limited POA
  • The purpose of the POA is complete and no date to end was specified
  • You feel the POA is no longer necessary

INSTRUCTIONS TO FILL A P.O.A. REVOCATION:

A copy of the revocation should be given to the person (Agent or Attorney-in-Fact) as soon as possible.

Copies should be provided to any party with whom the Agent may have had dealings before the revocation.

Copies should be given to any party with whom the Agent may be expected to deal with after the revocation.

Have any third party sign the revocation and keep one copy for your records. If that is not possible, mail the revocation by first-class mail with a signed return receipt request to verify delivery.

THE P.O.A. REVOCATION DOCUMENT SHOULD CONTAIN:

  • Date of the Revocation of Power of Attorney
  • Date of original POA
  • Printed name and address of Principal (person who originally granted power)
  • Printed name and address of Attorney-in-Fact (person who was given the power)
  • Signature of the Principal (person who is revoking the power of attorney) signed in front of Notary
  • Signature of witnesses (not necessary in most States)
  • Notary Acknowledgement


REVOCATION OF POWER OF ATTORNEY


I, _________________________, (Principal's name) address: ______________________ do revoke the power of attorney dated: _________________, _____ 20_____, which was given to _______________________________, (Attorney-in-Fact) address: _______________________________________ to act in my behalf as my true and lawful attorney in order to handle my affairs.

This revocation is dated: _____________________, _____ 20_____.


_______________________________

Signature of Person Revoking the Power of Attorney

WITNESS

1- _____________________________ of _________________________________(address)

2- _____________________________ of _________________________________(address)

NOTARY ACKNOWLEDGEMENT

On _____________________, _____ 20_____, ____________________________ (Person Revoking POA) personally appeared before me and, being dully sworn, did state that he/she is the person mentioned in this document and that he/she signed this document in my presence.

State of___________________

County of____________________

___________________________________

Notary Signature

My commission expires: _____/_____/20_____


General Power of Attorney

UNITED STATES BY REGION:

New England Region: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
Great Lakes States: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin
Middle Atlantic States: Delaware, New Jersey, New York, Pennsylvania
Atlantic Coast and Appalachian States: Kentucky, Maryland, North Carolina, Tennesse, Virginia, West Virginia
Southeast and Gulf States: Alabama, Florida, Georgia, Mississippi, South Carolina
Mountain States: Colorado, Idaho, Montana, Utah, Wyoming
Plains States: Iowa, Kansas, Missouri, Nebraska, North Dakota, South Dakota
South Central States: Arkansas, Lousiana, Oklahoma, Texas
Southwest Desert States: Arizona, Nevada, New Mexico
Pacific States: Alaska, California, Hawaii, Oregon, Washington


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