Revocation Of Power Of Attorney Template - State Of New York Page 2

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AffiDAvit of SeRviCe
state Of new yORk, cOunty Of
ss.:
I, the undersigned, being sworn, say: I am over 18 years of age and reside at
On
I served the within Revocation of Power of attorney
service
by mailing a copy to each of the following persons at the last known address set forth after each name below.
by mail
by delivering a true copy personally to each person named below at the last known address set forth after each
personal
service on
name below.
individual
by transmitting a copy to the following persons by
faX at the telephone number set forth after each name
service by
electronic
below
e-maIL at the e-mail address set forth after each name below.
means
by dispatching a copy by overnight delivery to each of the following persons at the last known address set forth
Overnight
delivery
after each name below.
service
(If more than one box is check—indicate after each name the type of service used.)
sworn to before me on
_____________________________________________________
The name signed musT be prinTed beneaTh
RevoCAtioN of PoWeR of AttoRNeY
Principal
service of a copy of the Revocation of Power of attorney admitted.
Dated
20
____________________________________________
P
rint name ___________________________

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