Revocation Of Power Of Attorney Form

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REVOCATION OF POWER OF ATTORNEY
TO WHOM IT MAY CONCERN:
I ____________________________________________________, revoke and declare null and void the
POWER OF ATTORNEY I granted to _________________________________________which is dated
________________________, 20________.
Please be advised that the above-named person no longer has power to act as my attorney-in-fact in
any way.
Date: __________________________
_______________________________________
(Principal)
STATE OF ________________
County of __________________________________________
The foregoing instrument was acknowledged before me this ______day of _________________, 20____.
by ________________________________________.
_____________________________________
Notary Public

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