Form 21/form 31 - Revocation Of Power Of Attorney/affidavit Of Attestation Of An Instrument

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POA-1
REVOCATION OF POWER OF ATTORNEY
FORM 21
Land Titles Act
Sections 115
I (We),
hereby revoke the power of attorney given by me to
dated
, and recorded in the Land Titles Office as instrument number
In witness whereof, I have hereunto subscribed my name this
.
SIGNED by the above named
(Signature)
in the presence of
(Signature)
(Witness Sign Here)

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