North Carolina Power Of Attorney Revocation

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NORTH CAROLINA POWER OF ATTORNEY REVOCATION
STATE OF NORTH CAROLINA
{
{REVOCATION OF POWER OF ATTORNEY
COUNTY OF _______________
{
KNOW ALL MEN BY THESE PRESENTS, that I, _________________________________________________
of the County and State hereinabove named, do hereby, REVOKE, ANNUL, and CANCEL that certain Power Of Attorney granted
by me, as principal, to _______________________________________________, as attorney-in-fact, which said Power Of Attorney
was conferred by me by instrument dated the ________day of ________________________ in the year 20 _____, and duly recorded
in the __________________________ County Register of Deeds office, of North Carolina.
IN TESTIMONY WHEREOF, I have hereunto set my hand and seal this ________ day of _____________________in the year _____
__________________________________________________(seal)
STATE OF NORTH CAROLINA
COUNTY OF ______________________
I, a Notary Public of said State and County aforesaid, do hereby certify that ____________________________________________
Personally appeared before me this day, and (i) have personal knowledge of the identity of the principal, or (ii) I have seen satisfactory
evidence of the principal identity, by current state or federal identification with the principal photograph in the form of a
________________________________, or (iii) a credible witness has sworn to the identity of the principal each acknowledging to me
that he or she voluntarily signed the foregoing document for the purpose stated herein and in the capacity indicated.
Witness my hand and official seal or stamp, this the _________day of __________________, in the year _______ .
_________________________________________________
Notary Public Official Signature
(seal or stamp)
_________________________________________________
Notary Printed or Typed Name
My commission expires:_____________________________

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