Power of attorney revocation
Power of attorney revocation form
POWER OF ATTORNEY REVOCATION
Reference is made to certain power of attorney granted by
(Grantor) to (Attorney-in-Fact), and date
,20 .
This document acknowledges and constitutes notice that the Grantor hereby revokes,
rescinds and terminates said power-of-attorney and all authority, rights and power thereto
effective this date.
Signed under sael this day of , 20 .
_______________________________
Grantor
Acknowledged:
________________________________
STATE OF
COUNTY OF
On before me, , personally appeared ,
personally known to me (or proved to me on the basis of satisfactory evidence) to be the
person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me
that he/she/they executed the same in his/her/their authorized capacity(ies), and that by
his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument. WITNESS my hand and official seal.
Signature____________________________
Affiant ____Known ____Unknown
ID Produced____________________
(Seal)
|
Forms Home Page
More forms in this category:
Personal and Family
Irrevocable Trust Agreement
Last Will and Testament
Living Will Declaration
Pre-Marital Agreement
Power of Attorney Assignment
Power of Attorney Revocation
Request Under Freedom of Information Act
Revocable Living Trust
Resignation
Trip Permission
Place these forms on your PC for fast
access whenever you need them.
Print, edit and modify them for your specific needs.
|
Legal forms
< BACK
Download the entire
collection of legal forms and legal letters.
Business
Forms
|
