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Free Legal Forms page - Revocation of Power of Attorney

NOTICE OF REVOCATION OF POWER OF ATTORNEY
I, _________(1)____________, of __________(2)__________, by written instrument
dated ________(3)____________, _____(4)_, appointed _____________(5)______________ of
____________(6)____, my attorney in fact for the purposes and with powers therein set forth, a
copy of which is attached hereto as Exhibit "A".
Notice is hereby given that I have revoked, and do hereby revoke, the above-described
power of attorney, and all power and authority thereby given, or intended to be given, to
____________(5)_______________.
Dated ____________(7)_____________, _____(8)_.
_____________(9)_______________
STATE OF _______(10)____________
COUNTY OF ______(11)____________
BEFORE ME, the undersigned authority, on this _(12)_ day of _______(13)________, ___(14)_,
personally appeared ___________(15)___________ to me well known to be the person
described in and who signed the Foregoing, and acknowledged to me that he executed the same
freely and voluntarily for the uses and purposes therein expressed.
WITNESS my hand and official seal the date aforesaid.
___________(16)________________
NOTARY PUBLIC
My Commission Expires:__(17)___

NOTICE
The information in this document is designed to provide an outline that you can follow
when formulating business or personal plans. Due to the variances of many local, city, county
and state laws, we recommend that you seek professional legal counseling before entering into
any contract or agreement.