Revocation / Termination / Cancellation of Power of Attorney - Free Legal Forms and Contracts

This free legal form, agreement and contract is provided as is and should be used for information, sample and example purposes only. Always consult your attorney. It is a valid legal document.

POWER OF ATTORNEY REVOCATION

Reference is made to certain power of attorney granted by __________________________________ (Grantor) to __________________________________ (Attorney-in-Fact), and dated _________________, 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 seal this ____ day of_______________________________, 20____.

____________________________________
[Signature of Grantor]

____________________________________
[Printed or Typed Name of 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)