Free Revocation of Power of Attorney Form

The free Revocation of Power of Attorney form can be used with any type of Power of Attorney. When you revoke or cancel a Power of Attorney, you terminate the authority given to your attorney-in-fact in the original POA document.

If you choose to use a Revocation of Power of Attorney form, a copy of the revocation document must be given to the attorney-in-fact and any party that had dealings with the attorney-in-fact before the POA was revoked.

If you think that you need verification of the Revocation of Power of Attorney, then a third party should witness the document and copies need to be kept in a safe place.

Prepare a Free Revocation of Power of Attorney Form

To prepare your Revocation of Power of Attorney form for your personal affairs you will need the following:

  • The printed name and address of the principal that granted the Power of Attorney in the first place
  • Date of the original Power of Attorney
  • The printed name and address of the attorney-in-fact
  • Date of the Revocation of Power of Attorney form
  • The principal will then need to sign the Revocation of Power of Attorney form in the presence of a notary
  • Notary acknowledgement to accompany the Revocation of Power of Attorney

Free Revocation of Power of Attorney Form

You can download the following free Revocation of Power of Attorney form and tailor it to your needs. Fill free to copy and paste, then print out the form as needed:

Free Revocation of Power of Attorney Form

SAMPLE REVOCATION OF POWER OF ATTORNEY

STATE OF _____________________
COUNTY OF ____________________

KNOW ALL MEN BY THESE PRESENTS

I, _________________________________________, (name and address) hereby revoke all Powers of Attorney executed prior to the __________ day of ___________________, _____, made by me and appointing _____________________________, as my Attorney-in-Fact, and ____________________________________________, as my successor Attorney(s)-in-Fact.
IN WITNESS WHEREOF, I have hereunto set my hand on this the __________ day of ___________________, _____.

Signature of Principal

The foregoing Revocation was signed by ____________________________in our presence, and we, at her request and in her presence, and in the presence of each other, each of us being over the age of 18 years, have hereunto subscribed our names as Witnesses on this the __________ day of ___________________, _____.

__________________________
Witness

__________________________
Street Address

__________________________
City, State and Zip Code

STATE OF _______________________
COUNTY OF ____________________

BEFORE ME, the undersigned authority, on this day personally appeared ____________________________(principal), who, having been duly sworn, states that she is executing this Revocation in the presence of the two Witnesses as shown above and for the purposes therein expressed.

SWORN TO, SUBSCRIBED AND ACKNOWLEDGED BEFORE ME by ___________________________________ and by the said witnesses and ____________________________________, on this ___ day of _______________ , _____________.

Notary Public