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


Dated ____________(7)_____________, _____(8)_.


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.



My Commission Expires:__(17)___


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.

Back to Legal Forms list

Notice: Information provided in this website is not intended to substitute for professional advice, including but not limited to professional legal advice. If you submit a question or comment it is assumed that you are interested in soliciting, receiving or giving general information and not legal advice. Laws vary by state, and the laws described in this website may be different in your state or may have been changed since the information was posted. The legal help offered in this website comes from volunteers who may not have any formal legal training or knowledge, and all information should be confirmed with a qualified legal professional before use. All information is made available on an "as is" basis. You should accept legal advice only from a licensed legal professional with whom you have an attorney-client relationship. Use of this website is subject to the terms of use.

Judgment .com and its designs and related marks are trademarks of Judgment .com
Judgment .com - All rights reserved

Terms and Conditions of Use

FREE and FUN Sites :
  Travel Apparel | Self-Improvement | Horoscope Content | Is it a Holiday ?
Greetings | Lyrics | CupidMailMessageProfiles | Horoscopes | Pants | Judgments | Recipes | Games | Free Auctions | Jokes | Riddles | ChoreGerodontics