Revocation of Power of Attorney
I, [Principal: full name], of [Principal: address] (the “Principal”), being of sound mind, make this Revocation of Power of Attorney (the “Revocation”). By this Revocation I withdraw the authority I gave under the power of attorney identified below, give notice of that withdrawal to the agent and to every person who may have relied on it, and direct that no further act be taken under it.
1. Power of Attorney Revoked
The instrument revoked (the “Power”) is the following: [Type of power of attorney revoked], signed by me on or about [Date the power of attorney was signed], naming [Agent named in it], of [Agent: address], as my agent and attorney-in-fact (the “Agent”), and naming [Successor or alternate agent named in it (or “None”)] as successor or alternate agent. Other identifying details: [Other identifying details (or “None”)]. Recording status: [Was the power of attorney recorded?]. Recording details: [Recording details (county, book/page or instrument no.; or “None”)]. If more than one instrument answers this description, this Revocation applies to each of them.
2. Revocation
I revoke the Power in its entirety, together with every authority, appointment, delegation and power granted under it, whether to the Agent, to any successor or alternate agent, or to any person to whom the Agent has delegated authority. From the Effective Date, neither the Agent nor any other person has authority to act for me under the Power, to hold themselves out as my attorney-in-fact under it, or to sign, transact, receive or deal with any property, account or matter in my name in reliance on it.
3. Effective Date
This Revocation is effective on [Revocation effective] (the “Effective Date”) as between me and the Agent, whether or not the Agent has received it by then, and as to any third party on the earlier of the Effective Date and the date the third party receives actual notice of it. Reason for revocation: [Reason (optional; or “None stated”)]. I am not required to state a reason and the absence of one does not affect this Revocation.
4. Notice to the Agent
I direct the Agent, and any successor or alternate agent, on receipt of this Revocation: to cease immediately every act under the Power; to return to me, within ten days, every original and copy of the Power in their possession and every document, card, key, password or item of property held under it; to deliver to me within thirty days a written account of every act taken, payment made and sum received under the Power, with supporting records; and to notify me in writing of every person, bank, agency or business to which the Agent presented the Power. The Agent’s fiduciary duties in respect of acts already taken, including the duty to account, survive this Revocation.
5. Notice to Third Parties
This Revocation is notice to every bank, credit union, brokerage, insurer, title or escrow company, government agency, health care provider, employer, landlord, business and other person that has received or may receive the Power that the Power is revoked and that the Agent no longer has authority to act for me. I will deliver a copy of this Revocation to at least the following: [Institutions and people to be notified]. A third party that receives this Revocation and afterwards honours the Power does so at its own risk and without the protection given to a person who acts in good faith without notice of a revocation.
6. Recording
If the Power was recorded in any public office, I direct that this Revocation be recorded in the same office, with reference to the recording details stated in Section 1, so that it appears in the public record with the Power. Where a recorder requires a notarial acknowledgment, this Revocation shall be acknowledged before a notary public on a printed copy before recording.
7. Prior Acts
This Revocation does not invalidate any act taken by the Agent within the scope of the Power, in good faith, before the Agent received notice of this Revocation, and does not release the Agent from liability for any act outside the scope of the Power or in breach of the Agent’s duties. I reserve every claim and remedy I have against the Agent.
8. Other Documents
Unless expressly identified in Section 1, this Revocation does not revoke any other power of attorney, health care directive, trust, will, beneficiary designation or account authorisation I have signed, each of which remains in effect according to its terms. If I have signed a new power of attorney, it is unaffected by this Revocation and I intend it to be honoured.
9. Governing Law; Copies; Electronic Signature
This Revocation is governed by the laws of the State of [Governing law (state)]. If any provision is held invalid, the remaining provisions shall be given full effect. A photocopy, scan or electronically signed copy of this Revocation is as effective as the original. This Revocation may be signed electronically, and the electronic execution record, timestamps and document fingerprints kept by the signing platform are evidence of execution; where the Power was notarised or recorded, or the law of my state requires it, I intend to have this Revocation acknowledged before a notary public on a printed copy, and that copy shall be my Revocation.
10. Signature and Witness
10.1 Signature. I sign this Revocation of Power of Attorney on the date shown in the execution record, having read it and understood it, freely and without duress or undue influence.
10.2 Witness. The witness, by signing below, declares that: (1) the Principal is personally known to me or proved their identity to me by satisfactory evidence; (2) the Principal signed or acknowledged this Revocation in my presence and appeared to be of sound mind and under no duress, fraud or undue influence; (3) I am at least eighteen years of age and am not the Agent or successor agent named above, nor the spouse or child of either; and (4) I signed in the presence of the Principal. Witness: [Witness: name], of [Witness: address].
10.3 Notary. Where required, the notarial acknowledgment of the Principal’s signature is to be completed on a printed copy of this Revocation in the form prescribed by the state in which it is acknowledged.
Signatures
Principal (the person revoking) · Witness