Power of Attorney Revocation Form - Kansas

PLEASE USE BLUE OR BLACK INK PLEASE PRINT CLEARLY IN BLOCK CAPITAL LETTERS
1 | Invesco Account Number and Registration Information
Social Security Number Invesco Account Number (List all applicable)
Account Registration (Please print name(s) as it appears on account.)
Primary Phone Number Alternate Phone Number
2 | Revocation of Attorney-in-Fact
Full Name of Attorney-in-Fact to be Removed
3 | Authorization and Signature(s) (Account Owner or Attorney-in-Fact may sign to request removal.)
By signing below, I acknowledge that upon Invesco Investment Services, Inc. (IIS) receipt of this signed form, the Power of
Attorney associated with the aforementioned account(s) will be terminated. Any prior authority granted to the Attorney-in-Fact
will be terminated and IIS will no longer honor instructions from the Attorney-in-Fact unless a new Power of Attorney Authori-
zation Form or Power of Attorney Authorization Incapacitated Person Form is received by IIS.
Signature (Required) Title Date (mm/dd/yyyy)
x
4 | Mailing Instructions
Please send completed and signed form to:
(Direct Mail) (Overnight Mail)
Invesco Investment Services, Inc. Invesco Investment Services, Inc.
P.O. Box 219078 c/o DST Systems, Inc.
Kansas City, MO 64121-9078 430 W. 7th Street
Kansas City, MO 64105-1407
For assistance please contact an Invesco Client Services representative at 800 959 4246, weekdays, 7 a.m. to 6 p.m.
Central Time.
Power of Attorney Revocation Form
Use this form to revoke a Power of Attorney designation previously assigned to an Invesco account(s).
AIM-FRM-61-E 04/15
Page 1/1
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Power of Attorney Revocation Form - Kansas PDF

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