Revocation of Durable Power of Attorney Form
REVOCATION OF DURABLE POWER OF ATTORNEY
PLEAST TAKE NOTICE that on the day of , ,
(insert name and address of donor of Power)
did duly make and appoint
(insert name and address of donee of Power)
PLEASE TAKE FURTHER NOTICE that (insert name of donor of Power)
has revoked, voided and annulled the said Durable Power of Attorney and all powers and
authority given to (insert name of donee of Power) are hereby voided and annulled.
IN WITNESS WHEREOF, (insert name of donor of Power) (has) (have) hereto set
forth (his) (her)this day of , .
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