Free notice of revocation of power of attorney form you can print

I, ____________________, of ____________________, by written instrument dated ____________________, 20___, appointed ___________________________ of ________________, 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 _________________________, 20___.

____________________________

STATE OF ___________________

COUNTY OF __________________

BEFORE ME, the undersigned authority, on this __ day of _______________, 20__, personally appeared ______________________ 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.

___________________________
NOTARY PUBLIC

My Commission Expires:_____