This Revocation of Power of Attorney is used to revoke a power of attorney previously executed by a individual. A power of attorney appoints an agent to act on behalf of an principal for some specified purpose. This document effectively revokes the authority granted to the agent and complies with state laws that require the revocation to be in a signed written instrument and delivered to the agent. This should be utilized by a principal located in Missouri to revoke a power of attorney.
Docstoc Legal Agreements This Revocation of Power of Attorney is used to revoke a power of attorney previously executed by a individual. A power of attorney appoints an agent to act on behalf of an principal for some specified purpose. This document effectively revokes the authority granted to the agent and complies with state laws that require the revocation to be in a signed written instrument and delivered to the agent. This should be utilized by a principal located in Missouri to revoke a power of attorney. ® DISCLAIMERS: ALL INFORMATION AND FORMS ARE PROVIDED “AS IS” WITHOUT ANY WARRANTY OF ANY KIND, EXPRESS, IMPLIED, OR OTHERWISE, INCLUDING AS TO THEIR LEGAL EFFECT AND COMPLETENESS. They are for general guidance and should be modified by you o r your attorney to meet your specific needs and the laws of your state. Use at your own risk. Docstoc, its employees or contractors who wrote or modified any form, are NOT providing legal or any other kind of advice and are not creating or entering into an Attorn ey-Client relationship. The information and forms are not a substitute for the advice of your own attorney. Use of this document and our service are deemed to be your acknowledgement and agreement to the following: The disclaimers and links on this page and the back page(s); our Terms of Service (http://www.docstoc.com/popterm.aspx?page_id=15), and read more here (http://www.docstoc.com/popterm.aspx?page_id=114) for additional disclaimers and more. You also agree that if you are not the person using the document and services that you will provide such person(s) who will be with these front and back disclaimer pages. This document is not approved, endorsed by, or affiliated with any State, or governmental or licensing entity. Entire document copyright © Docstoc®, Inc., 2010 - 2013. All Rights Reserved REVOCATION OF POWER OF ATTORNEY I, ______________________ [Instruction: Insert the name of the principal], of _________________________ [Instruction: Insert the address of principal], City of ____________________ [Instruction: Insert the City], County of _______________________ [Instruction: Insert the County], State of Missouri, (hereinafter referred to as “Principal”) , having executed a _______________ [Instruction: Choose the appropriate - General or Durable] Power of Attorney on the ____ [Month] ____ [Date], 20____, to __________________________ [Instruction: Insert the name of attorney-in-fact/agent] my attorney-in-fact/agent, to act in my behalf as my true and lawful attorney in order to handle ____________________________ [Instruction: Insert the purpose for which attorney in fact is appointed, Example: my financial affairs and health care decisions.] I hereby revoke that Power of Attorney in accordance with [STATUTE], by written revocation signed and dated by me and pursuant to its explicit provision that it may be revoked by me by written instrument signed by me and delivered to my attorney-in-fact/agent. This is my written revocation of the above referenced Power of Attorney and I am providing a copy of it to my attorney-in-fact/agent. Signature of Principal : ______________________________________________ Printed Name of Principal : ______________________________________________ I, at the request and in the presence of _________________ [Instruction: Insert the name of the Principal] have subscribed my name below as witness. I declare that I am of sound mind and of 18 years of age or older and hereby confirm Principal’s expression to revoke the _______________ [Instruction: Choose the appropriate - General or Durable] Power of Attorney. To the best of my knowledge the Principal is of the age of majority, or is otherwise legally competent to revoke a Power of Attorney, and appears of sound mind and under no undue influence or constraint. Under penalty of perjury, I declare these statements are true and correct on this ________ day of ____________________, 20______. Witness Signature #1 : _____________________________________________ Name : _____________________________________________ Address : _____________________________________________ [Instruction: The witness must be of 19 years of age or older]. © Copyright 2011 Docstoc Inc. registered document proprietary, copy not 2
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