Power of Attorney Revocation Form

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Power of Attorney Revocation Form

A power of attorney revocation form is used to terminate an active power of attorney. The document is drafted for and signed by the principal when they wish to revoke an agent’s power. Most powers of attorney will include a provision that it can be cancelled via a written revocation signed by the principal.

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Last updated July 25th, 2025

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A power of attorney revocation form is used to terminate an active power of attorney. The document is drafted for and signed by the principal when they wish to revoke an agent’s power. Most powers of attorney will include a provision that it can be cancelled via a written revocation signed by the principal.

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When to Revoke a Power of Attorney

  • The tasks have been completed.
  • The principal wishes to change agents.
  • When amending a POA or creating a new one.
  • Death or incapacity of the agent.

Sample


Download: PDF (Blank) | PDF (Sample Data)

REVOCATION OF POWER OF ATTORNEY FORM
STATE OF [STATE]
COUNTY OF [COUNTY]I, [PRINCIPAL NAME], with a mailing address of [PRINCIPAL ADDRESS], hereby revoke all Powers of Attorney executed prior to [MM/DD/YYYY], made by me and appointing [ATTORNEY-IN-FACT NAME] as my Attorney-in-Fact, and [SUCCESSOR ATTORNEY-IN-FACT NAME(S)] as my successor Attorney(s)-in-FactIN WITNESS WHEREOF, I have hereunto set my hand on [MM/DD/YYYY].Signature of Principal: __________________________

WITNESS ACKNOWLEDGEMENT

The foregoing revocation was signed by [PRINCIPAL NAME] in our presence, and we, at their request and in their presence, and in the presence of each other, each of us being over the age of 18 years, have hereunto subscribed our names as witnesses on [MM/DD/YYYY].

Signature of Witness: __________________________
Witness Address: [WITNESS ADDRESS]

Signature of Witness: __________________________
Witness Address: [WITNESS ADDRESS]

NOTARY ACKNOWLEDGEMENT

STATE OF [STATE]
COUNTY OF [COUNTY]

BEFORE ME, the undersigned authority, on this day, personally appeared [PRINCIPAL NAME], who, having been duly sworn, states that he/she is executing this revocation in the presence of the witness(es) as shown above and for the purposes therein expressed.

Sworn to, subscribed, and acknowledged before me by [PRINCIPAL NAME] on [MM/DD/YYYY].

____________________________________
Notary Public
[NOTARY PRINTED NAME]

My Commission Expires: [MM/DD/YYYY]

(Seal)

How to Use the Form

Step 1 – Complete and Sign the Revocation Form

Draft the revocation form, including the following information:

  • State and country in which the POA is effective.
  • Principal’s name and address.
  • The date the revocation is effective.
  • The name of the attorney-in-fact whose power is being revoked (and that of the successor attorney-in-fact, if any).

Regardless of whether it is required by state law, it’s recommended that the revocation form be notarized. Some states also require that two adult witnesses sign.

Step 2 – Record Revocation (Optional)

If the POA being revoked was originally recorded in the county recorder’s office, the revocation document should also be recorded to ensure the original POA is deemed ineffective.

Step 3 – Notify Agent and Other Parties

The principal must inform the attorney-in-fact that their power is revoked. The principal can send the revocation form by certified mail to obtain proof of delivery.

To prevent fraudulent activity, the principal must also ensure any individual or entity that has received a copy of the POA also receives a notice of revocation.

Examples of parties that may require notification:

  • Accountants and lawyers
  • Insurance offices
  • Banks and credit unions
  • Business partners
  • Close friends and relatives

Step 4 – Destroy Copies of POA (Optional)

The revoked POA and any copies that the principal has or that have been collected by third parties can be destroyed. Destroying all originals and known copies of a POA effectively revokes it in most states.