Revocation Of Power Of Attorney Form - Vermont Legal Aid, Inc.
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1REVOCATION
OF POWER OF ATTORNEY
Instructions: You can revoke a power of attorney simply by telling your agent that you are
revoking the power of attorney. This document is a more formal way of doing the same thing.
REVOCATION OF POWER OF ATTORNEY
I, ____________________________ (your name), of _______________ (your town), Vermont,
hereby revoke any and all Powers of Attorney and all authority to act as my Agent given to
_________________________ (Agent’s name). From this date forward, my former Agent has
no authority to handle my personal or financial affairs. Under 14 V.S.A. § 3507(b), my former
Agent must comply with this revocation. This document serves as notice of the revocation to the
Agent and to all parties that receive it. A photocopy has the same effect as the original.
SIGNATURE OF PRINCIPAL
(You sign here)
Date
A notary’s signature is optional. This form revokes a power of attorney even if it is not notarized.
SIGNATURE OF NOTARY
At (city/town)
, (state)
, the principal appeared
personally before me and signed this Revocation of Power of Attorney.
(Notary signs here)
Date
My commission expires on _____________
Verm ont Legal Aid, Inc. - Power of Attorney Revocation
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