Revocation Of Power Of Attorney

Revocation of Power of Attorney

To: Name of Agent

Street Address

City, State, Zip

On __________________________, 2006, I signed a Power of Attorney appointing

_____________________________ as my Agent. That Power of Attorney and the authority

granted there under is hereby REVOKED. This revocation is effective immediately.

Date: ____________________________

___________________________________

(Name of Principal)

____________________________________

(Name of Witness)

Notary

Mailed regular and certified mail

(Number of certified mail)

(Date Mailed)

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Parent category: Legal