REVOCATION OF POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
That the [General or Special] Power of Attorney executed by
[name of principal] and recorded in book , at page ,
of the records of County, State of , by
by which the undersigned [name of principal] constituted
[name of attorney] attorney for the purpose set forth in
said Power of Attorney, is hereby wholly revoked, cancelled
and annulled.
Dated:
____________________________
NOTE: THIS FORM SHOULD NOTARIZED. FOR FORMAT SEE
LETTERFORM 1000 INDEX UNDER NOTARY FORMS.
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