Power of Attorney Revocation Form

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Revocation of Power of Attorney

This form will notify all concerned parties that a power of attorney relationship has been ended or revoked. It must be notarized and witnessed in most states to be valid, and can be used in two situations:

  1. To revoke a power of attorney before the set termination date
  2. The termination date has been met, but you want to ensure all parties are aware.

Written by Nolo Law

November 2007, 6th Edition

eForm: 17.99

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The form below is a very basic one and has not been vetted by our attorneys nor updated to reflect changing laws. Chances are you will need something more comprehensive. Nolo.com provides much more professional forms.




Reference is made to certain power of attorney granted by ___________________________ (Grantor) to ______________________________(Attorney-in-Fact), and dated the _____ day of __________,20__ .

This document constitutes notice that the Grantor hereby revokes, rescinds and terminates said power-of-attorney and all authority, rights and power thereto effective this the _____ day of ____________, 20__.









Subscribed and sworn before me this the _____ day of ____________, 20__.

WITNESS my hand and official seal.

______________________________ My commission expires:

Notary Public




These forms are provided AS IS. They may not be any good. Even if they are good in one jurisdiction, they may not work in another. And the facts of your situation may make these forms inappropriate for you. They are for informational purposes only, and you should consult an attorney before using them.

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