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Notice Of Revocation Of Power Of Attorney
I, _________(1)____________, of __________(2)__________, by written
instrument dated ________(3)____________, 19__(4)_, appointed
_____________(5)______________ of ____________(6)____, my attorney in fact for the
purposes and with powers therein set forth, a copy of which is attached hereto as Exhibit
"A".
Notice is hereby given that I have revoked, and do hereby revoke, the
above-described power of attorney, and all power and authority thereby given, or intended
to be given, to
____________(5)_______________.
Dated ____________(7)_____________, 19__(8)_.
_____________(9)_______________
STATE OF _______(10)____________
COUNTY OF ______(11)____________
BEFORE ME, the undersigned authority, on this _(12)_ day of _______(13)________, 19_(14)_,
personally appeared ___________(15)___________ to me well known to be the person described
in and who signed the Foregoing, and acknowledged to me that he executed the same freely
and voluntarily for the uses and purposes therein expressed.
WITNESS my hand and official seal the date aforesaid.
___________(16)________________
NOTARY PUBLIC
My Commission Expires:__(17)___
NOTICE
The information in this document is designed to provide an outline that
you can follow when formulating business or personal plans. Due to the variances of many
local, city, county and state laws, we recommend that you seek professional legal
counseling before entering into any contract or agreement.
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