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Arizona Revocation Power of Attorney Form

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Arizona Revocation Power of Attorney Form allows the principal to formally revoke powers of attorney granted to an agent, and send copies of this information to any relevant third party, such as a bank, hospital, etc.

How to Write

1 – Obtain the Arizona Revocation of Power of Attorney Form

Use the “PDF,” “ODT,” or “Word” button beneath the file image on the right to save this form directly to your machine.

2 – Identify the Principal and the Attorney-In-Fact

In the section labeled “Principal,” locate the columns labeled “Name,” “Place of Residence,” and “Date of Birth.” This information must match the that of the individual who wishes to revoke a previously issued Power of Attorney. Report the Full Name of this party in the first box, the Complete Residential Address in the second column, and the Date of Birth in the third column. In the section labeled “Attorney-In-Fact/Agent,” there will also be three boxes (“Name,” “Place of Residence,” and “Date of Birth”). Here, you will need to report the Agent’s Full Name, Complete Residential Address, and Date of Birth. Make sure the Name of the Agent matches that on the Power of Attorney being revoked in spelling, capitalization, and punctuation.

3 – Revoke the Correct Document

After Identifying the parties involved, it will be time to Identify the Authority being revoked. To begin, locate the words “Type of Power of Attorney. If the Authority being Revoked is a General Power of Attorney then mark the first box. If the Authority being Revoked is a Special Power of Attorney, then mark the second box. Next, find the statement introduced by the phrase “Date of Power of Attorney…” Report the exact Date the Power of Attorney being Revoked went into effect on the blank line provided. The following area will require one row of information to be reported if the Revoked Power of Attorney was filed in a County Recorder’s Office. Find the heading “County and State in which Recorded,” then report the Name of the County and the State where the Revoked document was recorded and filed by the relevant parties and institution. In the column labeled “Date Recorded,” report the exact Date the Revoked Power of Attorney was recorded in the County on the record books. In the third column, labeled “Docket Number,” enter the Docket Number assigned when the concerned document was submitted. In the fourth column, report the Page Number assigned by the County Clerk/Recorder to the Power of Attorney when it was submitted.

4 – Verify the Revocation

The first step to verifying this document will be the “Signature of Principal.” The Principal revoking the Power of Attorney must Sign his or her Name on this line.

On the top of the next page, the Principal will need to enter his or her Name on the first blank line of the first paragraph. The Principal must also report the Date this document is being Signed on the blank lines following the words “…this Revocation fo the Power of Attorney this.” Finally, the Principal must Sign his or her Name on the blank line (for a second time) labeled “Signature of the Principal.”The next paragraph will concern itself with the individual witnessing this Signing. The Witness must enter his or her Name on the blank line preceding the term “…the Witness.” Then in the next three blank areas, the Witness must enter the Calendar Date, Month, and Year he or she witnessed this Signing. At the bottom of this paragraph, the Witness must Sign his or her Name.

The next area is the Notary Public Area where the Notary Public serving this Signing will provide such facts as the Location of the Signing, the Individuals appearing before the Notary, and the Date of the Signing. The Notary Public’s information and seal will be provided below this area. Make sure these items are present.


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