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Connecticut Revocation of Power of Attorney Form

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Connecticut Revocation of Power of Attorney Form is for canceling a power of attorney in the event that you do not want it to be used anymore. This form can be used for any type of power of attorney that you created, but it is vitally important that you let your agent know and any other entities that may have been relying on your power of attorney that you are revoking it. An entity that does not have knowledge of the revocation is not liable for relying on a properly executed power of attorney.

How to Write

1 – Organize All The Necessary Documents

You will require an up-to-date copy of the authority document to be revoked so that information reported will remain identical to its original recording. When you are ready to fill out and issue this form, open it using one of the buttons presented on the right.

2 – Present The Requested Information

This form will require the information specific to the parties and document it is focused on. To begin, indicate if the document of previous authority is one with Health Care Powers, Financial Powers, or falls into the “Other” category by marking the appropriate box. If you have selected “Other,” you must define the document type being revoked on the blank space provided.

3 – Supply The Specifics To This Revocation

The main paragraph, starting with the word “I,” must have the Name of the Principal revoking power entered on the first blank space.

Present the Title of the previous authority document being revoked on the second blank space of this paragraph (following the words “…of the document titled”)

The next three blank spaces require a report on the Execution Date of the authority document being revoked.

Locate the phrase “…which appointed” and enter the Name of the Attorney-in-Fact that was named on the targeted authority document.

Use the next blank space to record the Name of the Alternate Agent named on the document being revoked.

4 – Verify Principal Intent To Revoke Power

The final statement on this document, “This revocation was signed….” must have the Calendar Date this form is being signed reported on the three blank spaces provided in this statement.

The Principal using this form to revoke a previous authority must sign his or her Name on the blank space labeled “Signature of Principal.”

The last blank space must have the Signature Party’s Name in Print.

This signature must be performed before a Notary Public. The last page of this document will provide a space for the notarization to take place.


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