Updated January 13, 2023
An Iowa power of attorney revocation is required when someone wants to cancel a previously executed power of attorney document. This form can be used for any type of authority delegation. After executing a revocation, it is important to alert the agent and provide them, as well as any other person or entity that may rely on it, with a copy. Otherwise, a third party is not liable for acting on a POA if they have no knowledge of the revocation.
How to Write
1 – Obtain A Copy OF The Target Power Document And The Revocation Form
Consult your records and keep a copy of the document being revoked handy since the information requested will need to be presented exactly as it has been recorded in the target document. Then select the button beneath the image to open the document. Make sure to have the appropriate software program. If necessary, you may open a PDF with an up-to-date form-friendly browser then print it.
2 – Define What Type Of Power Document Is Being Revoked
There are several types of Power Documents that may be targeted by this revocation. Before we begin entering the information onto this form, we will need to indicate the type of Power Document this revocation will be aimed at. There will be three checkboxes provided at the top of this form. Mark the box labeled “Health Care Powers” or “Financial Powers” if the target Authority delivers Health Care or Financial Powers (respectively). If the target document fits into neither of these categories, then mark the box labeled “Other” and describe the type of Authority being revoked on the blank lines provided.
3 – Supplement The Revocation Statement With The Required Information
Now that we have defined what type of Power Document is being targeted, we must identify the Principal. This is the individual who has issued the targeted Power Document and, now, intends to revoke it. Provide the Legal Name of the Principal on the first blank line in the main paragraph.
Once the Principal has been identified, it will be time to report the exact Title of the Targeted Document on the blank space between the words “…the document titled” and “that…”
In order to solidify the exact document being revoked, enter the Date of Execution of the Authority to be terminated on the blank spaces after the words “…executed on the.” Typically, this will be the same as the Signature Date, however, this is not a given so make sure to double-check any additional instructions regarding the Execution Date. This date should be reported as a Calendar Day, Month, and Year. 
The next task at hand will be to name the Agent/Attorney-in-Fact/Health Care Agent, whose Principal Powers and Authority will be terminated by this revocation. To do this enter the Legal Name of the Agent on the empty space before the words “as my agent.” If an Alternate or Successor Agent has been also designated with Authority and his or her Principal Powers, enter this individual’s name on the blank space before the words “as my alternate successor agent.” 
4 – The Principal Must Sign This Paperwork To Make This Revocation Effective
The Principal must personally tend to the statement beginning with the words “This revocation was signed the” by utilizing the three empty spaces provided to report the Date he or she is signing this document.
The Principal must sign the blank line labeled “Signature of Principal.” On the blank space below this, the Principal must Print his or her Name.
The last page of this form shall be filled in and stamped by the Notary Public obtained for this Principal Signing. Once this entity has notarized this paperwork, make sure to send a copy to all relevant institutions and deliver to the Agent whose Power is being revoked. The original should be kept safely with the Principal.