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Illinois Power of Attorney Revocation Form

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Illinois Power of Attorney Revocation Form

Updated January 12, 2023

An Illinois power of attorney revocation cancels a previously authorized power of attorney in Illinois. It should be noted that in order for this power of attorney revocation to be effective, the parties involved must be aware of the revocation. It is therefore important that the principal is sure their agent and relevant financial institutions are aware of the revocation, and better yet, have copies in their files. A person who is not aware of the revocation is not liable for relying on the original power of attorney.

How to Write

1 – Review The Original Document Then Open The Revocation On This Document

The original Authority that will be revoked by this paperwork should be consulted while filling out the form on this page. You may select the button to open the form.

2 – The Issuing Principal

The Principal issuing this revocation must have his or her Name (First, Middle, Last) documented on the first blank line. This form will also require the Principals’ Street Address, City, County, and State recorded on the next four blank lines.

3 – The Document Targeted For Revocation

Next, there will be two parentheses. One containing the word “Property” and the other containing the word “HealthCare.” If the document being revoked deals with the Principal’s Property, then cross out the word “HealthCare. If the document being revoked deals with the Principal’s HealthCare, then cross out the word “Property.”

On the line following the word “…dated,” enter the Date on the document being revoked.

On the line after the word “…empowering,” record the Name of the Agent or Attorney-in-Fact whose Principal Authority is being revoked.


4 – Executing This Paperwork

Directly below this paragraph will be a Date line and Signature line. The Principal must enter the Date of Signature.

The Principal must, then, sign this form above the words “Signature of Principal.”

This form should be notarized by a Notary Public. There will be a section below this strictly for the Notary’s verifications and credentials to be supplied. Only the Notary Public may supply these items.