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Kansas Power of Attorney Revocation Form

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Kansas Power of Attorney Revocation Form should be used when you want to revoke a power of attorney that is currently in effect. Filling out and executing the document is not enough to make the revocation effective. You also need to make sure your agent knows about the revocation and has a copy. Additionally, any establishments or individuals that might rely on the original have knowledge about the revocation should be supplied with a copy of this revocation. A third party is not liable for relying on a power of attorney if they are unaware that it was revoked.

How to Write

1 – The Necessary Paperwork

You will need the original Power Issuance in order to fill out this form. The required revocation template will provide the standard language but will need some specifics in order to be useful. Once you have obtained this paperwork from your records, so you may transcribe the information properly, you may select one of the buttons on the right to open the desired form.

2 – Select A Definition For The Type of Power Being Revoked

The first objective will be to accurately define the type of document this form is aimed at. That is, what kind of Authority is being revoked here. You may mark the box labeled Financial Powers or Health Care Powers. If neither of these terms accurately define the document being revoked, then mark the box labeled “Other” and describe the type of Authority being revoked.

3 – The Principal Must Self-Report And Define the Revoked Authority

The language that should be used in a revocation is already present on this template, however, some items will need to be entered for display. First, the Name of the Principal revoking the previous Authority must be presented on the first blank space. The second and third blank required pieces of information will seek to name the revoked Authority precisely so that its Term of Effect may be terminated. Therefore, on the second blank space, report the exact title of the targeted Authority while the next three empty spaces, in this paragraph, will need the Date the revoked Authority was executed.

The next task will require the exact Name of the Agent and Alternate Agent named on the revoked Authority placed on the fourth and fifth blank lines (respectively).

4 – This Revocation Is To Be Signed By The Principal Issuing It

The Principal will need to enter the Date of his or her Signature personally across the blank spaces in the last sentence. This should be written out as the Day on the first space, the Month on the second space, and the Year of Signature on the third space. Below the last sentence of this template, the Principal must present his or her signature and printed name. The final page of this template, “Notary Acknowledgment,” will only be accepted if it is filled out by the Notary Public present during the Principal Signing. No other entity may satisfy this page’s requirement.


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