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Maine Revocation Power of Attorney Form

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Maine Revocation Power of Attorney Form should be issued when you wish to cancel a previous appointment of principal power, whether it be a durable power of attorney, health care power of attorney or limited power of attorney. When you want to cancel a power of attorney, it is important that you fill one of these out, have it notarized, and let your agent know that he or she is to no longer eligible to act on your behalf. You must provide copies of this paperwork to all institutions or medical providers that may have a copy of the original and may be relying on that.

How to Write

1 – The Power Designation Template Is Obtainable Here

To begin, obtain the paperwork by clicking on the “PDF,” “ODT,” or “Word” button then open this form. It is crucial that all the information reported here is done so accurately so have any necessary references available at the time you work on this paperwork.

2 – Declare What Type Of Authority Appointment Is Being Revoked.

Place a mark in one of the checkboxes at the top of this page. Each box will be labeled with a type of Power of Authority document

Mark the first check box if the previously delegated Authority Issuance would be considered a Health Care Power. If not, then leave the first checkbox unmarked. If the Authority being revoked can be considered a Financial Power, then mark the second checkbox, otherwise leave this check box unmarked. If the previously issued Authority cannot be considered either a Health Care or a Financial Authority document, then mark the third checkbox. This choice will need the Authority being revoked to be categorized manually, so use the blank line after the word “Other,” to declare what type of Authority is being revoked.

3 – Fill In The Specifics Required For This Template To Be Effective

Enter the Full Name of the Revoking Principal on the first blank space (just before the words “hereby immediately revoke…”Record the Full Title of the targeted Authority being revoked on the second blank line in this paragraph. Once you have reported the title, find the Date of Execution in the previous Authority then report it on the next three blank spaces. Enter the two-digit Calendar Day on the blank space after the words “…executed on the,” write out the Month on the blank line between the words “of” and the number “20,” and the two-digit year after the number “20.” Make sure this is the exact Date of Execution of the Document being revoked. Each Authority Delegation document will name an individual as the Principal’s Attorney-in-Fact or Agent in the document itself. Locate this Name, then record it precisely as it is reported in the original document. Similarly, some Authority documents will name a Successor or Alternate Agent. If the revoked Authority has such an entity named, he or she must be reported on the last blank line in this paragraph

4 – The Signature Date Must Be Supplied

The Principal who is revoking the previous Authority will do so through his or her physical Signature. This act of signing, therefore, must be accompanied by a Date to indicate when the previous document is being revoked. On the blank spaces in the “This Revocation was signed the,” enter the two-digit Calendar Day, the name of the Month, and the two-digit Year the Principal signs this form.

5 – This Form May Only Be Completed With A Notarized Principal Signature

The blank line labeled “Signature of Principal” and the blank line labeled “Print Name” required the Signature and Printed Name of the Principal presented by the Principal.

This form should be Notarized. This will help ensure every recipient take it seriously. In many cases, this act is required.


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