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Michigan Power of Attorney Revocation Form

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Michigan Power of Attorney Revocation Form

Updated June 07, 2023

A Michigan power of attorney revocation form is designed to terminate or cancel a previously authorized power of attorney. It is the first step in a two-part process. That is, filling out a revocation is generally insufficient if no one knows that you executed it. You also must inform others who have been relying on the original document, especially the agents it delivered principal authority to. If people don’t know it’s revoked, they must rely on the old document and will do so without penalty.

How to Write

1 – The Michigan Termination Paperwork Should Be Obtained Through This Page

You will need to provide a written Revocation of previously issued Powers of Attorney that should be terminated. Open the form using the buttons after the image on this page. Make sure to open and/or download the file type you prefer working with.

2 – Categorize The Targeted Authority

The first task at hand will be to identify the type of Principal Authority that will be terminated or revoked with this form’s completion. As a matter of convenience, three checkboxes have been provided at the top of the page: Health Care Powers, Financial Powers, and Other. Mark the checkbox that best describes the type of Authority being targeted in this revocation. Note: If you choose other, you must provide the category yourself by entering it on the blank space provided.

3 – Indicate Who Is Revoking What

The introductory statement will have a blank line after the first word (“I”). Enter the Legal Name of the Principal who has issued the previous Power Appointment, precisely as it was reported in that Power Appointment, on this line.

The next two pieces of required information will also only be obtainable from the Power Appointment being revoked. After the word “…titled,” transcribe the Title of the targeted Authority on the blank space provided. Then, enter the Date of Execution (named in the Power Appointment), on the blank spaces after the term “…I previously executed”. Make sure to enter this Date as the Two-Digit Calendar Day of the Month, the Name of the Month, and the Two-Digit Year. Next, we will need to make sure the Agent(s) Named in the previously issued Authority is (are) specifically named here in this Revocation or Termination of Principal Authority. List the Full Name of the Primary Agent in the targeted Power Appointment on the space after the word “…appointed.” It is imperative that you report this Name exactly as it appears in the targeted document. Then, on the next blank space, enter the Name of the Alternate Successor Agent (if more room is needed, cite an attachment with a list of the Agent(s) wielding Principal Authority in the targeted Power Appointment.


4 – The Notarized Execution Of This Revocation

Now, the Principal will need to go to a Notary Public’s Office and sign this form in his or her presence, making sure to follow any additional instructions provided by this Notary. To begin, the statement “This revocation…” will require the Principal’s Signature Date entered by the Principal. The Principal must enter the Two-Digit Calendar Day of the Month on the first blank space, the Name of the Month on the second blank space, and the Two-Digit Calendar Year of Signing on the third blank space. The Principal will need to sign the “Signature of Principal” line below this statement then, Print his or her Name on the empty line below the Signature. The “Notary Acknowledgment” section may only have its required items supplied by the Notary Public present at the time of the Principal signing.