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North Dakota Revocation of Power of Attorney Form

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North Dakota Revocation of Power of Attorney Form may be used to revoke an existing power of attorney. It can be used for any type of power of attorney including a durable, guardian of the child, health care POA and others. In addition to formally executing this document, you should make sure that relevant parties receive a copy and are thus put on notice that you have revoked your POA. If someone is not aware of your revocation, then they may not be liable for continuing to use their representation powers.

Laws – § 30.1-30-04

How to Write

1 – The Revocation Document On This Page Should Be Downloaded

Make sure you have a copy of the Authority being revoked for reference. When you are ready, download a copy of the form necessary to revoke this Authority by selecting one of the buttons beneath the image.

2 – Define The What Type Of Authority Must Be Revoked

The type of Principal Powers that must be terminated through this Principal Revocation should be indicated at the start of this paperwork. This can be achieved by checking one of the first three checkboxes at the top of this page. You may define the Powers as being “Health Care Powers” or “Financial Powers.” If the Powers issued by the Principal does not fit into either of these categories, then mark the “Other” box and describe the category the previously issued Authority would fall under on the blank line provided

3 – The Principal And The Issued Power Must Both Be Named

Enter the Legal Full Name of the Principal, issuing this document, on the first blank line in the main paragraph. In addition to identifying the Principal, the document being revoked will need to be named. Supply the Title of the Authority paperwork being revoked on the second blank line in this paragraph. Continue identifying the revoked paperwork by entering its Execution Date using the three blank lines after the phrase “…I Previously Executed On The” as a way of presenting the Execution Date’s Calendar Day, Month, and Year.

4 – Report On Whose Power Is Being Revoked

Another method of identifying the previously issued Authority will be to decidedly name any Agent and Alternate Successor Agent on the blank lines following the phrase “…Which Appointed” and preceding the words “As My Alternate Successor Agent” (respectively).

5 – The Principal Must Issue This Revocation Through A Notarized Signature

This Revocation must be signed by the Principal to be taken seriously. Furthermore, it should be notarized. The Principal should enter the Date of this Revocation using the statement beginning with the term “This Revocation Was Signed The…”Once this task has been completed the Principal must sign his or her Name on the blank line labeled “Signature Of Principal” then print his or her Name on the “Print Name” line. The second page of this form has been supplied for the use of the Notary Public overseeing this document’s Principal Signing.

If you still have it, you may want to write “REVOKED” across your original POA and attach it to the revocation. It is imperative that you provide copies of the revocation to your agent(s) and let any other institutions know that you have revoked the document.


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