Updated January 10, 2023
A Nevada revocation power of attorney form is a document that terminates a power of attorney. This is part of a two-step process to make the termination effective. After you execute the form, you need to let all of the relevant parties know that you have revoked your power of attorney – especially your agent and successor agent. A revocation is not effective unless people know that it has been revoked.
How to Write
1 – Organize Your References Then Open The Document On this Page
Before obtaining this form, make sure all your materials are organized accordingly. The information requested here will need to be recorded accurately. When you are ready, use one of the buttons beneath the image on this page to obtain a blank copy.
2 – Determine And Report The Type Of Power Being Revoked
Go to the upper left-hand corner of this document. Here, you will find three check boxes. You must select the check box that best defines the subject matter of the Authority document being revoked. You may choose “Health Care Powers,” “Financial Powers,” or (if neither of these are accurate) “Other.” Keep in mind that if you select the check box labeled “Other,” you will need to define what the Power Document’s category on the blank line provided. 
3 – Record Some Basic Information Regarding The Previous Power Appointment
The first paragraph will seek to expand on the definitions of the previous Power Appointment this document. First, we will need the Full Name of the Principal who originally issued the previous Appointment and intends to revoke it now. Enter the Principal’s Full Name on the blank space preceding the words “…hereby immediately revoke.”
The second blank space in this paragraph should have the exact Title of the revoked Powers entered. This should be transcribed precisely as it appears on the original document.
The third item that requires attention takes the form of three blank spaces after the words “I Previously Executed On The…” Here, we must enter the Calendar Day, Month, and Year when the original Powers Document (to be revoked) was executed. Make sure to report the Calendar Day numerically (i.e. 1 through 31), the Calendar Month Name written out, and the Calendar Year as a two digit year.
The last two blank lines will call for the Names of the Agent or Attorney-in-Fact and Alternate or Successor Attorney-in-Face was granted Principal Power through the Power Appointment being revoked. If no Successor Attorney-in-Fact has been named then you may write in the word none in the last blank space. Make sure each Attorney-in-Fact named in the original document is named in this revocation.
4 – The Principal’s Signature Will Finalize This Revocation
The Principal must enter the Date of Signature across the blank spaces in the statement beginning with the phrase “This Revocation Was Signed The…”
The Principal must sign his or her Name on the blank line labeled “Signature Of Principal.” He or she must then provide the Printed version of the Signature on the blank line labeled “Print Name.”
The Notary Acknowledgment page will provide the Notary Public present at the time of signing with a place to supply the verifications and notarization seal necessary to Notarize the Principal Signing.