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Utah Revocation of Power of Attorney Form

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Utah Revocation of Power of Attorney Form is a legal method to revoke a prior delegation of authority bestowed upon an agent. In order to issue this type of paperwork, you must be the principal named in the power of attorney that must be terminated.  Only the individual who has authorized another party to use his or her name can terminate such consent (unless it is done so by the courts).

This paperwork will provide the required language a revocation must contain though it will also need some basic information supplied to it. Once it is completed it should be formally issued in writing to the concerned agent(s), successor agent(s), and any other entity who has been given a copy of the document being revoked. Unless each concerned party receives this revocation, it will be expected to honor the directives of the status quo.

LawsSection 75-5-306

How to Write

1 – Obtain The Revocation Tool Required To Terminate Principal Powers

The template on this page can be downloaded to your machine as a PDF File. Click on the PDF button to open and save it to your machine. Be prepared with some basic information regarding the granted Authority.

2 – The Revocation Document Should Be Described

The document that will terminate through this revocation must have the Principal Powers it delegates categorized. This can be done by checking one of the checkboxes at the top left-hand corner of this document. If the previously designated Principal Authority concerns the Principal’s Health Care, then mark the first checkbox. If the previously designated Principal Authority is financial in nature, then mark the second checkbox. If the Powers being revoked cannot be classified as either Health Care Powers or Financial Powers, then describe what type of Principal Powers are being revoked on the blank space after the word “Other” and mark the corresponding checkbox.

3 – Items Of Information Must Be Supplied Where Requested

After defining the type of Principal Powers being delivered, record the Full Name of the Principal who has issued them on the blank space that is just before the words “… Hereby Immediately Revoke….”

The next available blank line will require the Title of the document the Principal used to delegate the Principal Powers recorded on it. To further define the document being revoked, enter its Date of Execution using the available areas to record each component of the previous Authority’s Execution Date

The Attorney-in-Fact who was granted Principal Power and will now have it revoked must have his or her Full Name entered on the space following the words “…Which Appointed”

If the document whose Principal Powers are being revoked has named an Alternate Successor to the Attorney-in-Fact listed above, then document his or her Name on the last blank space before the words “…As My Alternate Successor Agent.”

4 – The Principal Can Only Set This Document In Motion With A Signature

The Principal named above will have to issue this Revocation to each concerned party, especially the Attorney-in-Fact(s) whose Powers are being revoked. For this Revocation to be considered an accurate representation of the Principal’s expectations, he or she will need to enter the Date of Revocation on the blank lines in the statement beginning with the words “This Revocation Was Signed The…”

The Principal must sign and print his or her Name on the blank lines below this Date immediately after it has been entered

The Notary Public commissioned for the notarization of the Principal Signature will satisfy the “Notary Acknowledgment” section as part of this process.


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