Form to Revoke Power of Attorney

Use this form to revoke (remove) Power of Attorney from your agent.

Use this text or use the fillable PDF form that is below the text.

Instructions: You can revoke a power of attorney simply by telling your agent that you are revoking the power of attorney. This document is a more formal way of doing the same thing.

REVOCATION OF POWER OF ATTORNEY

I, [write your name], of [write your town], Vermont, hereby revoke any and all Powers of Attorney and all authority to act as my Agent given to [write your Agent’s name]. From this date forward, my former Agent has no authority to handle my personal or financial affairs. Under 14 V.S.A. § 3507(b), my former Agent must comply with this revocation. This document serves as notice of the revocation to the Agent and to all parties that receive it. A photocopy has the same effect as the original.

SIGNATURE OF PRINCIPAL

[You sign here]

Date: [Write the date]

A notary’s signature is optional. This form revokes a power of attorney even if it is not notarized.

SIGNATURE OF NOTARY

At [write the city/town],[write the state], the principal appeared personally before me and signed this Revocation of Power of Attorney.

[Notary signs here]

Date: [Write the date]

My commission expires on [write expiration date]