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State of Ohio Advance Directives Health Care Power of Attorney  Form

State of Ohio Advance Directives Health Care Power of Attorney Form

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Attorney-in-fact/Agent. This is my written revocation of the above referenced General Durable Power of Attorney and I am providing a copy of it to my attorney-in-fact/Agent. DATED this the _________ day of ______________________________, 20____. Signature of Declarant: __________________________________________________________ Printed Name of Declarant: _______________________________________________________ Address of Declarant:...
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