Fill and Sign the Louisiana Revocation 497309037 Form

REVOCATION OF POWER OF ATTORNEY STATE OF LOUISIANA PARISH OF ________ BE IT KNOWN that on the ______ day of ________ 20 ___ , before me, the undersigned, a Notary Public duly commissioned and qualified in and for the aforesaid Parish and State, and in the presence of the undersigned witnesses, personally came and appeared: _____________ , wife of _____________ , with whom she is presently living and residing, a person of the full age of majority and a resident of ________ Parish, Louisiana, whose mailing address is _____________ ; who declared that she does hereby revoke that certain mandate and Power of Attorney granted by her to _____________ by act dated the ___ day of ________ 20 ___ , before _____________ , Notary Public, which mandate and Power of Attorney is recorded at Conveyance Book ________ , Folio ________ , under Entry No. ________ of the records of ________ Parish, Louisiana, revoking and canceling any authority granted to the said _____________ in that instrument. THUS DONE AND SIGNED on the date indicated above at _____________ , ________ Parish, Louisiana, in the presence of the undersigned Notary Public, qualified in said State and Parish, and the undersigned competent witnesses, who have signed with the parties after due reading of the whole. WITNESSES: _____________________________ ______________________________ _____________ _____________________________ ____________________________ NOTARY PUBLIC