Fill and Sign the Louisiana Revocation 497309145 Form

REVOCATION OF UNITED STATES OF AMERICA POWER OF ATTORNEY STATE OF LOUISIANA BY [_PRINCIPAL_] PARISH OF [_PARISH_] BE IT KNOWN that on [_Date_] , before me, [_NOTARY_] , 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: [_PRINCIPAL_] , wife of [_Husband_] , domiciled in [_Dom_Parish_] , and having as her present mailing address [_Address_] ; who declared that she hereby revokes that certain mandate and power of attorney granted by her to [_AGENT_] by act dated [_Mandate_Date_] before [_Mandate_Notary_] , Notary Public, which mandate and power of attorney is recorded at [_Recordation_] of the [_Recordation_Parish_] public records, revoking and canceling any authority granted to the said [_AGENT_] in that instrument. THUS SIGNED ON the date indicated above at [_City_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: _____________________ ________________________ [_PRINCIPAL_] _____________________ State of Louisiana Parish of _____________ On this _____ day of ________ , 20__, before me personally appeared ___________________________, to me known to be the person (or persons) described in and who executed the foregoing instrument, and acknowledged that (he/she/they) executed it as (his/her/their) free act and deed. _____________________________ [_NOTARY_] , NOTARY PUBLIC My commission expires: _____________________________ [_DATE_] * * * * * * * * * * REVOCATION OF POWER OF ATTORNEY : This is an act revoking a previous written mandate in accordance with LA C.C. Article 3027. Note that third parties are not bound by the revocation until given notice (LA C.C. 3029). WORD KEY : EXPLANATION : [_PRINCIPAL_] Name of person revoking power of attorney. In this case the principal is a married woman. For alternative appearances, see document Appearances - F1AAPP1. [_PARISH_] Parish in which revocation is signed. [_Date_] Date on which revocation is signed. [_NOTARY_] Notary before whom revocation is signed. [_Husband_] Husband of principal, given for identification purposes. [_Dom_Parish_] Parish of principal's domicile. [_Address_] Mailing address of principal. [_AGENT_] Name of agent whose authority is revoked. [_Mandate_Date_] Date of revoked power of attorney. [_Mandate_Notary_] Notary before whom revoked power of attorney was signed. [_Recordation_] Recordation data on revoked power of attorney. [_Recordation_Parish_] Parish in which revoked power of attorney is recorded. [_City_Parish_] City and parish in which revocation is signed.