Fill and Sign the Revocation of General Durable Power of Attorney Arizona Form

REVOCATION OF POWER OF ATTORNEY I, __________________________________ , Declarant, having executed a General Durable Power of Attorney on the _____ day of ____________ , 20 _____ , naming __________________________________ my attorney-in-fact/agent, do hereby revoke that Power of Attorney pursuant to its explicit provision that it may be revoked by me by written instrument signed by me and delivered to my 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. I, ___________________________________ , the principal, sign my name to this Revocation on this _____ day of __________________ , 20 _____ , and, being first duly sworn, do declare to the undersigned authority that I sign and execute this instrument as my Revocation and that I sign it willingly, that I execute it as my free and voluntary act for the purposes expressed therein and that I am eighteen years of age or older, of sound mind and under no constraint or undue influence. ________________________________________ Principal I, __________________________________ , the witness, sign my name to the foregoing Revocation being first duly sworn and do declare to the undersigned authority that the principal signs and executes this instrument as his/her revocation and that he/she signs it willingly, and that I, in the presence and hearing of the principal, sign this Revocation as witness to the principal's signing and that to the best of my knowledge the principal is eighteen years of age or older, of sound mind and under no constraint or undue influence. ________________________________________ Witness Revocation of Power of Attorney Page 1 of 2 State of Arizona County of ___________________ Subscribed, sworn to and acknowledged before me by __________________________________ , the principal, and subscribed and sworn to before me by __________________________________ , witness, this _____ day of __________________________________ . ________________________________________ Notary Public SEAL Address of Declarant: __________________________________ Revocation of Power of Attorney Page 2 of 2