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

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

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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. DATED this the ____ day of __________________ , 20 ____ . Signature of Declarant: __________________________________________________________ Printed Name of Declarant: __________________________________ Address of Declarant: ___________________________________ Revocation of Power of Attorney Page 1 of 1

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