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Fill and Sign the Revocation of Statutory Durable Power of Attorney for Health Care Kansas Form

Fill and Sign the Revocation of Statutory Durable Power of Attorney for Health Care Kansas Form

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REVOCATION OF DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS I, ___________________________________________________________________, Declarant, having executed a Durable Power of Attorney For Health Care Decisions on the ________ day of ________________________, 20____, naming ____________________________________ ___________________________________ my attorney-in-fact/agent. This is my written revocation of the above referenced Durable Power of Attorney For Health Care Decisions 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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Sample revocation of statutory durable power of attorney for health care kansas
Revocation of statutory durable power of attorney for health care kansas form
Kansas statute 58 30,106
Kansas statute 58-2557
Kansas REVISED Statutes
K.S.A. 58 25 137
Ksa 58 3086
Chapter 58 article 46 of the Kansas Statutes

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