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Fill and Sign the Revocation Power Attorney 497296672 Form

Fill and Sign the Revocation Power Attorney 497296672 Form

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REVOCATION POWER OF ATTORNEY: CARE AND CUSTODY OF CHILD OR CHILDREN I, ___________________________________________________________________________, Declarant, having executed a Power of Attorney: Care and Custody of Child or Children on the ________ day of _________________________________________, 20____, naming _______________________________________ ___________________________________ my attorney-in-fact/agent, do hereby revoke that Power of Attorney pursuant to its provision that it may be revoked by me in writing. This is my written revocation of the above referenced 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: ___________________________________________________________ Arkansas Code §18-12-502 provides that "No letter of attorney, duly acknowledged or proved and certified as prescribed by this act, shall be revoked but by the maker of the letter of attorney or his legal representatives, which revocation shall be in writing acknowledged or proved before the proper court or officer and filed for record in the county or counties where the letter of attorney was intended to operate. All such letters of attorney shall be revoked and deemed void from the time of filing revocations for record." State of Arkansas County of ______________________________ This document was acknowledged before me on the _____ day of ________________________, 20_____ by ___________________________________________________ (Name of principal). __________________________________________ (Signature of Notarial Officer) (Seal, if any) __________________________________________ (Title (and Rank)) My commission expires: ______________

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