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Fill and Sign the This is My Written Revocation of the above Referenced Power of Attorney and I Am Providing a Form

Fill and Sign the This is My Written Revocation of the above Referenced Power of Attorney and I Am Providing a Form

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Open the document and fill out all its fields.
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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: ___________________________________________________________

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How to Sign a PDF on iPhone How to Sign a PDF on iPhone

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