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Connecticut Revoking General Power of Attorney Form


Connecticut Revoking General Power of Attorney Form
Connecticut Revoking General Power of Attorney Form
DOCUMENT REVOKING GENERAL POWER OF ATTORNEY
KNOW ALL PERSONS BY THESE PRESENTS:
That I, ________________________ (YOUR NAME), of
___________________________ (YOUR ADDRESS), Connecticut, hereby REVOKE in all
respects, the General Power of Attorney granted by me to
_________________________________________ (name), of ______________________
(address) and ____________________________________ (name), of
______________________ (address), on _______ (date of revoked Power of
Attorney).
IN WITNESS WHEREOF, I have hereunto set my hand and seal at
__________________, Connecticut, this _______ day of ______________, 20___.
Signed, sealed and delivered in the
presence of:
First Witness:
___________________
Second Witness:
___________________
L.S. (Signature):
_______________________
Your Name:
________________________
STATE OF CONNECTICUT)
) ss.: (town) ____________; _______ ,20__
COUNTY OF __________)
Personally appeared _______________, signer and sealer of the within
and foregoing instrument and acknowledged the same to be his/her free act and
deed, before me.
________________________________
Commissioner of the Superior Court
Notary Public
My commission expires:
INSTRUCTIONS FOR SIGNING
DOCUMENT REVOKING POWER OF ATTORNEY
ARRANGE FOR:
TWO ADULT WITNESSES; AND
A NOTARY PUBLIC, CONNECTICUT ATTORNEY, OR: (1) judge of court of
record or a family support magistrate; (2) clerk or deputy clerk of a court having a
seal; (3) commissioner of deeds or town clerk; or (5) justice of the peace.
Connecticut Revoking General Power of Attorney Form
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