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Utah Revocation Power of Attorney Form

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Utah Revocation Power of Attorney Form
Utah Revocation Power of Attorney Form
Revocation of Power of Attorney
Approved Board of District Court Judges January 16, 2009
Page 1 o f 1
Revocation of Power of Attorney
I swear that the following is true:
(1) On ___________________________ (date), I signed a written power of attorney
appointing ____________________________________ (name) the attorney-in-
fact for ____________________________________ (name), delegating my
powers as parent or guardian.
(2) I revoke that power of attorney and assume full rights and responsibilities of a
parent or guardian.
Date
Sign here
Typed or printed name
Date:
Sign here
Typed or printed name
Notary Seal
Utah Revocation Power of Attorney Form