REVOCATION OF POWER OF ATTORNEY OR
OF AUTHORITY GRANTED IN POWER OF ATTORNEY
I,
(the
Principal),
executed
a
___________________________ [name of document], dated ___________ (“power of attorney”). I:
☐ Revoke the power of attorney in its entirety.
OR
☐ Revoke the authority of ______________ [name of agent] to act under the power of attorney.
OR
☐ Revoke the authority given under ______________ [paragraph/section #] of the power of attorney,
or as otherwise described as follows:
☐ *The power of attorney was recorded in the office of the Clerk and Recorder as follows:
[Reception/Film No.] [Book/Page No.], on
_______County of ____________, State of ___________.
[date]
in
This Revocation is effective ____________ [date or “immediately”].
Dated:
Principal
Subscribed and sworn to before me in the county of ___________, State of Colorado, this ______ day of
________________, 20____.
______________________________
Notary’s Official Signature
______________________________
Commission Expiration
*Check only if Power of Attorney was recorded.
NOTE ON USE: Use of this form does not constitute the exclusive method of revoking a power of attorney
or authority granted under a power of attorney; however, this form should be provided to agents and
third parties that may rely on the underlying power of attorney.
No. 406. Rev. 11-19. REVOCATION OF POWER OF ATTORNEY