Notice of Revocation of a Non-Executory Power of Attorney

Notice of Revocation of a Power of Attorney Not Coupled with Execution

Served through the Notary Public in [Notary Public’s place]

From the Notifying Party: [Principal’s name], residing at [Principal’s address]

To the Notified Party: [Agent’s name], residing at [Agent’s address]

Subject of the Notice

I had appointed you to exercise certain powers on my behalf under the instrument authenticated before the Notary Public in [Place of authentication], under No. [Instrument number], dated [Instrument date].

I have now decided to remove you from the said power of attorney and cancel the aforementioned instrument. I hereby serve you with this notice to cease representing me under it as of the date on which you receive this notice, under penalty of considering any use of this power of attorney after that date to constitute fraud and breach of trust.

The person who gives notice has thereby issued the required warning.

[Place of execution], [Notice date]

The Notifying Party

Name: [Principal’s name] Signature: [Principal’s signature]