![]()  | Arkansas Revocation Power of Attorney Form | 
The Arkansas revocation power of attorney form is a form that is required to be completed and delivered to the Agent(s) that have been selected by a Principal. Once the Principal is prepared to release the Agent(s) from their duties, complete the document and provide signature before a notary public. The document will be effective as of the date entered by the Principal.
How to Write
Step 1 – Select the appropriate power(s) to be revoked:
- Health Care
 - Financial
 - Other – (If there are other titled documents to be revoked, enter them on the line provided on the form
 
Step 2 – Parties –
- Enter the name of the Principal
 - Provide the title to the document(s) to be revoked
 - Enter the date of execution of the document(s)
 - Enter the name(s) of any named Agents
 - To make the revocation available immediately enter the date of revocation in dd/mm/yyyy format
 - Enter the Printed Name of the Principal
 - Enter the Signature of the Principal (Before a Notary)
 - Copies of the document will serve as originals and must be provided to the Agent(s) as well as any other interested parties
 
Step 3 – Notary Acknowledgement –
When the document is complete, the Principal must present before a notary to provide signature. After the Notary has witnessed the signature, they will complete all required notary information on the form and provide the notary seal







