Kentucky Revocation Power of Attorney Form

The Kentucky revocation power of attorney form is a legal document that provides, to a Principal, who has implemented a power of attorney and would now like to revoke the powers, a way to provide written notice. Although this is a simple document, it will require acknowledgement by a Notary Public.

Once complete and acknowledged, the Principal must deliver the document or have it served to the Agent to provide notification that the status of the document and that the powers that they had been granted are no longer valid.

How to Write

Step 1 – Download the document – Begin by selecting from the document to be revoked:

  • Health Care Powers
  • Financial Powers
  • Other (if there are other powers documents, list them in the line provided

Step 2 – Parties  –

  • Enter the name of the Principal
  • Add the title of the document you’re preparing to revoke
  • Enter the date that the document was implemented originally
  • Provide the name of the initial Agent
  • Provide the name of the Alternate (Successor) Agent (if one had been elected)

Step 3 – Official Date of Revocation –

  • Enter the desired date that the Principal would like to have recognized as their actual date of revocation in dd/mm/yyyy format

Step 4 – Principal’s Signature and Notary Acknowledgement

  • Enter the printed name of the Principal
  • The Principal must enter their Signature

Once the Notary witnesses the Principal’s signature, the notary will acknowledge the document with their information and placement of an official seal (if any)

Step 5 – Copies –

  • The Principal must provide copies of this document to anyone who may hold a copy, so that all interested parties will be advised.