Massachusetts Revocation Power of Attorney Form

The Massachusetts revocation power of attorney form is a document that will allow a Principal or a Parent to revoke a powers document that had been created but now the Principal or Parent would like to revoke the document and reclaim powers from the Agent or Guardian of children. This document allows a Principal or Parent to remain in compliance with the “written notice” aspect of their agreement with the Agent or Guardian.

This document must be signed before a notary public.

How to Write

Step 1 – Select the powers to be revoked:

  • Health Care Powers
  • Financial Powers
  • Other (ie: Minor Child Powers etc)

Step 2 – The Parties – Enter the following:

  • The name of the Principal or Parent
  • Add the title of the document(s) to be revoked
  • Enter the date the document is being executed
  • Provide the name of the Agent or Guardian
  • Provide the name of the Alternate (Successor) Agent

Step 3 – Enter the date that the revocation should be recognized

Step 4 – Signatures – to be signed before a notary public:

  • Enter the printed name of the Principal or Parent
  • Enter the Principal’s Signature

Step 5 – Notarization –

The notary shall witness the signature of Principal or Parent. The Notary Public shall then complete the remainder of the document so that the document shall be acknowledged.