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