Ohio Revocation Power of Attorney Form

The Ohio revocation power of attorney form is a legal document that complies with the requirements of all powers documents to absolve the assigned Agent(s) of their stated responsibilities according to the powers document prepared by the Principal. This document will allow the Principal to revoke all powers, by completion of this document. The document must be signed before a Notary Public and then be delivered or served to the Agent(s) so that each shall be properly notified.

It’s advisable, as well, that the Principal (or a their new agent if one is assigned) send copies to anyone holding copies of the document or interested health care providers, creditors, banking institutions or any others.

How to Write

Step 1 – The Parties – Submit the following information:

  • The Principal’s name
  • Complete Address
  • AND
  • The name of the Agent
  • City of Residence
  • Enter the year in which the powers document was executed and became effective
  • Attach a copy of the powers document

Step 2 – Signature and Notarization – Must be signed before the notary:

  • Read the statement
  • Enter the date of revocation in dd/mm/yyyy format
  • Enter the Principal’s Signature

Notarization –

  • Once the Notary has witnessed the Principal’s signature, they shall then complete the acknowledgment by signature, date and official seal