Virginia Revocation Power of Attorney Form

The Virginia revocation power of attorney form is a document that is completed and either delivered or served by a Principal to an Agent to notify them that a powers document for which they were named Agent, has been revoked.The document must be delivered or served to the Agent before it will be effective. This document must be witnessed.

How to Write

Step 1 – Use of Document –

  • Check the box indicating the use of the document
  • Other – Enter the title of the powers document to be revoked

Step 2 – The Parties – Enter the following:

  • Principal’s name
  • Enter the title of the document
  • Date of the date of execution of the document
  • Agent’s name
  • Alternate Agent’s name

Step 2 – Date of Revocation –

  • Enter the date of the revocation in dd/mm/yy format

Step 3 – Signature – Must be witnessed:

  • Printed name of Principal
  • Principal’s signature
  • Notary must witness the Principal’s signature
  • Notary shall acknowledge the document by completing the required information

Step 4 – Copies –

  • Provide copies to anyone who may have a copy of the powers document