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- REVOCATION OF POWER OF ATTORNEY
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- Whereas the undersigned, of by a writing dated
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- ___________,19__ did make, constitute and appoint _____________
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- of _______________________ as my attorney in fact.
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- Now, therefore, the undersigned hereby revokes and makes
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- void the said power of attorney forthwith and all powers
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- authority conferred thereby is terminated and shall cease as the
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- date subscribed below.
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- Dated:
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- ______________________________ __________________________
- Witness
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- Form 613
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