The Maine Revocation Power of Attorney Form is an essential legal document allowing an individual to revoke or cancel a previously granted power of attorney.

Power of attorney is an authoritative document that allows one individual (the agent) to act on behalf of another (the principal).

The circumstances that lead someone to grant such power can change, and when they do, the principal might need a process to nullify it.

This form ensures that the process is conducted in an orderly and legal manner, safeguarding the interests of everyone involved.



Part I


In this section, you’re given a clear choice regarding the specific domain for which you’re revoking power of attorney.

This aims to provide clarity and specificity, ensuring that the revocation only applies to your intended area.


Step 1: Health Care Powers


Select this if you’re revoking the authority for someone to make healthcare decisions on your behalf. This can encompass decisions like medical treatments or end-of-life choices.


Step 2: Financial Power


This pertains to any financial decisions or transactions. By ticking this, you’re ensuring that the said individual will no longer have the authority to handle your financial matters.


Step 3: Other


Other specific powers might not be mentioned in the first two options. In such cases, you can manually specify what they are.

Step 4: Title of the Document


Insert the full title of the Power of Attorney you’re revoking.

This specifies the exact document being targeted, ensuring there’s no ambiguity about which authority is being revoked.

Step 5: Date


Fill in the day and month you signed the original power of attorney.

This provides a timestamp to identify the document in question, ensuring clarity and precision.

Step 6: Agent’s Full Name


Write the full name of the person you had designated as your agent.

This confirms the identity of the individual whose authority you’re revoking, preventing potential confusion.


Step 7: Alternate Successor Agent’s Name


Provide the name of the person you had chosen to act as a backup or successor agent, if applicable.

To ensure that, if you had chosen a backup for the primary agent, their authority is also clearly revoked.


Step 8: Date


State the day and month you’re signing this revocation form.

This confirms when you decided to revoke a power of attorney, making the revocation timely and valid.

Step 9: Signature of Principal


Sign your name.

Your signature provides a binding confirmation of your decision, making the revocation legally effective.


Step 10: Full Name


Print your name clearly in legible letters.

This printed name acts as an extra layer of confirmation, ensuring your identity is unmistakably clear.

Step II



This section is completed by a notary public. When you present this form to a notary, they’ll validate your identity, watch you sign, then add their details and seal to confirm the document’s authenticity.


Step 1: Your County


The notary will fill in the name of the county.

This establishes the jurisdiction where the notarization occurs, ensuring local legal protocols are followed.


Step 2: Date


The notary completes this section with the exact day, month, and year when the signing of the document is being acknowledged.

It’s a timestamp, crucial for determining the exact day the document was verified, which can be essential for legal validity and archival purposes.


Step 3: Notary Public Name


The notary will insert their name.

Identifying the notary by name is a declaration of the official who authenticated the document. It’s pivotal to ensure that a certified individual verifies the information.


Step 4: Name



Here, the name of the person or persons whose signature(s) is/are being authenticated is filled in.

This specifies who presented themselves before the notary, emphasizing direct interaction and identity verification.


Step 5: Signature


The notary will affix their signature.

The notary’s signature and seal certify that the signer was indeed the person they claimed to be, and the signing was done in the notary’s presence.



Step 6: Printed Name


The notary neatly prints their name.

A printed name complements the signature and aids in the legibility of the notary’s identity.


Step 7: Expiration Date


The notary provides the exact date when their commission will expire.

This is to confirm the notary’s current active status and validate that they conducted the notarization during the effective period of their commission.




The Maine Revocation Power of Attorney Form is a decisive tool for retracting previously granted powers.

In our lives, situations and relationships evolve, and with these changes, one might feel the need to retract permissions previously given.

This form ensures such a decision is communicated clearly, legally, and transparently, with due regard to all parties.

Always remember to distribute copies to all concerned parties and keep the original for your records, ensuring everyone is aligned with your decision.