The West Virginia Revocation of Power of Attorney Form is a crucial legal document that formally allows an individual to cancel a previously granted power of attorney.

This ensures that the designated agent no longer has the authority to act on the principal’s behalf. Such a revocation may be necessary due to changing circumstances, a breakdown in trust, or the principal’s change of mind.

This document provides clarity and ensures the protection of the principal’s interests and rights. It’s a testament to the importance of having control over one’s affairs and the ability to change decisions when deemed necessary.

 

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 Powers

 

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: Legal Name

 

Begin by writing your full legal name. This identifies you as the principal who initially granted the power of attorney. It’s essential to be clear about who is revoking the power to avoid any ambiguity.

Example: I, Jane Elizabeth Doe

 

Step 5: Document Title

 

Specify the title of the original power of attorney document you’re revoking. This ensures that there’s no confusion about which document’s powers are being nullified.

Example: document titled “General Power of Attorney for Financial Affairs”

 

Step 6: Date

 

Indicate the exact date you signed the original power of attorney. This provides a reference point and further clarity about the document in question.

Example: I previously executed on the 5th of June, 2020

 

Step 7: Agent

 

Name the individual you initially designated as your agent. This person was previously granted the authority to act on your behalf.

Example: which appointed Robert James Smith as my agent

 

Step 8: Alternate Agent

 

If you had named an alternate agent in the original document, specify their name here. This person would have stepped in if the primary agent could not act.

Example: and Emily Grace Williams as my alternate successor agent.

 

Step 9: Date

 

State the date you’re signing this revocation form. It’s a testament to when you made the decision to revoke the power of attorney.

Example: This revocation was signed the 10th of August, 2023

 

Step 10: Signature of Principal 

 

Sign your name. Your signature affirms your intent and decision to revoke the power of attorney.

Example: Signature of Principal Jane Elizabeth Doe

 

Step 11: Print Name

 

Print your full name legibly. This ensures clarity, especially if your signature is hard to decipher.

Example: Print Name Jane Elizabeth Doe

 

 

Part II

 

 

Step 1: County 

 

Specify the county where you’re signing this document in West Virginia. This provides jurisdictional context.

Example: County of Jefferson

 

Step 2: Date

 

The notary will fill out this section, indicating the date they witnessed your signature and their name.

Example: On this 10th day of August, in the year 2023, before me Notary John A. Brown

 

Step 3: Print Name

 

The notary will print their name for clarity.

  • Example: Print Name Notary John A. Brown

 

Step 4: Expiration Date

 

The notary will indicate when their commission expires, ensuring they are currently authorized to notarize documents.

Example: My Commission Expires on 15th December, 2025

 

Conclusion


The West Virginia Revocation of Power of Attorney Form is a testament to the dynamic nature of life and relationships.

It underscores the importance of controlling one’s decisions, even after making them.

By filling out this form diligently and accurately, you ensure that your wishes are respected and that there’s no ambiguity about your intent.

Always consult with legal counsel when dealing with such documents to protect all parties’ rights and interests.