Notice of Revocation of Power of Attorney

I, __________________________________, of __________________________, City of ______________________________, County of __________________________, State of ___________________________, hereby give notice that I have revoked, and do hereby revoke, the power of attorney dated ________________________, given to ______________________________ [name of attorney-in-fact], empowering said ______________________________ to act as my true and lawful attorney-in-fact, and I declare that all power and authority granted under said power of attorney is hereby revoked and withdrawn. DATED: __________________ ___________________________________ Signature of Principal WITNESSES: ____________________________ Residing at _________________________________ ____________________________ Residing at _________________________________ State of _____________ County of ___________ On this _____ day of ____________, 20__, ________________________ personally appeared before me and executed this document in my presence. ___________________________________ Notary Public