Revocation of Power of Attorney

I, the undersigned

(Full legal name) ______________________________

(Identity number) ______________________________ residing at

(Address) ____________________________________

____________________________________

hereby revoke the Power of Attorney dated _____________________ and granted to

(Full legal name) ________________________________

(Identity number) ______________________________ residing at

(Address) ____________________________________

____________________________________

I hereby give notice to _____________________ (Agent listed in Power of Attorney) and all other interested parties that I withdraw every power and authority thereby given and declare the above Power of Attorney null and void and of no further force or effect.

Executed this ______ day of __________________20 ____

at ______________________________________

Signature: ________________________________

in the presence of the undersigned witnesses:

Witness 1.

Name: ______________________

Address: _____________________________________________

Signature: ________________________

Witness 2.

Name: ______________________

Address: _____________________________________________

Signature: ________________________

Acknowledgement

This document was acknowledged before me on this ______day of ____________________20__ by ________________________(Principal's Full legal name)

Signature of Notary Public ______________________

Full legal Name ______________________________

My commission expires ________________________

State of ________________________

County of ______________________