Revocation Of Power of Attorney {100.1.2}

(Top 3 inches reserved for recording data) REVOCATION OF POWER OF ATTORNEY Minn. Stat. 523.11, subd. 2 DATE: Minnesota Uniform Conveyancing Blanks Form 100.1.2 (2011) (month/day/year) The undersigned hereby revokes the Power of Attorney dated Principal, to relating to real property in (month/day/year) , from , as Grantor and , as Attorney-in-Fact, County, Minnesota, legally described as follows: Check here if all or part of the described real property is Registered (Torrens) If filed for record, the Power of Attorney was filed (or in Book of . , as Document Number ), in the Office of the Page (month/day/year) County Recorder Registrar of Titles of (check the applicable boxes) County, Minnesota. If filed with the Registrar of Titles, insert the number of the Certificate of Title: (signature) NOTE: This instrument should be recorded in the office of the County Recorder or the Registrar of Titles in the County where the real property is situated. See Minn. Stat. 523.11, subd. 2 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 Minnesota Uniform Conveyancing Blanks Form 100.1.2 State of Minnesota, County of This instrument was acknowledged before me on , by . (month/day/year) (Stamp) (signature of notarial officer) Title (and Rank): My commission expires: (month/day/year) THIS INSTRUMENT WAS DRAFTED BY: (insert name and address) American LegalNet, Inc. www.FormsWorkFlow.com