Revocation of Durable Power of Attorney for Health Care - Indiana 2026

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The document is a formal revocation of a previously executed Durable Power of Attorney for Healthcare by the Declarant. It states the Declarant's intention to revoke the authority granted to their attorney-in-fact/agent, in accordance with the provisions allowing such revocation through a written instrument.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name as the Declarant in the designated field. This identifies you as the individual revoking the Durable Power of Attorney.
Next, specify the date on which you originally executed the Durable Power of Attorney for Healthcare. This is crucial for legal clarity.
In the section where it asks for your attorney-in-fact/agent's name, input their full name. This ensures that they are aware of the revocation.
Fill in today's date in the 'DATED this' section to indicate when you are formally revoking the document.
Finally, sign and print your name in the respective fields to validate your revocation. Ensure that all information is accurate before saving or sending.

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