Power of Attorney and Health Care Revocation for West Virginia - West Virginia 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name as the Declarant in the designated field. This identifies you as the individual revoking the Power of Attorney.
3. Fill in the date when you originally executed the Power of Attorney. This is crucial for legal clarity.
4. Next, specify the name of your attorney-in-fact/agent whom you are revoking authority from. Ensure accuracy to avoid any confusion.
5. Complete the date section at the bottom where you are signing this revocation. This indicates when you formally revoked the Power of Attorney.
6. Sign and print your name in the respective fields to validate your revocation. Include your address for additional identification.

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