Revocation of Statutory Durable Power of Attorney for Health Care - Ohio 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in your name as the Declarant at the top of the form. This identifies you as the individual revoking the power of attorney.
3. Next, indicate the date on which you originally executed the Durable Power of Attorney for Health Care. This is crucial for legal clarity.
4. In the designated space, write the name of the person you appointed as your attorney in fact. This informs all parties involved about whom you are revoking authority from.
5. Complete the date section at the bottom of the form where you are signing this revocation. Ensure that it reflects today’s date.
6. Sign and print your name in the provided fields to validate your revocation.
7. Lastly, if required, complete the Certificate of Acknowledgment section by having a Notary Public witness your signature.

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