Fillable Printable Revocation of Enduring Power of Attorney - Queensland

Revocation of Enduring Power of Attorney - Queensland

REVOCATION OF AN ENDURING POWER

OF ATTORNEY

Use this form if you wish to revoke (cancel) the

appointment of a person or persons as your attorney/s

(enduring power).

Form 6

Queensland

Powers of Attorney Act 1998

(Section 49)

ver: 1–14/5/98

Notice to user

As principal (the person revoking the appointment), you

complete Part 1 and Part 2 of this form.

You will need a witness to sign at the end of Part 2 and to

complete Part 3.

Note: You must take reasonable steps to inform every attorney

affected by this revocation that you are bringing his/her

appointment to an end. If you fail to do this, your attorney can

legally continue to make decisions on your behalf.

If the power of attorney is registered under the Land Titles Act

1994, you must also deregister it.

PART 1: Statement revoking the appointment of an attorney

or attorneys

1. I, ______________________________________________________________________________ ,

[Print your full name here]

of _____________________________________________________________________________ ,

[Print your address here]

revoke the enduring power of attorney dated ______________________________________ ,

[Write here the date when the enduring power of attorney was signed]

which appointed ________________________________________________________________

________________________________________________________________________________

[Print here the name/s of your attorney/s]

as my attorney/s.

PART 2: Statement of understanding

Before signing this statement, read it carefully and tick the appropriate boxes.

2. I fully understand that I am revoking a document where I gave power to my attorney/s

to make decisions on my behalf about:

personal matters (including health matters)

financial matters.

I understand that I was able to specify or limit the power of my attorney/s, and that I

was also able to give instructions about how the power was to be exercised.

I understand that the enduring power of attorney gave my attorney the power to do,

for me, anything that I could lawfully do myself in relation to these matters (except for

special personal/health matters), subject to any limitation that I set.

I understand that, under the Act, my attorney/s could not begin to make decisions on

my behalf until:

■ (if ever) I became incapable of understanding the nature and foreseeing the

effects of such decisions, or of communicating those decisions;

■ (if any) the time or occasion specified in the form appointing an attorney/s for

financial matters.

I understand that I may change or revoke an enduring power of attorney at any time

so long as my power to make such a decision is not impaired—that is, so long as I am

capable of making another enduring power of attorney. (Note: You can revoke an

enduring power of attorney without necessarily making another one.)

[Sign your name here]

[Your witness signs here]

[Write the date here]

I, _________________________________________________ , state that:

[Person signing for the principal prints his/her full name here]

(a) I am at least eighteen years old

(b) I am not a witness for this directive or an attorney for the

principal.

[Person signing for the principal signs here]

PART 3: WITNESS’S CERTIFICATE

In order to revoke an enduring power of attorney, the principal must have the same capacity as

that needed to make an enduring power of attorney. It is your responsibility to check that the

principal has this capacity.

It is strongly recommended that you make a record of the proceedings and of the questions you

asked to determine that the principal had the capacity to revoke the enduring power of attorney.

3. I, ______________________________________________________________________________ ,

[Print your full name here]

state that—

(a) I am a:

justice of the peace

commissioner for declarations

lawyer

notary public,

(b) I am not:

■ the person signing for the principal

■ or an attorney of the principal

■ or a relation of the principal or of the principal’s attorney/s,

I am not a current paid carer or health-care provider for the principal

I am a current paid carer or health-care provider for the principal, but the

enduring power of attorney being revoked appointed an attorney/s for financial

matters only

(note: ‘paid carer’ does not mean someone receiving a carer’s pension or similar

benefit),

(d) (tick one box only)

the principal signed this revocation of an enduring power of attorney in my

presence,

in my presence, the principal instructed a person to sign this revocation of an

enduring power of attorney for the principal on his/her behalf, and that person

signed it in my presence and in the presence of the principal,

and

(e) at the time that this revocation of an enduring power of attorney was signed, the

principal appeared to have the capacity to make an enduring power of attorney

giving the same power as the document being revoked—that is, to understand the

matters set out in Part 2.

[Witness signs here]

________________________

[Witness writes the date here]

June 2000