Revocation of Power of Attorney
for Business Affairs

I, (Principal Name)

Principal Address

Hereby revoke the Power of Attorney given to (Attorney-in-fact Name)

Attorney-in-fact Address

Originally executed on (Date of original POA)

Description of Power of Attorney being revoked (or attach copy):

This revocation is effective as of (Effective Date of Revocation)

Additional Statements or Instructions (if any):

Signature of Principal

Date

Witness

Date

Notary Acknowledgment (if required):

Revocation of Power of Attorneyfor Business Affairs