Product: Credit reporting or other personal consumer reports

MISSOURI POWER OF ATTORNEY REVOCATION Use of this form is for the power of attorney of : - XXXX XXXX XXXX XXXX  related to ss # XXXX - XXXX XXXX- For Account portions covering decisions of the document titled UNSECURED LOAN, that I allegedly executed on the XXXX of XX/XX/XXXX, which resulted in the appointment of XXXX XXXX as my agent and as my alternate successor agent. I hereby notify said agent ( s ) and any other interested persons and institutions that all portions of said documents are revoked.

l. POWERS BEING REVOKED These are the powers to act on my behalf that have been REVOKED from XXXX XXXX XXXX XXXX  shall NOT have the power to act on my behalf in the following ways. 
I. No Power to Make Payments or Collect Monies Owed. 

XXXX XXXX in fact has no power to make any payments on any accounts I may owe and to hold, collect and request any sums that may be due, owing or payable to me or in which I may hereinafter acquire an interest, in whatever form, whether liquidated or unliquidated, to have, use, and take all lawful means in my name for the collection and recovery thereof, and to adjust, sell, compromise, and agree for the same and to execute and deliver for me, on my behalf, and in my name, all endorsements, releases, receipts, or other suffcient discharges for the same.

2. No Power to Acquire, Lease and Sell Personal Property. 

XXXX XXXX in fact has no power to acquire, purchase, exchange, I lease, grant options to sell, and sell and personal property, or any interests therein, on such terms and conditions, including credit arrangements ; XXXX XXXX infact has no power to execute, acknowledge or deliver, under seal or otherwise, any and all assignments, transfers, titles, papers, documents or instruments in connection therewith. 
XXXX XXXX has no power to purchase, sell or otherwise dispose of, assign, transfer or convey shares of stock, bonds, securities and other personal property now or hereafter belonging to me, whether standing in my name or otherwise, and wherever situ ated. 
XXXX. No Power to Acquire, Lease and Sell Real Property. 
XXXX XXXX in fact has no power to acquire, purchase, exchange, lease, grant options to sell, sell or convey real property, or any interests therein, on such terms and conditions, including credit arrangements of any type. XXXX XXXX infact has no power to execute, acknowledge and deliver, under seal or otherwise, any and all assignments, transfers, deeds, papers, documents or instruments in connection with. 
4. No Management Powers. XXXX XXXX has no power to maintain, repair, improve, invest, manage, insure, rent, lease, encumber, and in any manner deal with any real or personal property, tangible or intangible, or any interests therein, that I now own or may hereafter acquire, in my name and for my benefit, upon such terms and conditions in connection with.

5. No Banking Powers. XXXX XXXX in fact has no power to open and close accounts, make, receive, and endorse checks and drafts, deposit and withdraw funds, acquire and redeem certificates of deposit, in banks, savings and loan associations, and other institutions, execute or release such deeds of trust or other security agreements as may be necessary or proper in the exercise of the rights and powers herein granted.

6. No Motor Vehicles. XXXX XXXX has no power to apply for a 2 Certificate of Title upon, or endorse and transfer title thereto, for any automobile, truck, pickup truck, van, motorcycle, or other motor vehicle, or to represent in such transfer or assignment that the title to said motor vehicle is free and clear of all liens and encumbrances except those specifically set forth in such transfer or assignment.

7. No Tax Powers. XXXX XXXX  in fact has no power to act without imitation on my behalf with regard to federal income taxes ( Forms 1040, 1040EZ, 1040X, etc. ), state and local income taxes, estate, gift ( Form 709 ) or other tax returns of all sorts, whether federal or state and local, including where appropriate joint returns, FICA returns, payroll tax returns, claims for refunds, requests for extensions of time to file returns or pay taxes, extensions and waivers of applicable periods of limitation, protests and petitions to administrative agencies or courts, including the tax court, regarding tax matters, and any and all other tax related documents, including but not limited to consents and agreements under Section 2032A of the Internal Revenue Code or any successor section thereto and consents to split gifts and closing agreements, for all tax periods from XXXX through XXXX, and for all jurisdictions ; to complete Internal Revenue Service Form 2848, Power of Attorney and Declaration of Representative ( or other prescribed form ) on my behalf as well as to perform all other functions contemplated by that form whether they are required or merely permissible ; to consent to any gift and to utilize any gift-splitting provisions or other tax election ; or to prepare, sign, and file any claims for refund of any tax ; to post bonds, receive confidential information or contest deficiencies determined by the Internal Revenue Service or any state or local taxing authority : to exercise any and all elections that I may have under federal, state or local tax laws including without limitation the allocation of any generationskipping tax exemption to which I may be entitled ; to the extent that I may have omitted some power or discretion, some tax period, some form or some jurisdiction, I hereby REVOKE from XXXX XXXX powers to amend the Internal XXXX Revenue Service form power of attorney ( presently Form XXXX or Form XXXX ) in my name. 
8. No Safe-Deposit Boxes. XXXX XXXX has no power to open or have access at any time or times to any safe-deposit box rented by me or to which I may have access, where so ever located, including drilling, if necessary, and to remove all or any part of the contents thereof, and to surrender or relinquish said safe-deposit box ; and any institution in which any such safe-deposit box may be located shall not incur any liability to me or my estate as a result of XXXX XXXX attempts to exercise this power. 
9. No Gift Making Powers. XXXX XXXX has no power to make gifts, grants, or other transfers including the forgiveness of indebtedness and the completion of any charitable pledges I may have made without consideration, either outright or in trust to such person ( s ) ( XXXX XXXX ) or organization trying to act as my attorney in fact shall not have to power to, including, without limitation, the following actions : ( a ) transfer by gift in advancement of a bequest or devise to beneficiaries under my will or in the absence of a will to my spouse and descendants in whatever degree ; ( b ) or release of any life interest, or waiver, renunciation, disclaimer, or declination of any gift to me by will, deed, or trust. 
10.No Lending and No Borrowing. XXXX XXXX has no power to make loans by my name ; to borrow money in my name, individually or jointly with others. 
XXXX XXXX in fact has no power to give promissory notes or other obligations therefor ; or to deposit or mortgage as collateral or for security for the payment thereof any or all of my securities, real estate, personal property, or other property of whatever nature and wherever situated, held by me personally or in trust for my benefit. 
11. No Contracts. XXXX XXXX has no power to enter into any contracts of whatever nature or kind in my name. 
12. No Health Care. XXXX XXXX has no power to take any steps Page 4 of 6 necessary to arrange for my admission to any type of health care facility, including, without limitation, a hospital, rehabilitation facility, skilled nursing facility, or hospice, or to authorize the release of my medical records ever.

13. HIPAAXXXX XXXX XXXX has no power or authority as my personal representative for all purposes of the Health Insurance Portability and Accountability Act XXXX ( XXXX XXXX XXXX. XXXX ). 
14. No Power to Hire or Pay for Services. XXXX XXXX has no power to retain such accountants, attorneys, social workers, consultants, clerks, employees, workers, or other people in connection with the management of my property and affairs and to make payments from my assets for the fees of such people so employed. 
15. No Reimbursement. XXXX XXXX has no power to reimburse anyone for any reasonable expenses incurred in connection with such services ; and 16. No Power to Sue Third Parties Who Fail to Act Pursuant to Power of Attorney. If any third patty ( including stock transfer agents, title insurance companies, banks, credit unions, and savings and loan associations ) with whom XXXX XXXX may try and seeks to transact with refuses to recognize XXXX XXXX as my attorney-in fact who has no authority to act on my behalf pursuant to this Power of Attorney, XXXX XXXX has no power to sue or recover from such third party all resulting damages, costs, expenses incurred because of such failure to act. The costs, expenses, and attorney fees incurred in bringing such an action shall be charged to XXXX XXXX. 
17. Other No Powers to conduct the following. XXXX XXXX has no power, authority or authorization to report any information tied to account o nyone ever to include all credit reporting agencies like XXXX, XXXX XXXX, XXXX, XXXX or any secondary credit reporting agencies like XXXX XXXX Page 5 of 6 This instrument is to be construed and interpreted as a revocation power of attorney. The enumeration of specific powers herein is not intended to, nor does it, limit or restrict the general powers revoked and not granted to XXXX XXXX. 
This instrument is executed and delivered in the State of Missouri and the laws of such state shall govern all questions as to the validity of this power and the construction of its provisions. Nevertheless, I intend that this instrument be given full force and effect in any and all XXXX states or countries in which I may find myself, where I may own property, whether real or personal. I revoke any bond required to give bond and it any bond was required from REPRISE FINANCIAL. This revocation takes effect immediately. A photocopy has the same effect as an original. This revocation was signed the XXXXXXXX XXXX XXXX XXXX XXXXXXXX. 
Signature of Principa Print Name NOTARY ACKNOWLEDGMENT [ XXXX XXXX XXXX XXXX XXXX XXXX ] The foregoing instrument was acknowledged before me by means of C physical presence oryonline notarization, on this day XXXX, of this ( month ), XXXX, of this ( year ) XXXX, Produced Identification : XXXX XXXXXXXX. Type of Identification Produced : MO XXXX. 
Acknowledged by ( Type/Write Name of Notary Public ) XXXX XXXX XXXX XXXX  XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XX/XX/XXXX ( XXXX ( Signature of Notary Public ) Page 6 of 6