Living Will Declaration of (Full Legal Name)
Declaration made this ____ day of ________, 20 .
I, (Declarant's Full Legal Name), being at least eighteen (18) years of age and of sound and disposing mind, willfully and voluntarily make known my desires that my dying shall not be artificially prolonged under the circumstances set forth below. I further declare:
.
.
중략
.
.
The declarant has been personally known to me, and I believe him/her to be of sound and disposing mind. I did not sign the declarant's signature above for, or at the direction of, the declarant. I am not a spouse, parent, or child of the declarant. I am not entitled to any part of the declarant's estate or directly financially responsible for the declarant's medical care. I am competent and at least eighteen (18) years of age.
Dated this ____ day of ________, 20 .
____________________________________
Witness
____________________________________
Witness |
2008.01.11
1페이지
