ILLINOISDECLARATION

ILLINOIS DECLARATION

This declaration is made this _____ day of __________, 20__.I____________________, being of sound mind, willfully and voluntarily make known my desires that my moment of death shall not be artificially postponed.

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The declarant has been personally known to me and I believe him or her to be of sound mind. I saw the declarant sign the declaration in my presence (or the declarant acknowledged in my presence that he or she had signed the declaration) and I signed the declaration as a witness in the presence of the declarant. I did not sign the declarant's signature above for or at the direction of the declarant. As of the date of this instrument, I am not entitled to any portion of the estate of the declarant according to the laws of intestate succession or, to the best of my knowledge and belief, under any will of declarant or other instrument taking effect at declarant's death, or directly financially responsible for declarant's medical care.

Witness _______________________________________

Witness _______________________________________

[hwp/doc/pdf]ILLINOISDECLARATION