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Florida ______ Signature of person taking acknowledgment (Notary Public) _________________________________ Name typed, printed, or stamped -5- __________, ______ by __________________________ (name of Principal), who is personally known to me or who has produced ________________________________ as identification. ___________________________: ___________________________________ State of __________________________ ) ) ss County of ________________________ ) The foregoing instrument was acknowledged before me this _____ day of ______________________ State: ___________________________________ Witness Signature: ___________________________________ Name: ___________________________________ City: __________________________________ State_______ (state). ________________________________ Signature of Principal Witness Signature: ___________________________________ Name: ___________________________________ City: ______________________is Power of Attorney. I may revoke this Power of Attorney at any time by providing written notice to my Agent. Signed on ________________ (date), at _______________________ (city), ___________________ting from judgment errors made in good faith. However, Agent will be liable for breach of fiduciary duty, failure to act in good faith and/or willful misconduct, while acting under the authority of thed by operation of law, any person relying in good faith on the authority of this document, without notice of such termination, shall be held harmless. -4- Agent shall not be liable for losses resule of the revocation. I agree to indemnify the third party for any claims that arise against the third party because of reliance on this power of attorney. If this General Power of Attorney is terminatt by my Agent. Any third party who receives a copy of this document may act under it. Revocation of the power of attorney is not effective as to a third party until the third party has actual knowledgy Agent; (b) my Agent to have any rights or ownership with respect to any life insurance policies I may own on the life of my Agent; and/or (c) my assets to be subject to a general power of appointmensition of any proceeds paid to my Agent based on this document. The powers granted to my Agent by this power-of-attorney are limited to the extent necessary to prevent (a) my income to be taxable to mll still remain in full force and effect and not be affected by any partial invalidity. No person needs to inquire as to the reasons for the use or issuance of this power-ofattorney or as to the disposcope of powers granted herein in any manner. If any part of this document is held to be invalid, illegal or unenforceable under applicable law, then the remaining unaffected parts of the document sha Agent. This Power of Attorney shall be construed broadly as a General Power of Attorney. The listing of specific terms, rights, acts or powers are not intended to restrict or limit the definition or s my Agent If so requested by myself or any authorized personal representative or fiduciary acting on my behalf, my Agent shall provide an accounting for all funds handled and all acts performed as myall reasonable expenses incurred as a result of carrying out any provision of this Power of Attorney. If desired, my Agent shall also be entitled to reasonable compensation for any services provided aack of capacity to receive and evaluate information effectively, to communicate decisions, and/or to manage my financial resources and affairs properly. My Agent shall be entitled to reimbursement of , and -3- authority of this document shall remain in full force and effect thereafter until my death or until my disability or incapacity. As used herein, "disability" or "incapacity" shall mean a ly Agent or my Agent's estate. This General Power of Attorney and the rights, powers, and authority of my Agent shall become effective immediately upon execution of this instrument. The rights, powersstate, trust, or other entity, as may be appropriate. However, Agent may not disclaim assets, to which I would be entitled, if the result is that the disclaimed assets pass directly or indirectly to mif such trust exists at the time of such transfer. 17. To disclaim any interest (subject to other provisions of this document), which might be transferred or distributed to me from any other person, e obligations of support which my Agent may owe to others, excluding those whom I am legally obligated to support. 16. To transfer any of my assets to the trustee of any revocable trust created by me, y hold in favor of my Agent, my Agent's estate, my Agent's creditors, or the creditors of my Agent's estate, or (c) use any of my assets to discharge any of my Agent's legal obligations, including any any of my assets, interests or rights, directly or indirectly, to my Agent, my Agent's estate, my Agent's creditors, or the creditors of my Agent's estate, (b) exercise any powers of appointment I mannual right shall be non-cumulative and shall lapse at the end of each calendar year. However, my Agent may not, unless specifically authorized by this document, (a) gift, appoint, assign or designategifts made shall be limited to gifts that qualify for the federal gift tax annual exclusion, shall not exceed in value the federal gift tax annual exclusion amount in any one calendar year, and this aocuments. Gifts to minors may be made to the minor directly or parent, guardian or close friend of the minor or pursuant to the Uniform Gifts to Minors Act or the Uniform Transfers To Minors Act. Any le property, to such persons or organizations without regard to whether such gifts are a part of my estate planning or otherwise, and if necessary, to file any state and federal gift tax returns and drnmental agencies, relating to tax matters and to negotiate, compromise or settle any matter with such agency. 15. To make gifts and charitable contributions of my real, personal, tangible or intangibdy, including, but not limited to, federal, state, local or other income and tax returns and necessary and/or related documents; to obtain or provide information to and from any agency, including gove accountants, investment professionals, brokers and real estate agents. 14. To prepare, or cause to be prepared, sign, and/or file any documents with any federal, state, local or other governmental boy own or have an interest in or may own or have an interest in, in the future. 13. To employ any professional and/or business assistance as may be appropriate, including but not limited to, attorneys, any and all rights, including proxy rights, with respect to stocks, bonds, debentures, commodities, options or any other investments. -2- 12. To maintain and/or operate any business that I currentlstorage area owned or leased by me alone or in conjunction with any other person, including access to their contents, and to examine, remove, keep or otherwise dispose of the contents. 11. To exercisery to deposit, negotiate, sell or transfer any note, security, or draft of the United States of America, including U.S. Treasury Securities. 10. To have access to any safe deposit box, vault or other ank statements, passbooks, drafts, warrants, money orders, certificates, cashier checks, cash or vouchers payable to me by any person, firm, corporation or political entity; to perform any act necessanking or financial institution with respect to any of my accounts, including, but not limited to, making deposits and withdrawals, negotiating or endorsing any checks or other instruments, obtaining bavings accounts, certificates of deposit, investment accounts, brokerage accounts, retirement plan accounts, and other similar accounts with financial institutions; to conduct any business with any bay Agent, to act as my "Representative Payee" for the purpose of receiving Social Security benefits. 9. To open, maintain and/or close bank accounts, including, but not limited to, checking accounts, sle request by any government or its agencies in connection with governmental benefits (including but not limited to, medical, military and social security benefits), and to appoint anyone, including ms, retirement plans, insurance benefits and government program including, but not limited to, Social Security and Medicare; to prepare applications, provide information, and perform any other reasonabnd to make any elections and disclaimers under such policies. 8. To receive, deposit, hold, demand, deal with and/or sue to recover all payments I receive from any annuity, pension, retirement benefitansaction. 7. To apply for, purchase, maintain and/or deal with insurance and annuity contracts, insurance policies, including life insurance upon my life or the life of any other appropriate person aure; the right to remove tenants and to recover possession; and the right to ask for, demand, sue for, collect, recover and receive all monies which may become due and owing to me by reason of such trred in the future by me) and to execute any necessary document, instrument or deed for such transactions. This includes the right to sell or encumber any homestead that I now own or may own in the futr manner (on such terms and at prices my Agent may deem proper) deal with all, any part or any interest in any real or personal property or asset whatsoever, tangible or intangible (now owned or acqui, me or in which I have or may hereafter acquire any interest, to have, or use. 6. To maintain, manage, insure, lease, rent, sell, mortgage, improve, repair, exchange, invest, reinvest and in any otheidends, certificates of deposit, any and all documents of title and demands whatsoever, whether agreed to or disputed, now due or due -1- in the future, owned by, due, owing payable, or belonging to or entity. 5. To receive, hold, possess and/or invest any and all sums of money, accounts, debts, bonds, commercial papers, checks, drafts, causes of action, bequests, deposits, notes, interests, divtake any and all legal steps necessary to recover and collect any amount or debt owed to me. 4. To adjust, compromise and settle any claim, against me or asserted on my behalf against any other personion of mortgages, lien, judgments, security agreements and other debts and obligations and such other instruments in writing of whatever kind and nature as may be. 3. To request, ask, demand, sue and s, certificates of deposit of, or investments with or through banks, savings and loan, brokers, mutual fund companies or other institutions, proofs of loss, evidences of debts, releases, and satisfactments, leases, mortgages, notes, insurance policies, receipts, title documents, checks, drafts, letters of credit, stock certificates, proxies, warrants, commercial papers, withdrawal and deposit slipy such contract and/or agreement, including but not limited to applications, assignments, bills of sale or lading, bonds, contracts, covenants, conveyances, deeds, options, trust deeds, security agree of whatever kind or nature, on my behalf and in my name. 2. To enter into binding contracts on my behalf and to sign, endorse and execute any written agreement and document necessary to enter into anvirtue of this power of attorney and the rights hereby granted. My Agent's powers and authority shall include, but not be limited to: 1. To conduct, engage in, and transact any and all lawful businessngible, or matter whatsoever as I could do if personally present. I hereby ratify and confirm all acts that my Agent, or my Agent's substitute or substitutes, shall lawfully do or cause to be done by legal right or obligation whatsoever that I now have or may later acquire in connection with or relating to any person, item, transaction, thing, business, property, real or personal, tangible or inta____________________________________________ my true and lawful attorney-in-fact for me and in my name, and in my behalf. My Agent shall have full power and authority to perform any act, power, duty, Principal") maintaining an address at _______________________________________________ do hereby make and appoint ________________________________________ ("Agent") maintaining an address at: _________ppointment, the agent assumes the fiduciary and other legal responsibilities of an agent. -3- GENERAL POWER OF ATTORNEY KNOW ALL PERSONS BY THESE PRESENTS: I, ____________________________________ ("document does not authorize anyone to make medical and other health-care decisions for you. You may revoke this power of attorney if you later wish to do so. AGENT: By accepting or acting under the ach action undertaken by your agent, within the scope of this power of attorney document, is legally binding upon you. If you have any questions about these powers, obtain competent legal advice. This . You ("principal") are providing another person ("agent") with the power to handle business and legal matters on your behalf, including the power to sell, mortgage or dispose of your property. Any sully include state specific instructions. -2- CAUTION! PRINCIPAL: The Powers granted by this power of attorney document are broad and sweeping. Before signing this document, consider its consequencestute for legal advice. Furthermore, this information is general information that is not state specific. Whenever appropriate, the instructions included with the forms packages offered for sale, generatorneys (available at findlegalforms.com as well), stays in effect even if the Grantor later becomes disabled or incapacitated. Please note that this information is not intended as and is not a substiif necessary. Although, some states don't require that a General Power of Attorney be witnessed, it is always a very good idea to do so. Another type of Power of Attorney, called a Durable Power of Atoperty. Notarization will make it more difficult for any third party to challenge the validity of the Power of Attorney and will allow the General Power of Attorney to be recorded as a public record, revoke a General Power of Attorney at any time. A General Power of Attorney should always be notarized, even if your state does not require it, especially if the Agent will be dealing with any real prpowerful" instrument and should be granted with care. Any action undertaken by the Agent, within the scope of the Power of Attorney document, will be legally binding upon the Grantor. The Grantor can ney-In-Fact for the Principal does not need to be a lawyer. Almost anyone can be appointed an Attorney-In-Fact by a power of attorney. The Agent should be a competent adult. A Power of Attorney is a "remains effective until the death of the Grantor or until the Grantor becomes disabled or incapacitated. Note that the word "attorney" is not used here to mean "lawyer". The person acting as the Attornt person (called the "Principal" or "Grantor") to authorize someone else (called the "Agent" or "Attorney-InFact") to act on his or her behalf. This particular Form becomes effective immediately and se of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com -1- Information General Power of Attorney A General Power of Attorney allows a natural "mentally" competebe a starting point for you and should not be used without consulting with an attorney first. An Attorney should be consulted before negotiating any document with another party. [_] The purchase and uweeping, as the Agent has the power to handle business and legal matters on the Principal's behalf. [_] These forms are not intended and are not a substitute for legal advice. These forms should only e Agent (or attorney-in-fact) as to the tasks the Agent should complete. The Grantor should also be very careful in the selection of the Agent. The powers granted by this document are very broad and sitnesses. [_] The Principal should keep the original document, as well as a copy. The Agent should have access to the original document as needed. [_] The Principal should be careful in instructing tha public record, if necessary. [_] Two witnesses need to sign the Power of Attorney. The witnesses should be competent adults. The Agent, the Agent's spouse or children, and the Notary should not be wncipal (i.e. the person granting the Power of Attorney; sometimes called the Grantor) should sign the document before a Notary. Notarization will allow the General Power of Attorney to be recorded as er of Attorney [_] This General Power of Attorney becomes effective immediately and remains effective until the death of the Grantor or until the Grantor becomes disabled or incapacitated. [_] The PriInstructions & Checklist General Power of Attorney [_] This package contains (1) Instructions & Checklist for General Power of Attorney; (2) Information for General Power of Attorney; (3) General Pow FloridaFlorida seal) Self-proved Will Affidavit ­ Florida Probate Code 732.503 _________ (date). _____________________________________________ (Signature of Officer) ____________________________________________________ (Print, type, or stamp commissioned name and affix official me or who has produced ____________________________ (type of identification) as identification and subscribed by me in the presence of the testator and the subscribing witnesses, all on ______________ally known to me or who has produced _______________________________ (type of identification) as identification, and _______________________________ (name of third witness) who is personally known to who is personally known to me or who has produced _______________________________ (type of identification) as identification and _______________________________ (name of second witness) who is person me or who has produced ____________________ (type of identification) as identification, and sworn to and subscribed before me by the witnesses, _______________________________ (name of first witness)________ (Witness) Print Name: ___________________________________ Acknowledged and subscribed before me by the testator, _______________________________, (testator's name), who is personally known to (Witness) Print Name: ___________________________________ _____________________________________________ (Witness) Print Name: ___________________________________ _____________________________________e the testator's will and signed it in our presence and that we each signed the instrument as a witness in the presence of the testator and of each other. _________________________________________________________________, and ______________________________________,, have been sworn by the officer signing below, and declare to that officer on our oaths that the testator declared the instrument to btrument, and to the subscribing witnesses, that I signed this instrument as my Will. _____________________________________________ (Testator) We ______________________________________, and ___________f ______ Self-Proved Will Affidavit STATE OF FLORIDA COUNTY OF ________________________ I, _______________________________________________, declare to the officer taking my acknowledgment of this ins____________________________ ___________________________________ ___________________________________ Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 9 o____________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ _______________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ __________________________________, ______ Witness Signature: Name: Address: City: State: Witness Signature: Name: Address: City: State: Witness Signature: Name: Address: City: State: ___________________________________ ___ness Page 8 of ______ influence; The maker is age 18 or older. Each of us is now age 18 or older, is a competent witness, and resides at the address set forth after his or her name. Dated: _________he maker is of sound mind and memory; We believe that this Will was not procured by duress, menace, fraud or undue Initials: __________ Testator __________ Witness __________ __________ Witness Witence and at testator's request, and in the sight and presence of each other, do hereby subscribe our names as witnesses on the date shown above. We understand this is the Testator's Will; We believe tnd presence by _____________________________ (the "Testator"), who declared this instrument to be his/her Last Will and Testament and we, at the Testator's request and in the Testator's sight and presjury under the laws of the State of ____________________ that the above instrument, which consists of _____ pages, including the page(s) which contain the witness signatures, was signed in our sight aas witnesses. Each witness must read the following clause before signing. The witnesses should not receive assets under this Will.) We, the undersigned, hereby certify and declare under penalty of perbelow to witness my signature. Testator's Signature: _______________________________________________ Name: _________________________________________ (Notice to Witnesses: Three (3) adults must sign ______________ (city), that I declare this to be my Last Will and Testament, that I am of legal age and sound mind, that I make this under no constraint or undue influence and ask the Witnesses named uld affect only that provision and all other provision should remain effective. IN WITNESS WHEREOF, I have signed my name below to this Will, this _____ day of ____________________, ______. at ______ll matrimonial rights or controls by his or her spouse. 6. Severability. If any provision of this Will is declared invalid, illegal or unenforceable, any invalidity, illegality or unenforceability sho of property which may exist between any beneficiary and his or her spouse, and every gift together with the income therefrom shall remain the separate property of a beneficiary hereunder, free from ator. 5. Matrimonial Rights. No gift, or the income therefrom, under this Will shall be assigned or anticipated, or fall into any community of property, partnership or other form of sharing or divisionributed between or among two or more beneficiaries, the specific items of property comprising the respective shares shall be determined by such beneficiaries if they can agree, and if not, by my Executions or nonactions as the fiduciary, except for such actions or non-actions which constitute fraudulent conduct or bad faith. 4. Beneficiary Disputes. If any bequest requires that the bequest be dist all claims or Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 7 of ______ expenses in connection with or arising out of that fiduciary's good faith acwho is a natural person shall, in the absence of fraudulent conduct or bad faith, be liable individually to any beneficiary of my estate, and my estate shall indemnify such natural person from any andons under this Will, Each beneficiary shall be deemed not to have survived me unless the beneficiary is living on the thirtieth day after the date of my death. 3. Liability of Fiduciary. No fiduciary dopted person is not more than twelve years of age on the date of the court order granting such adoption. 2. Thirty Day Survival Requirement. For the purposes of determining the appropriate distributi refer to the person or persons intended regardless of gender or number The terms "child" and "descendant" shall include an adopted person and such adopted person's descendants, if, but only if, the aterpreting its provisions. Throughout this Will the use of any gender shall be deemed to include all genders, and the use of the singular the plural, and vice versa. and any pronouns shall be taken tohe following: 1. Paragraph Titles and Gender. The titles given to the paragraphs of this Will are inserted for reference purposes only and are not to be considered as forming a part of this Will in inany person, official, authority, court or tribunal whatsoever or whomsoever. ARTICLE X MISCELLANEOUS PROVISIONS The provisions in this Will for the distribution of my estate shall be supplemented by teven-hand among the beneficiaries and all such exercise of their powers, authority and discretion shall be binding upon all of the beneficiaries and shall not be subject to any question or review, by on any one or more of the beneficiaries or would otherwise, but for the foregoing, be considered as being other than an impartial exercise of their duties hereunder or as not being maintenance of an anted herein in what Executor or Trustee deems to be the best interest, whether monetary or otherwise, of the beneficiaries, whether or not such exercise may have the effect of conferring an advantaget be liable to the beneficiaries or their heirs or personal representatives by reason of the exercise of such discretion. The Executor or Trustee shall exercise the powers, authority and discretion grut not limited to attorney, accountant, agent, broker and other professional fees. The Executor or Trustee shall be fully protected in exercising any discretion granted to them in my Will and shall no to arbitration all such claims if the Executor or Trustee deem same advisable. 11. Pay all necessary and reasonable expenses and costs incurred in connection with administering my estate, including be owing by my estate or which my estate may have against others for such consideration or no consideration and upon such terms and conditions as the Executor or Trustee may deem advisable and to refert the time of my death. Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 6 of ______ 10. Compromise, settle, waive or pay any claim or claims at any timion, designation or exercise of discretion, entered into by the Executor or Trustee in good faith. 9. Windup, dissolve, settle or continue any partnership or business in which I may have an interest all not be liable to any person, whether beneficiary or otherwise, by reason of any loss, claim, tax or other cost experienced by any such person or by my estate resulting from any election, determinatvernmental body of any other country, state or territory, and such exercise of discretion by the Executor shall be conclusive and binding upon all the beneficiaries hereof. The Executor or Trustee sha designations permitted by any statute or regulation enacted by the federal government of the United States of America, by the legislature or government of any state, or by any other legislative or gor responsible for any injury to, consumption of or loss of any such property so used. 8. Make or refrain from making, in Executor's or Trustee's absolute discretion, any elections, determinations, andny tangible personal property or real property, without paying any rent, without giving any bond or security and without liability for any loss or damage. The Executor or Trustee shall not be liable outure interest shall be sold prior to falling into possession and no such interest not actually producing income shall be treated as producing income. 7. Permit any beneficiaries of my estate to use a absolute discretion without responsibility for loss to the intent that investments or assets so retained shall be deemed to be authorized investments for all purposes of my Will. No reversionary or fany share to be composed of money, property or undivided fractional share in property. 6. Retain any of my investments or assets in the form existing at the date of my death at Executor's or Trustee's for such length of time as they may think best. Make any division or distribution of my residuary estate in money or in other property or partly in both upon the basis of fair market value and cause uch terms, and either for cash or credit or for part cash and part credit as they may in their absolute discretion decide upon, or to postpone such conversion of my estate or any part or parts thereoficially interested in the property or any part thereof so valued. 5. Sell, call in and convert into money any part of my estate not consisting of money at such time or times, in such manner and upon s Executor or Trustee shall be final and binding upon all persons concerned, notwithstanding any fluctuation in market value and notwithstanding that one or more of the Executor or Trustee may be benef the Executor or Trustee shall in their absolute discretion fix the value of my estate or any part thereof for the purpose of making any such division, setting aside or payment and the decision of there or interest therein either wholly or in part in the assets forming my estate at the time of my death or at the time of such division, setting aside or payment, and I expressly will and declare thatge or mortgages and to pay off any mortgage or mortgages which may be in existence at any time forming part of my estate. 4. Make any division of my real or personal estate or set aside or pay any shar any part thereof, to borrow Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 5 of ______ money on any such real estate upon the security of any mortgaements and generally to manage any such property. The Executor or Trustee shall also have the right to renew and keep renewed any mortgage or mortgages upon any real estate forming part of my estate opair, in the manner and to the extent that the Executor or Trustee shall deem advisable. 3. To accept surrenders of leases and tenancies, to expend money in repairs, alterations, rebuilding and improvr such period as the Executor or Trustee shall determine; collect any income therefrom; and pay the taxes and expenses thereof, including the cost of keeping such property in adequate condition and reuch a sale, mortgage, lease or other disposition. The power of sale herein is discretionary and not mandatory. 2. Take charge of any real property as part of the probate administration of my estate focourt and without notice to anyone. I also give to the Executor or Trustee power to execute and deliver such deeds, mortgages, leases or other instruments and documents as may be necessary to effect s or personal property that may be included in my estate in such manner and for such purposes, for such prices, and upon such terms, credits and conditions as may be deemed advisable, without order of and the Trust, the Executor and the Trustee shall have the right and power to: 1. Lease, sell, grant options, partition, exchange, mortgage, or otherwise encumber or dispose of all or part of any reale with regards to the administration of any Trust created by this Will, and in addition to other powers and authority granted by law or necessary or appropriate for proper administration of my estate or surety shall be required of any Executor serving hereunder. ARTICLE IX POWERS OF EXECUTOR & TRUSTEE In addition to the existing authority of the Executor with regards to the Will and of any Trusteiction over my estate, using "informal", "unsupervised", or "independent" probate or equivalent legislation designed to operate without unnecessary intervention by the probate court. No bond, securityal or substituted and whether one or more. To the extent permitted by law, the Executor shall have the right to administer my estate without adjudication, order or direction of the court having jurisd "Executor" in this my Will shall include each Executor, Executrix, and Personal Representatives of my Will, my estate or any portion thereof who may be acting as such from time to time whether origininue to serve as Executor for any reason, I appoint ___________________________________, , to be the Executor of this my Will in the place and stead of the first aforementioned Executor. References toARTICLE VIII NOMINATION OF EXECUTOR I appoint ___________________________________, ("Executor") as the Executor of this my Will. If such person or entity cannot, does not or is unable to serve or conts the guardian of the property of such child pursuant to the provisions of applicable law. Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 4 of ______ and stead of the first aforementioned Guardian. It is my wish that before the expiration of ___ days from the date of my death the appointed Guardian apply to have custody of such child(ren) and act a such person cannot, does not or is unable to serve or continue to serve as Guardian for any reason, I appoint ___________________________________, as the Guardian of my minor child(ren) in the place If it becomes necessary to appoint a Guardian for any of my minor child(ren) under the age of eighteen years, I appoint ___________________________________, as the Guardian of my minor child(ren). Ifaries under the Trust once a year. If a beneficiary is a minor or has a disability, the Trustee may provide such accounting to that beneficiary's Guardian, Conservator or Trustee. ARTICLE VII GUARDIANill in the place and stead of the first aforementioned Executor. No bond, security or surety shall be required of any Trustee serving hereunder. The Trustee shall provide an accounting to the beneficiis Will. If such person or entity cannot, does not or is unable to serve or continue to serve as Trustee for any reason, I appoint ___________________________________, , to be the Trustee under this Winion and judgment, feels that the `proceeds' may be subject to any type of seizure or other legal proceeding. ARTICLE VI TRUSTEE I appoint ___________________________________, as the Trustee under thbeneficiary has not accepted any of the benefits so renounced. The Trustee may withhold the distribution of any income or principal to any beneficiaries under the Trust if Trustee, in Trustee's own oprenounced by a beneficiary, the trust shall be construed as though such beneficiary predeceased me if the beneficiary's renunciation occurred within nine months following the date of my death and the of any beneficiary to renounce, in whole or in part, any provisions of the trust for the benefit of such beneficiary, or upon any power of appointment herein granted. As to any interest in the trust Trust shall not be subject to any assignment, anticipation, creditor's claim, seizure, attachment or other manner of legal process. this provision shall not be deemed to be a limitation upon the rightave been required to distribute it had I died intestate, unmarried, and a resident of the state of ___________________ at such time and owning such property. 5. The interest of any beneficiary in the is Will or when the trust is ended, none of the intended beneficiaries of the trust is living, the Trustee shall distribute the property to whomever and in the same proportions as, my Executor would hhares per stirpes. Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 3 of ______ 4. If at any time prior to the termination of the Trust created under thdants surviving him or her, then such share or the amount thereof then remaining shall be divided among any of my other children, who shall be living at the time of the death of such child, in equal sed by this Will for any of my minor children. If any of my child(ren) should die before receiving the whole of his or her share under the Trust created by this Will, and if such child leaves no descen remaining shall be divided among the descendants of such child in equal shares per stirpes. The Trustee shall administer such shares for any descendants under the age of _____________ years as directng income and principal of the Trust. If any of my child(ren) should die before receiving the whole of his or her share under the Trust created by this Will, then such share or the amount thereof thener share of the Trust, including any share of undistributed income. When my youngest child reaches the age of _______ years, this Trust will terminate and the Trustee shall give that child any remainin) such portion shall be added to the principal. 3. As each minor child reaches the age of _______ years, the Trust will terminate as to that child alone and the Trustee shall give that child his or hhe final distribution at the termination of the trust. If during any year that the Trust is in effect any portion of the income from the trust is not paid to or applied for the benefit of the child(ren, but should be based on the individual need(s) of my child(ren) and on the availability of assets in the trust. Any such payments shall not be deducted from or charged to the child(ren)'s share of t professional education) until such time as each child is no longer a minor as defined herein. If deemed necessary by the Trustee, such amounts paid to my child(ren) need not be equal among my childrey minor child(ren) or their descendants such sums from the income or principal of the Trust as the Trustee deems appropriate for their maintenance, support, health and education (including college andpart of the Trust assets. In Trustee's discretion, the Trust assets may be converted into cash or other instruments in order to make the administration of the Trust easier. 2. The Trustee shall pay an(ren). The share of the proceeds of any life insurance policy on my life, any pension plan, contract or other policy passing to any minor children shall be held in trust by the Trustee and treated as held, managed, invested, administered and distributed by the Trustee, under the provisions of this Will, in order to provide for the care, health, support, maintenance and education of any minor childstee named in this Will, to invest and to hold in trust, as a private trust, (herein referred to as "Trust" or "Trust assets") for the benefit of my child(ren). 1. The Trust assets shall be retained, erred to as "minor child(ren)" for purposes of this Will and the Trust created thereby. I direct the Executor to transfer all assets that have passed under this Will to any minor child(ren) to the Truufficient discharge to the Executor. ARTICLE V TRUST FOR MINOR CHILDREN If at the time of my death, any of my child(ren) are under the age of ____________ years, those children shall be deemed and ref_______ Witness Witness Page 2 of ______ the time of the distribution or to any other person the Executor may consider to be a proper recipient thereof. Receipt of any such distribution shall be a s or to a parent, guardian, conservator, committee of such person, trustee of such person, person with whom the beneficiary resides at Initials: __________ Testator __________ Witness __________ ___re in my estate before attaining the age of majority or while under any other disability, I authorize the Executor to nevertheless make any distribution for any such person directly to the beneficiaryintestate at the time fixed for distribution under this provision. Except as may be specifically otherwise provided herein or directed otherwise by law, if any person should become entitled to any shaduary estate shall be distributed to my heirs-at-law, their identities and respective shares to be determined under the laws of the State of ________________________, then in effect, as if I had died ______________________________________________________________________ ____________________________________________________________________________ If any such beneficiary does not survive me, my resis. If none of the named child(ren) or their descendants, survive me, I direct that my residuary estate be distributed in equal shares per stirpes to: ___________________________________________ ______d and given to my child(ren) _____________________________________________________________________ (name(s)). If more than one child is named, then the distribution shall be in equal shares per stirped is named, then the distribution shall be in equal shares per stirpes. Residuary Estate I direct that my residuary estate, including any real property and personal property, be distributed, bequeatheduary estate. Primary Residence All my interest in my primary residence or homestead, if any, shall be distributed to my child(ren) ___________________________________ (name(s)). If more than one chiltate. _____________________________________________ shall be distributed to ___________________________________. If this beneficiary does not survive me, this bequest shall be distributed with my resi___________________________________________ shall be distributed to ___________________________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary es___________________________________ shall be distributed to ___________________________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. __my death pursuant to any agreement with respect to such property. ARTICLE III DISPOSITION OF PROPERTY Specific Bequests I direct that the following specific bequests be made from my estate. __________shall not extend to or include any such taxes that may be payable by a purchaser or transferee in connection with any property transferred to or acquired by such purchaser or transferee upon or after l not seek reimbursement from any beneficiary for the payment of the taxes. Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 1 of ______ This direction n or conferred by me either during my lifetime or by survivorship. The payment of the taxes shall be made regardless of whether the taxes are owed by my estate or by any beneficiary. The Executor shale made regardless of whether the taxes are owed on property passing under this Will or any codicil hereto, outside of this Will, in connection with any insurance on my life or any gift or benefit give. The Executor shall create, out of the residue, a separate fund for the purpose of paying any inheritance taxes in the amount necessary to pay said inheritance taxes. The payment of the taxes shall bthe capital of my general estate. All taxes (including income taxes and inheritance taxes) and any interest and penalties thereon owed because of my death shall be paid out of the residue of my estate of court and without order of any court. ARTICLE III PAYMENT OF DEBTS AND EXPENSES I direct that my just debts, testamentary expenses and expenses of last illness be first paid out of and charged to d interment, including the disposition of the ashes or the acquisition of any burial site and the erection and engraving of monuments and markers, regardless of any limitation fixed by statute or rule________________ Born on _________________ ARTICLE II FUNERAL & BURIAL EXPENSES I authorize the Executor of my Will to pay such sums as the Executor deems proper for my funeral, cremation or burial an the following child(ren): Name: _______________________________________ Born on _________________ Name: _______________________________________ Born on _________________ Name: ______________________________________ (state), revoke my former Wills and Codicils and publish and declare this to be my Last Will and Testament. ARTICLE I MARRIAGE & CHILDREN I am single. I have never been married. I havedocument should be discussed with a tax professional. Last Will And Testament Of ______________________ I, _________________________________________ (name), of ____________________ (county), ________y first to make sure it fits your particular situation. Advice from a local attorney is always recommended when dealing with estate planning matters. Any possible tax consequences arising out of this ute for legal and/or tax advice. Laws vary from time to time and from state to state. These forms should only be a starting point for you and should not be used or signed without consulting an attorneo as the "Marital Deduction". If the recipient spouse is not a U.S. citizen, the deduction is limited (it was $100,000 in 1999). This information and these forms are not intended and are not a substitare holding in trust; any joint property you own In addition, each individual may leave an unlimited amount to his or her spouse upon death without any federal estate tax liability. This is referred td other personal effects); [] partnership (business) interests; [] individual retirement accounts and qualified employee benefit plans; [] the face value of any life insurance policy; [] property you the assets in your estate. Assets may include the following: [] real estate; [] stocks and bonds; [] bank accounts; [] tangible personal property (household furnishings and furniture, jewelry, art, anome near the $1,000,000 level, you really shouldn't use this will and should consult with tax professionals and an attorney. Before using this Will, it may be helpful to determine the value of all of state tax. As your estate approaches $1,000,000 in value and exceeds that amount, the greater your need for professional estate tax planning advice. If Information about Wills ­ Page 2 your assets c000,000. The amount of the credit increases over the next few years. The credit is available to each individual and his or her spouse. Estates totaling $1,000,000 or more could be subject to federal erovides that upon the death of an individual, there is a credit against the estate tax otherwise due on a portion of the value of an individual's estate. For a person dying in 2003, that credit is $1,cipal estate-planning document. If you have a large estate, you may need more complicated planning to reduce or limit death taxes. Testators should have an understanding of tax laws. Federal tax law pits self-proving, but requires the affidavit to be in a specific format similar to the one included in our wills. The Will is for anyone in any life situation where this Will is to be used as the prinifornia and the District of Columbia, the courts have some latitude to accept a will as self proved, to require an affidavit of the witnesses or to require the witnesses to testify. New Hampshire permffidavit in those states will not invalidate the Will (since it is a separate document from the Will). In those states it will have to be "proven" in court, like any other will. In Ohio, Maryland, Caltion. A few states like Louisiana, Maryland, Ohio and Vermont (as of 1999).do not have statutes permitting self proving wills. The affidavit will be of no use in those states. However, including the as are not available when they are needed.. However, even with the Affidavit, the Will may still be subject to contest on such grounds as undue influence, lack of testamentary capacity, or prior revocas for signing a Will were followed. The Affidavit may eliminate the need to have witnesses testify, that the formalities in signing the Will were followed. The Affidavit can also be useful if witnesselaws, all wills were proved by having one or more of the witnesses come into court and testify under oath, or through sworn affidavits, that each saw the Testator sign the will and that the formalitie. The Affidavit does not affect the validity or legality of the Will. However, it can speed up the admission of the Will to probate after the death of the Testator. Before the adoption of more modern osed self-proving affidavit, which contains the Testator's acknowledgment and the affidavit of the witnesses, made before a Notary, that all required formalities were observed when the Will was signediary designations (such as life insurance or employee benefit plans), and assets held in trust generally will not be required to be probated and will not be governed by this Will. The Will has an enclate for the Testator's estate. It merely directs how the assets, which are individually owned by the Testator, will be distributed. Assets held jointly with rights of survivorship, assets with benefic of Use found at findlegalforms.com Information about Wills This Will distributes the assets of the person making the Will (the "Testator") as specified by the Testator. This Will does not avoid problanning matters. Any possible tax consequences arising out of this document should be discussed with a tax professional. [_] The purchase and use of these forms is subject to the Disclaimers and Terms you and should not be used or signed without consulting an attorney first to make sure it fits your particular situation. Advice from a local attorney is always recommended when dealing with estate pcompleteness. [_]These forms are not intended and are not a substitute for legal and/or tax advice. Laws vary from time to time and from state to state. These forms should only be a starting point forions ­ Page 5 [_] These forms are provided "as is" and no implied or express warranties have been made or are provided as to their suitability for any specific purpose or as to their legal effect or lawyer before they are signed. If the Testator moves to another state, the current will should be checked by a lawyer in their new state to make sure it meets local requirements. Checklist & Instructs percentages equal 100%. Check the totals before signing the Will. State and federal laws, which affect estate planning, can vary over time and from place to place. All wills should be reviewed by a f the estate. Consult an attorney if you wish to disinherit a spouse or any children. If any part of the Will calls for distribution in percentages, make sure that the total of all of the beneficiary'ne of the Executors dies.. Most state laws guarantee a minimum share of an estate to a spouse when the other spouse dies. The Will may be invalid if a spouse receives nothing or only a small portion ostroyed and an entirely new Will should be signed. New wills are commonly necessary when, for example, the Testator's marital status changes, if the Testator has a child or if a named beneficiary or oWill, do not modify it by adding, deleting, or modifying words on the face of the Will. Such changes are usually disregarded. Instead when changes are desired, the original and all copies should be desed on the size of the total taxable estate and other matters. The tax results of the choices made in this Will should be discussed with a competent tax advisor. If it becomes necessary to change the enefits, life insurance proceeds and survivor benefits arising in other contracts and plans are not normally governed by a will. This Will is not designed to reduce taxes. Estate taxes, if any, are baw or by any contract. For example, the Will does not dispose of property held in joint tenancy with rights of survivorship or property held in trust. In addition, the distribution of retirement plan bided to the person named as Executor / Personal Representative. This Will does not dispose of property that, on the death of the Testator, would automatically pass to another person by operation of laay used for reference purposes, only the original can be admitted to probate. Copies are rarely accepted. A copy of the Will should be kept by the Testator and may also (if Testator so wishes) be provuch as a safe deposit box at a bank or lawyer's office. Unlike other legal instruments where multiple originals are prepared, only one original "copy" of a will should be prepared. While photocopies mmake sure that they are willing and can serve. If you select a bank or trust company, be sure to check into their fees for such services. The original of the Will should be kept in a secure location st company) that can be trusted to manage and administer the Trust that may be set up for your child(ren). It is best to talk to people (and banks or trust companies) before naming them as Trustee, to ng them as the Guardian of the child(ren), to make sure that they are willing and can serve. Great care should be taken in selecting the Trustee. It is very important to pick a person (or bank or truslly as this person may have custody of the Testator's child(ren). It is also very important to pick a person that can be trusted to take care of the chil(ren). It is best to talk to people before namithat they are willing and can serve. If you select a bank or trust company, be sure to check into their fees for such services. Checklist & Instructions ­ Page 4 The Guardian should be picked carefued to handle financial matters and to deal appropriately with family members. It is best to talk to people (and banks or trust companies) before naming them as a Personal Representative, to make sure entered by hand in the bottom right of each page. The Personal Representative / Executor, should be picked carefully. It is very important to pick a person (or bank or trust company) that can be trustminister oaths. The affidavit states that all required formalities were observed when the Will was signed. The total number of pages (excluding i.e. not counting the self-proving affidavit) should be ttach it to the end of the Will. The Affidavit contains the Testator's acknowledgment and the affidavit of the witnesses, made before a Notary or other person authorized to take acknowledgments and adluded, should not be counted because the affidavit is not a part of the Will itself. The Testator and the witnesses should sign the self-proving affidavit (called "Proof of Will" in some states) and a earlier Will). The Witnesses should indicate the total number of pages in the Will, including the page(s) on which the witness signature lines appear. The page with the self-proving affidavit, if inc, the date should be filled in (preferably by hand), with the date of the actual signing. This step could be crucial to determine the validity of the Will at a later date (i.e. if this Will revokes anhe Testator and each other and of the notary public. The witnesses must be satisfied that the Testator is an adult of sound mind and he/she is signing the Will freely and willingly. Wherever requestedach page of the Will. This can prevent subsequent substitution of pages. The witnesses should also initial the bottom of each page of the Will. All witnesses must sign their names in the presence of tut to sign is my Last Will and Testament. I am signing it freely and voluntarily", or similar words. Although not required in most states, it is a good idea for the Testator to initial the bottom of e signed, is intended to be the Testator's Last Will and Testament. However, the witnesses don't need to read or know the contents of the Will. For example, the Testator can say: "The document I am abory should watch the Testator sign the Will. The notary public is needed for the self-proved affidavit. Before signing the Will, the Testator should orally declare that the document that is about to bef one of the witnesses can't be located. The witnesses should not be beneficiaries under the Will. For example children, spouses, heirs or executors should not be witnesses. All witnesses and the notaerested and adult witnesses and a notary public. The signature of a third witness can provide additional protection if the signature of one of the witnesses is deemed to be invalid for any reason or i a share of the estate. Checklist & Instructions ­ Page 3 Although most states only require two witnesses, the Testator should sign the Will in the presence of three (3) qualified, competent, disintg of "sound mind" usually means that the Testator knows that he/she is signing a Will, is familiar with the property and the value thereof and knows about relatives and others who might be entitled toront of each other. · · · · · · · The Testator (i.e. the person who is writing the Will) must be of "sound mind" when signing the Will and must be of legal age (i.e. eighteen in most states). Beinlly not part of the Will) states that all required formalities were observed when the Will was signed. The Affidavit needs to be completed and signed , by the Testator, all Witnesses and a Notary in fe; []name Witnesses: Witnesses must provide and fill out: [] name of state; [] number of pages; [] name of testator; [] witness signatures and info Affidavit: The enclosed Affidavit (although technicaaking care of the property, and making distributions to the beneficiaries Article X: Contains miscellaneous provisions. Signature Block: Testator needs to fill out: [] day month year city; [] Signaturhe will. Testator must provide and fill out [] the name of executor (spouse); [] name of alternate executor. Article IX: Powers of Executor and Trustee empowers them to deal with matters like taxes, tutstanding debts, administration expenses and taxes out of the testator's estate. After paying debts and expenses, the Personal Representative will pay whatever is left to the beneficiaries named in t the first choice cannot serve. The Executor will have the responsibility (after the testator's death) of managing the testator's property. The Personal Representative is also responsible for paying o VIII: Deals with the appointment of the Testator's Personal Representative (i.e. Executor) and alternate; It allows the Testator to name an Executor to administer the estate, and an alternate in casetor must provide and fill out [] the name of Guardian; [] name of alternate Guardian. [] number of days within which Guardian has to apply to be officially appointed as guardian of child(ren). Articlecertain age. Testator must provide and fill out [] the name of Trustee; [] name of alternate Trustee. Article VII: Deals with appointment of the Guardian and an alternate for the minor children. Testaee's specific duties/responsibilities. It allows the Testator to name a person and an alternate to act as the Trustee that will administer the assets passing under the Will for any child(ren) under a s ­ Page 2 for purposes of the Trust (this needs to be entered four (4) times in this section); ; [] state under whose laws the will is made. · Article VI: Deals with appointment of Trustee and Trustcle V: Deals with the creation of a trust for any minor children. Testator must provide and fill out: [] age when children should not be considered minors any longer · · · · Checklist & Instructionom the residuary estate will be given; []name of "alternate" beneficiaries to whom the residuary estate will be given if child(ren) predecease Testator. [] state under whose laws the will is made Artientity property is given to (three blank paragraphs are provided, but you can add as many as you need). []name of child(ren) to whom the primary residence (if any) is given; []name of child(ren) to whersons or charities and gives any primary residence and the residuary estate to the child(ren). Testator must provide and fill out: [] description of property (or dollar amount); [] name(s) of person/es payments of debts and expenses. Article IV: Disposes of specific property, primary residence and residuary property.. Allows Testator to give specific dollar amounts or other property to specific por each child. Three spaces are provided for names of children. You can add or remove spaces for names as necessary Article II: Authorizes payment of funeral and burial expenses. Article III: Authorizwill. Testator must provide and fill out: [] name, [] county and []state Article I: Gives the name(s) of the child(ren). Testator must provide and fill out [] name(s) of child(ren) and date of birth fhe enclosed Affidavit also needs to be completed. · · · Title: Enter name of Testator in blank space under title "Last Will and Testament of". Introduction: Contains preliminary information about the ss than $1,000,000. This Will is divided into various sections. The content of each section is explained below. Some sections require information to be provided and filled out in the space provided. Tfor any minor child(ren) and a Trustee to administer the minor children's assets. The Will also allows the Testator to make specific gifts to others as well. This Will is suitable for estates worth let distributes the assets of the Testator (i.e. person making the will) to the child(ren). If the children are minors at the time of the Testator's death, the Will allows the appointment of a Guardian ill ­ Single Person with Minor Children with selfproved affidavit. This Will is for a Single Person with one or more minor children, who has never been married, and includes a self-proved affidavit. IChecklist and Instructions Will - Single Person with Minor Children This package contains (1) Checklist and Instruction for Will ­ Single Person with Minor Children; (2) Information about Wills; (3) W FloridaFlorida im Deed - 2 who did not take an oath. _______________________________ Signature of Notary Public _______________________________ Printed Name of Notary My commission expires: _________________________ Quitclacknowledged before me on ______________________ by ___________________________________________ who is/are personally known by me or who has/have produced:_______________________ as identification and ______ ___________________________________ (Witness Signature) Print Name: ___________________________ State of FLORIDA ) ) County of __________________________ ) ss The foregoing instrument was a_____________________________ Quitclaim Deed - 1 Above reserved for official use only Signed in our presence: ________________________________ (Witness Signature) Print Name: _____________________ture ____________________________________________ Grantor's Printed Name Grantee's Address: _____________________________ _____________________________ Grantors Address: _____________________________ d any right or title to the aforesaid property, premises or appurtenances or any part thereof. EXECUTED this day of ________, 20 _______ . ____________________________________________ Grantor's Signantee's heirs, administrators, executors, successors and/or assigns forever; so that neither Grantor nor Grantor's heirs, administrators, executors, successors and/or assigns shall have, claim or deman______________, State of Florida with the following legal description: TO HAVE AND TO HOLD all of Grantor's right, title and interest in and to the above described property unto the said Grantee, Gra_____________________________________________ ("Grantee"), all right, title, interest and claim to the following real property in the City of ___________________________, County of ___________________tion, the receipt and sufficiency of which is hereby acknowledged, the undersigned, _________________________________________ ("Grantor"), hereby REMISES, RELEASES, AND FOREVER QUITCLAIMS to ______________________________ QUITCLAIM DEED KNOW ALL MEN BY THESE PRESENTS THAT: FOR A VALUABLE CONSIDERATION, in the amount of TEN AND NO/100 DOLLARS ($10.00) in hand and other good and valuable consideraed by: and when recorded, please return this deed and tax statements to: Above reserved for official use only Grantee's SS No:_______________________ Property Appraiser's Parcel ID # _______________should be consulted before negotiating any document with another party. The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Recording preparese forms are not intended and are not a substitute for legal advice. These forms should only be a starting point for you and should not be used without consulting with an attorney first. An attorney the title to the property. If you are a buyer taking a Quitclaim Deed, make sure that it satisfies your needs. Consult a real estate attorney and title insurance company to protect your interests. Thtle. A buyer will rarely accept a Quitclaim Deed as the only form of conveyance when buying a property. Quitclaim deeds are mainly used in family situations or to correct possible technical defects inature or quality of that interest, or even if any interest exists at all. This type of deed may be useful in cases where a party is unable to transfer a fee simple estate or make promises about the ti Quitclaim Deed This Quitclaim Deed form is used to convey an interest in real estate. A Quitclaim Deed does not include any promise or guarantee by the person making it (i.e. the Grantor) about the nuld be consulted before negotiating any document with another party. [_] The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Information for forms are not intended and are not a substitute for legal advice. These forms should only be a starting point for you and should not be used without consulting with an attorney first. An Attorney shoRecorder's (or similar) office. [_] Depending on the type of document, additional requirements may apply. Nonconforming documents may be returned unrecorded or may be charged additional fees [_] Theselegal description of the land. Verify that the legal description is correct. [_] A Quitclaim Deed may require other documents to be filed with it. Please check your local requirements with your local Quitclaim Deed may not be effective against third parties. Although witnesses are not required in all states, it is generally a good idea to use them. [_] Documents referencing land should include a Grantor should date and sign the Quitclaim Deed before a Notary and two witnesses. Among other things, Notarization will allow the Quitclaim Deed to be recorded as a public record. Without filing, theInstructions & Checklist for Quitclaim Deed [_] This package includes: (1) Instructions and Checklist for Quitclaim Deed; (2) General Information about Quitclaim Deeds; and (3) Quitclaim Deed [_] The FloridaFlorida Phone: _______________________________________ 2 ____________________________________ _____________________________________________ (Witness Signature) Print Name: ___________________________________ Address: ______________________________________ __ (Declarant's Signature) _____________________________________________ (Witness Signature) Print Name: ___________________________________ Address: ______________________________________ Phone: _______ ____________________________________________________________________________ ____________________________________________________________________________ __________________________________________________________________________________________ ____________________________________________________________________________ _______________________________________________________________________________________ I understand the full import of this declaration, and I am emotionally and mentally competent to make this declaration. Additional Instructions (optional): ________________________________________________________________________________________ ______________________________________ Zip Code: ___________________________ Phone: _____________________________________________________arry out the provisions of this declaration should my surrogate be unwilling or unable to act on my behalf: 1 Name: ____________________________________________________________________ Address: ________________ Zip Code: ___________________________ Phone: ____________________________________________________________________ I wish to designate the following person as my alternate surrogate, to cs of this declaration: Name: ____________________________________________________________________ Address: __________________________________________________________________ __________________________ be unable to provide express and informed consent regarding the withholding, withdrawal, or continuation of life-prolonging procedures, I wish to designate, as my surrogate to carry out the provisiony my family and physician as the final expression of my legal right to refuse medical or surgical treatment and to accept the consequences for such refusal. In the event that I have been determined tohe administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain. It is my intention that this declaration be honored bolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong artificially the process of dying, and that I be permitted to die naturally with only tal) and if my attending or treating physician and another consulting physician have determined that there is no reasonable medical probability of my recovery from such condition, I direct that lifepr if at any time I am incapacitated and _________ I have a terminal condition; or (initial) _________ I have an end-stage condition; or (initial) _________ I am in a persistent vegetative state (initif _____, ______ (year), I, __________, willfully and voluntarily make known my desire that my dying not be artificially prolonged under the circumstances set forth below, and I do hereby declare that, be discussed with a tax professional. [_] The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Living Will Declaration made this _____ day o sure it fits your particular situation. Advice from a local attorney is always recommended when dealing with estate planning matters. Any possible tax consequences arising out of this document shouldnd/or tax advice. Laws vary from time to time and from state to state. These forms should only be a starting point for you and should not be used or signed without consulting an attorney first to makeanties have been made or are provided as to their suitability for any specific purpose or as to their legal effect or completeness. [_]These forms are not intended and are not a substitute for legal astate. (c) Any limitations or conditions expressed orally or in a written declaration have been carefully considered and satisfied. [_] These forms are provided "as is" and no implied or express warrability of recovering capacity so that the right could be exercised directly by the principal. (b) The principal has a terminal condition, has an end-stage condition, or is in a persistent vegetative tions. Information & Instructions ­ Page 4 (2) Before proceeding in accordance with the principal's living will, it must be determined that: (a) The principal does not have a reasonable medical probnot sought within 7 days following the attending physician's decision to withhold or withdraw life-prolonging procedures, the attending physician may proceed in accordance with the principal's instrucithdraw life-prolonging procedures, the attending physician shall not withhold or withdraw life-prolonging procedures pending review under s. Ch765. Section 105. If a review of a disputed decision is r part II, the attending physician may proceed as directed by the principal in the living will. In the event of a dispute or disagreement concerning the attending physician's decision to withhold or wexpressing his or her desires concerning lifeprolonging procedures, but has not designated a surrogate to execute his or her wishes concerning life-prolonging procedures or designated a surrogate unde rebuttable presumption of clear and convincing evidence of the principal's wishes. Florida Statutes Title 44 Chapter 765 Section 304: Procedure for living will (1) If a person has made a living will care facility which is so notified shall promptly make the living will or a copy thereof a part of the principal's medical records. (3) A living will, executed pursuant to this section, establishes athe principal is admitted to a health care facility, any other person may notify the physician or health care facility of the existence of the living will. An attending or treating physician or health principal to provide for notification to her or his attending or treating physician that the living will has been made. In the event the principal is physically or mentally incapacitated at the time ysically unable to sign the living will, one of the witnesses must subscribe the principal's signature in the principal's presence and at the principal's direction. (2) It is the responsibility of theetative state. A living will must be signed by the principal in the presence of two subscribing witnesses, one of whom is neither a spouse nor a blood relative of the principal. If the principal is pharation and direct the providing, withholding, or withdrawal of life-prolonging procedures in the event that such person has a terminal condition, has an end-stage condition, or is in a persistent vego Living Wills. Florida Statutes Title 44 Chapter 765 Section 302: Procedure for making a living will; notice to physician. (1) Any competent adult may, at any time, make a living will or written declFlorida Living Will. This Florida Living Will is based on Florida Statutes Title 44 Chapter 765 Section 303. For your convenience, we have included useful excerpts from the Florida Statutes relating tion and Instructions Florida Living Will This package contains (1) Information and Instruction for Florida Living Will, including excerpts from the Florida Statutes relating to Living Will Forms; (2) ______________________ (Witness Signature) Print Name: ___________________________________ Address: ______________________________________ Phone: _______________________________________ -2- Informat____________ (Witness Signature) Print Name: ___________________________________ Address: ______________________________________ Phone: _______________________________________ ________________________________________________________________________ Signed: ____________________________________________________________________ Dated: ______________________________ ______________________________________________________ Address: __________________________________________________________________ Name: ____________________________________________________________________ Address: _________________e facility. I will notify and send a copy of this document to the following persons other than my surrogate, so they may know who my surrogate is. Name: ___________________________________________________ ____________________________________________________________________________ -1- I further affirm that this designation is not being made as a condition of treatment or admission to a health car__________________________________________________ ____________________________________________________________________________ ________________________________________________________________________to apply for public benefits to defray the cost of health care; and to authorize my admission to or transfer from a health care facility. Additional Instructions (optional): __________________________designee to make health care decisions, except for anatomical gifts, unless I have executed an anatomical gift declaration pursuant to law, and to provide, withhold, or withdraw consent on my behalf; ____________________________ Zip Code: ___________________________ Phone: ____________________________________________________________________ I fully understand that this designation will permit my o designate as my alternate surrogate: Name: ____________________________________________________________________ Address: __________________________________________________________________ _________________ Zip Code: ___________________________ Phone: ____________________________________________________________________ If my surrogate is unwilling or unable to perform his or her duties, I wish t care decisions: Name: ____________________________________________________________________ Address: __________________________________________________________________ _______________________________l) In the event that I have been determined to be incapacitated to provide informed consent for medical treatment and surgical and diagnostic procedures, I wish to designate as my surrogate for healthis subject to the Disclaimers and Terms of Use found at findlegalforms.com -3- Designation of Health Care Surrogate Name: ________________________________________________ (Last, First, Middle Initiay whenever a document is negotiated with another party. Any possible tax consequences arising out of this document should be discussed with a tax professional. [_] The purchase and use of these forms ithout consulting with an attorney first. Before using or signing this document you should have an attorney review it to make sure it fits your particular situation. You should also consult an attorneare not intended and are not a substitute for legal and/or tax advice. Laws vary from time to time and from state to state. These forms should only be a starting point for you and should not be used w are provided "as is" and no implied or express warranties have been made or are provided as to their suitability for any specific purpose or as to their lega l effect or completeness. [_]These forms as modified or revoked the authority of the surrogate pursuant to s. 744.3115. The surrogate may be directed by the court to report the principal's health care status to the guardian. [_] These forms licensed under chapter 400. (3) If, after the appointment of a surrogate, a court appoints a guardian, the surrogate shall continue to make health care decisions for the principal, unless the court h persons to ensure the continuity of the principal's health care and may authorize the admission, discharge, or transfer of the principal to or from a health care facility or other facility or program such application a condition of continued care if the principal, if capable, would have refused to apply. (2) The surrogate may authorize the release of information and medical records to appropriateccess to information regarding the principal's income and assets and banking and financial records to the extent required to make application. A health care provider or facility may not, however, makeician's order not to resuscitate. (d) Be provided access to the appropriate medical records of the principal. (e) Apply for public benefits, such as Medicare and Medicaid, for the principal and have a proposed treatments are to be withheld or that treatments currently in effect are to be withdrawn. (c) Provide written consent using an appropriate form whenever consent is required, including a physances if the principal were capable of making such decisions. If there is no indication of what the principal would have chosen, the surrogate may consider the patient's best interest in deciding thatusly with appropriate health care providers to provide informed consent, and make only health care decisions for the principal which he or she believes the principal would have made under the circumstssly limited by the principal, shall: -2- (a) Have authority to act for the principal and to make all health care decisions for the principal during the principal's incapacity. (b) Consult expeditiohall apply. Florida Statutes Title 44 Chapter 765 Section 205: Responsibility of the surrogate (1) The surrogate, in accordance with the principal's instructions, unless such authority has been exprending that a princ ipal lacks capacity for any other purpose. 5) In the event the surrogate is required to consent to withholding or withdrawing lifeprolonging procedures, the provisions of part III stly loses capacity as determined pursuant to this section. 4) A determination made pursuant to this section that a principal lacks capacity to make health care decisions shall not be construed as a fi of the surrogate. In the event the attending physician determines that the principal has regained capacity, the authority of the surrogate shall cease, but shall recommence if the principal subsequengained such capacity. Upon commencement of the surrogate's authority, a surrogate who is not the principal's spouse shall notify the principal's spouse or adult children of the principal's designationrogate's authority shall commence upon a determination under subsection (2) that the principal lacks capacity, and such authority shall remain in effect until a determination that the principal has re the facility shall notify such surrogate or attorney in fact in writing that her or his authority under the instrument has commenced, as provided in chapter 709 or Chapter 765 Section 203. 3) The sure principal's medical record. If the principal has designated a health care surrogate or has delegated authority to make health care decisions to an attorney in fact under a durable power of attorney, if the second physician agrees that the principal lacks the capacity to make health care decisions or provide informed consent, the health care facility shall enter both physician's evaluations in th evaluation in the principal's medical record. If the attending physician has a question as to whether the principal lacks capacity, another physician shall also evaluate the principal's capacity, andelf or himself or provide informed consent is in question, the attending physician shall evaluate the principal's capacity and, if the physician concludes that the principal lacks capacity, enter thatnot be inferred from the person's voluntary or involuntary hospitalization for mental illness or from her or his mental retardation. 2) If a principal's capacity to make health care decisions for hers04: Capacity of principal; procedure 1) A principal is presumed to be capable of making health care decisions for herself or himself unless she or he is determined to be incapacitated. Incapacity may xecuted pursuant to this section establishes a rebuttable presumption of clear and convincing evidence of the principal's designation of the surrogate. Florida Statutes Title 44 Chapter 765 Section 2alth treatment. (6) Unless the document states a time of termination, the designation shall remain in effect until revoked by the principal. -1- (7) A written designation of a health care surrogate estates otherwise, the court shall assume that the health care surrogate authorized to make health care decisions under this chapter is also the principal's choice to make decisions regarding mental heent to consent to mental health treatment and a guardian advocate is appointed as provided under Chapter 394 Section 4598. However, unless the document designating the health care surrogate expressly intment of a proxy pursuant to part IV. (5) A principal may designate a separate surrogate to consent to mental health treatment in the event that the principal is determined by a court to be incompetsignated alternate surrogate is able or willing to make health care decisions on behalf of the principal and in accordance with the principal's instructions, the health care facility may seek the appos unwilling or unable to perform his or her duties. The principal's failure to designate an alternate surrogate shall not invalidate the designation. (4) If neither the designated surrogate nor the deurrogate may also designate an alternate surrogate provided the designation is explicit. The alternate surrogate may assume his or her duties as surrogate for the principal if the original surrogate i of the document designating the health care surrogate. At least one person who acts as a witness shall be neither the principal's spouse nor blood relative. (3) A document designating a health care serson sign the principal's name as required herein. An exact copy of the instrument shall be provided to the surrogate. (2) The person designated as surrogate shall not act as witness to the execution for a principal shall be signed by the principal in the presence of two subscribing adult witnesses. A principal unable to sign the instrument may, in the presence of witnesses, direct that another p of Health Care Surrogate Form. Florida Statutes Title 44 Chapter 765 Section 202: Designation of a health care surrogate. (1) A written document designating a surrogate to make health care decisionsrida Designation of Health Care Surrogate is based on Florida Statutes Title 44 Chapter 765 Section 203. The following are useful excerpts from the Florida Statutes relating to the Florida Designationxcerpts from the Florida Statutes relating to the Florida Designation of Health Care Surrogate Form; (2) Florida Designation of Health Care Surrogate (Power of Attorney for Health Care) Form. This Floare Surrogate (Power of Attorney for Health Care) This package contains (1) Information and Instruction for Florida Designation of Health Care Surrogate (Power of Attorney for Health Care) including eith a tax professional. [_] The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Information and Instructions Florida Designation of Health Cour particular situation. Advice from a local attorney is always recommended when dealing with estate planning matters. Any possible tax consequences arising out of this document should be discussed we. Laws vary from time to time and from state to state. These forms should only be a starting point for you and should not be used or signed without consulting an attorney first to make sure it fits y made or are provided as to their suitability for any specific purpose or as to their legal effect or completene ss. [_]These forms are not intended and are not a substitute for legal and/or tax adviclth Care Directive. The first form is the Power of Attorney for Health Care and the second form is the Living Will. [_] These forms are provided "as is" and no implied or express warranties have beenFlorida Advance Health Care Directive This package contains both a Florida Power of Attorney for Health Care and a Florida Living Will. Together these forms are also sometimes known as an Advance Hea FloridaFlorida _____________ Name of Survivor: _______________________________ Address: ____________________________________________ City: _______________________________________________ State: __________________________________urposes (strike any of the following you do not want): (1) Transplant (2) Therapy (3) Research (4) Education Date: __________________ Signature of Survivor: __________________________________ Printed_______________ ________________________________________________________________________ ________________________________________________________________________ III. The gift is for the following pthe applicable box): Give any needed organs, tissues, or parts, OR Give the following organs, tissues, or parts only: _______________________ _________________________________________________________ity and state). I. I survive the decedent as (mark the appropriate box): spouse; adult son or daughter; parent; adult brother or sister; grandparent; or guardian of the decedent. II. I hereby (mark this anatomical gift from the body of __________________________________(name of decedent) who died on _____________, 20___ at_______________________________ in ____________________________________ (corney should be consulted for all serious legal matters. Anatomical Gift by Next of Kin or Guardian of the Person Pursuant to the Uniform Anatomical Gift Act and the law of this state, I hereby make rruption) however caused and on any theory of liability, whether in contract, strict liability, or tort (including negligence or otherwise) arising in any way out of the use of these materials. An att direct, indirect, incidental, special, exemplary, or consequential damages (including, but not limited to, procurement of substitute goods or services; loss of use, data, or profits; or business inteals are used at your own risk. In no event will: i) FindLegalForms, Inc, its agents, partners, or affiliates, or ii) the providers, authors or publishers of the forms, be responsible or liable for anym. These materials are provided "AS-IS." We do not give any express or implied warranties of merchantability, suitability or completeness for any of the materials for your particular needs. The materieated by use of these materials. FindLegalForms, Inc. does not provide legal advice. The purchase and use of these materials is subject to the "Disclaimers and Terms of Use" found at findlegalforms.con for the removal of a part from the body of the decedent, the physician, surgeon, technician, or enucleator removing the part knows of the revocation. Disclaimer No Attorney-Client relationship is cr a member of the person's class or a prior class. An anatomical gift by a person authorized under subdivision may be revoked by any member of the same or a prior class if, before procedures have beguoposing to make an anatomical gift knows of a refusal or contrary indications by the decedent. (3) The person proposing to make an anatomical gift knows of an objection to making an anatomical gift byAn anatomical gift may not be made by a person listed above if any of the following occur: (1) A person in a prior class is available at the time of death to make an anatomical gift. (2) The person pre decedent; (3) either parent of the decedent; (4) an adult brother or sister of the decedent; (5) a grandparent of the decedent; and (6) a guardian of the person of the decedent at the time of death ker for an authorized purpose, unless the decedent, at the time of death, has made an unrevoked refusal to make that anatomical gift: (1) the spouse of the decedent; (2) an adult son or daughter of th Gift Form An anatomical gift may be made any member of the following classes of persons, in the order of priority listed, may make an anatomical gift of all or part of the decedent's body or a pacemas made on behalf of the decedent by the next of kin or guardian. Included in this kit are the following: General Instructions for preparing your Anatomical Gift (by next of kin or guardian) Anatomicalt. As the next of kin or guardian, you can prepare and execute an Anatomical Gift on behalf of the decedent. This kit is designed to fulfill the obligations of the Uniform Anatomical Gift Act for giftFindLegalForms.com Information Donation Pursuant to the Uniform Anatomical Gift Act (by Next of Kin or Guardian) A loved one has died and you believe that he/she would desire to make an Anatomical Gif Florida