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Michigan ____________________ 2 ness: _________________________________________ Name of Witness: _________________________________________ Address: ________________________________________________ _______________________________________________ Name of Witness: _________________________________________ Address: ________________________________________________ _______________________________________________________ Signed by witpresence by the Declarant who appears to be of sound mind, and to be making this declaration voluntarily without any duress, fraud or undue influence. Signed by witness: __________________________________________________________________ _______________________________________________________________________ 1 STATEMENT OF WITNESSES We sign below as witnesses. This declaration was signed in our ment after careful consideration. I understand it's meaning and I accept its consequences. Signed: ___________________________________________ Dated: ______________ Address: __________________________m or manner that this declaration does not reflect my wishes. Photocopies of this signed and witnessed declaration shall have the same legal force and effect as the original document. I sign this docuved in my care shall have no civil or criminal liability for following my wishes as expressed in this document. I may change my mind and revoke this declaration at any time by communicating in any for______________________________ ______________________________________________________________________________ My family, the medical facility, and any doctors, nurses and other medical personnel invol________________________________________________________________________ ______________________________________________________________________________ ________________________________________________es concerning medical treatment are ______________________________________________________________________________ ______________________________________________________________________________ ______nable to participate in decisions regarding my medical care, it is my intention that this declaration be honored as the expression of my legal right to refuse or consent to medical treatment. My desirarant) being of sound mind, voluntarily make this declaration. In the event my doctor and at least one other doctor determine that I have become terminally ill or permanently unconscious and if I am ue and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Living Will DECLARATION I,__________________________________________________________, (Name of Decl local attorney is always recommended when dealing with estate planning matters. Any possible tax consequences arising out of this document should be discussed with a tax professional. [_] The purchas 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 your particular situation. Advice from aability for any specific purpose or as to their legal effect or completeness. [_]These forms are not intended and are not a substitute for legal and/or tax advice. Laws vary from time to time and fromn Chapter 700 Act 386 Section 700.5501 et. Seq. of the Michigan Compiled Laws. [_] These forms are provided "as is" and no implied or express warranties have been made or are provided as to their suitInformation and Instructions Michigan Living Will This package contains (1) Information and Instruction for Michigan Living Will; (2) Michigan Living Will. This Michigan Living Will is based in part o Michigan