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North Carolina ent (Notary Public) _________________________________ Name typed, printed, or stamped -5- ___ (name of Principal), who is personally known to me or who has produced ________________________________ as identification. _________________________________ Signature of person taking acknowledgm___ State of NORTH CAROLINA ) ) ss County of ________________________ ) The foregoing instrument was acknowledged before me this _____ day of ____________________, ______ by ____________________________________________ Witness Signature: ___________________________________ Name: ___________________________________ City: __________________________________ State: ________________________________________________ Signature of Principal Witness Signature: ___________________________________ Name: ___________________________________ City: __________________________________ State: ______________torney. I may revoke this Power of Attorney at any time by providing written notice to my Agent. Signed on ________________ (date), at _______________________ (city), North Carolina. ________________ment 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 this Power of Atn 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 resulting from judgation. 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 terminated by operatio 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 knowledge of the revocy 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 appointment by my Agent.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 my Agent; (b) mn 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 disposition of any s 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 shall still remaiower 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 scope of powerso 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 my Agent. This P 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 as my Agent If y 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 all reasonablethority 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 lack of capacitAgent'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, powers, and -3- auor 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 my Agent or my 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, estate, trust, f 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, if such trust r 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 obligations oets, 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 may hold in favoall 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 designate any of my assll 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 annual right shs 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 gifts made shao 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 documents. Gifties, 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 intangible property, t 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 governmental agencinvestment 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 body, including,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, accountants, ights, 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 currently own or have wned 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 exercise any and all r 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 storage area o, 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 necessary to deposit,cial 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 bank statementss, certificates of deposit, investment accounts, brokerage accounts, retirement plan accounts, and other similar accounts with financial institutions; to conduct any business with any banking or finant 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, savings accountany 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 my Agent, to acplans, insurance benefits and government program including, but not limited to, Social Security and Medicare; to prepare applications, provide information, and perform any other reasonable request by 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 benefits, retirement 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 and to make any 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 transaction. 7. ure 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 future; the rightuch 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 acquired in the futch 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 other manner (on sicates 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, me or in whi 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, dividends, certifll 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 person or entity. 5.es, 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 take any and as 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 satisfaction of mortgag mortgages, notes, insurance policies, receipts, title documents, checks, drafts, letters of credit, stock certificates, proxies, warrants, commercial papers, withdrawal and deposit slips, certificatet and/or agreement, including but not limited to applications, assignments, bills of sale or lading, bonds, contracts, covenants, conveyances, deeds, options, trust deeds, security agreements, leases,ind 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 any such contrac 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 business of whatever kter 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 virtue of this 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 intangible, or mat______________________________ 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, legal right orintaining an address at _______________________________________________ do hereby make and appoint ________________________________________ ("Agent") maintaining an address at: _______________________e agent assumes the fiduciary and other legal responsibilities of an agent. -3- GENERAL POWER OF ATTORNEY KNOW ALL PERSONS BY THESE PRESENTS: I, ____________________________________ ("Principal") manot 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 appointment, thrtaken 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 document does pal") 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 such action undeate specific instructions. -2- CAUTION! PRINCIPAL: The Powers granted by this power of attorney document are broad and sweeping. Before signing this document, consider its consequences. You ("princi advice. Furthermore, this information is general information that is not state specific. Whenever appropriate, the instructions included with the forms packages offered for sale, generally include stable 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 substitute for legalAlthough, 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 Attorneys (availzation 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, if necessary. al 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 property. Notarirument 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 revoke a Generr 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 "powerful" instive 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 Attorney-In-Fact foled 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 remains effectrms 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" competent person (calpoint 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 use of these foe 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 be a starting torney-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 sweeping, as thThe 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 the Agent (or at will be dealing with any real estate in Florida. The witnesses should be adults. Generally, anyone related by blood or marriage to the Principal, the Agent or the Notary should not be a witness. [_] be recorded as a public record, if necessary. [_] Although not always required, it is always a good idea to also have two witnesses sign the Power of Attorney. Two witnesses are necessary if the Agented. [_] The Principal (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 (3) General Power 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 incapacitatInstructions & Checklist North Carolina General Power of Attorney [_] This package contains (1) Instructions & Checklist for General Power of Attorney; (2) Information for General Power of Attorney; North CarolinaNorth Carolina ________________________________ Notary public [SEAL] Self-proved Will Affidavit ____________________________________, a witness, who is personally known to me or who has produced ______________________ as identification, this _______ day of __________________, 20____. ___________________ as identification, and by ____________________________________________, a witness, who is personally known to me or who has produced ______________________ as identification, and by ________wn to me or who has produced _____________________ as identification, and by _______________________________________________, a witness, who is personally known to me or who has produced _____________ame: ___________________________________ Address: ______________________________________ Subscribed and sworn to before me by _____________________________________, the testator, who is personally kno______________________________ (Witness) Print Name: ___________________________________ Address: ______________________________________ _____________________________________________ (Witness) Print N_____________________ (Testator) _____________________________________________ (Witness) Print Name: ___________________________________ Address: ______________________________________ _______________ competent to make a will), of sound mind and memory, and under no constraint or undue influence; and 5) each witness was and is competent and of proper age to witness a will. ________________________presence and hearing of the testator and in the presence of each other; 4) to the best knowledge of each witness, the testator was, at the time of signing, of the age of majority (or otherwise legallytestator; 2) the testator willingly and voluntarily declared, signed, and executed the will in the presence of the witnesses; 3) the witnesses signed the will upon the request of the testator, in the ment and whose signatures appear below, having appeared before me and having been first been duly sworn, each then declared to me that: 1) the attached or foregoing instrument is the last will of the ____________________________________, and __________________________________, and ___________________________________________, the witnesses, whose names are signed to the attached or foregoing instru__ COUNTY OF ________________________ I, the undersigned, an officer authorized to administer oaths, certify that _______________________________________________________________, the testator and _________________________________ Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 9 of ______ Self-Proved Will Affidavit STATE OF _________________________ Witness Signature: Name: Address: City: State: ___________________________________ ___________________________________ ___________________________________ ___________________________________ _____ddress: City: State: ___________________________________ ___________________________________ ___________________________________ ___________________________________ ______________________________________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Witness Signature: Name: As now age 18 or older, is a competent witness, and resides at the address set forth after his or her name. Dated: ____________________, ______ Witness Signature: Name: Address: City: State: _______red by duress, menace, fraud or undue Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 8 of ______ influence; The maker is age 18 or older. Each of us ido hereby subscribe our names as witnesses on the date shown above. We understand this is the Testator's Will; We believe the maker is of sound mind and memory; We believe that this Will was not procuhis instrument to be his/her Last Will and Testament and we, at the Testator's request and in the Testator's sight and presence and at testator's request, and in the sight and presence of each other, ument, which consists of _____ pages, including the page(s) which contain the witness signatures, was signed in our sight and presence by _____________________________ (the "Testator"), who declared t witnesses should not receive assets under this Will.) We, the undersigned, hereby certify and declare under penalty of perjury under the laws of the State of ____________________ that the above instr________________________ Name: _________________________________________ (Notice to Witnesses: Three (3) adults must sign as witnesses. Each witness must read the following clause before signing. Thethat I am of legal age and sound mind, that I make this under no constraint or undue influence and ask the Witnesses named below to witness my signature. Testator's Signature: _______________________e. IN WITNESS WHEREOF, I have signed my name below to this Will, this _____ day of ____________________, ______. at ____________________ (city), that I declare this to be my Last Will and Testament, ny provision of this Will is declared invalid, illegal or unenforceable, any invalidity, illegality or unenforceability should affect only that provision and all other provision should remain effectivnd every gift together with the income therefrom shall remain the separate property of a beneficiary hereunder, free from all matrimonial rights or controls by his or her spouse. 6. Severability. If a shall be assigned or anticipated, or fall into any community of property, partnership or other form of sharing or division of property which may exist between any beneficiary and his or her spouse, aperty comprising the respective shares shall be determined by such beneficiaries if they can agree, and if not, by my Executor. 5. Matrimonial Rights. No gift, or the income therefrom, under this Willwhich constitute fraudulent conduct or bad faith. 4. Beneficiary Disputes. If any bequest requires that the bequest be distributed between or among two or more beneficiaries, the specific items of pro __________ Witness Witness Page 7 of ______ expenses in connection with or arising out of that fiduciary's good faith actions or nonactions as the fiduciary, except for such actions or non-actions ith, be liable individually to any beneficiary of my estate, and my estate shall indemnify such natural person from any and all claims or Initials: __________ Testator __________ Witness __________ unless the beneficiary is living on the thirtieth day after the date of my death. 3. Liability of Fiduciary. No fiduciary who is a natural person shall, in the absence of fraudulent conduct or bad farder granting such adoption. 2. Thirty Day Survival Requirement. For the purposes of determining the appropriate distributions under this Will, Each beneficiary shall be deemed not to have survived meerms "child" and "descendant" shall include an adopted person and such adopted person's descendants, if, but only if, the adopted person is not more than twelve years of age on the date of the court oe deemed to include all genders, and the use of the singular the plural, and vice versa. and any pronouns shall be taken to refer to the person or persons intended regardless of gender or number The tphs of this Will are inserted for reference purposes only and are not to be considered as forming a part of this Will in interpreting its provisions. Throughout this Will the use of any gender shall bARTICLE X MISCELLANEOUS PROVISIONS The provisions in this Will for the distribution of my estate shall be supplemented by the following: 1. Paragraph Titles and Gender. The titles given to the paragrarity and discretion shall be binding upon all of the beneficiaries and shall not be subject to any question or review, by any person, official, authority, court or tribunal whatsoever or whomsoever. oing, be considered as being other than an impartial exercise of their duties hereunder or as not being maintenance of an even-hand among the beneficiaries and all such exercise of their powers, author monetary or otherwise, of the beneficiaries, whether or not such exercise may have the effect of conferring an advantage on any one or more of the beneficiaries or would otherwise, but for the foreg reason of the exercise of such discretion. The Executor or Trustee shall exercise the powers, authority and discretion granted herein in what Executor or Trustee deems to be the best interest, whethees. The Executor or Trustee shall be fully protected in exercising any discretion granted to them in my Will and shall not be liable to the beneficiaries or their heirs or personal representatives by 11. Pay all necessary and reasonable expenses and costs incurred in connection with administering my estate, including but not limited to attorney, accountant, agent, broker and other professional feeration or no consideration and upon such terms and conditions as the Executor or Trustee may deem advisable and to refer to arbitration all such claims if the Executor or Trustee deem same advisable._______ __________ Witness Witness Page 6 of ______ 10. Compromise, settle, waive or pay any claim or claims at any time owing by my estate or which my estate may have against others for such considstee in good faith. 9. Windup, dissolve, settle or continue any partnership or business in which I may have an interest at the time of my death. Initials: __________ Testator __________ Witness ___any loss, claim, tax or other cost experienced by any such person or by my estate resulting from any election, determination, designation or exercise of discretion, entered into by the Executor or Trudiscretion by the Executor shall be conclusive and binding upon all the beneficiaries hereof. The Executor or Trustee shall not be liable to any person, whether beneficiary or otherwise, by reason of ernment of the United States of America, by the legislature or government of any state, or by any other legislative or governmental body of any other country, state or territory, and such exercise of used. 8. Make or refrain from making, in Executor's or Trustee's absolute discretion, any elections, determinations, and designations permitted by any statute or regulation enacted by the federal govt giving any bond or security and without liability for any loss or damage. The Executor or Trustee shall not be liable or responsible for any injury to, consumption of or loss of any such property soest not actually producing income shall be treated as producing income. 7. Permit any beneficiaries of my estate to use any tangible personal property or real property, without paying any rent, withouents or assets so retained shall be deemed to be authorized investments for all purposes of my Will. No reversionary or future interest shall be sold prior to falling into possession and no such interoperty. 6. Retain any of my investments or assets in the form existing at the date of my death at Executor's or Trustee's absolute discretion without responsibility for loss to the intent that investmion of my residuary estate in money or in other property or partly in both upon the basis of fair market value and cause any share to be composed of money, property or undivided fractional share in prey may in their absolute discretion decide upon, or to postpone such conversion of my estate or any part or parts thereof for such length of time as they may think best. Make any division or distribut in and convert into money any part of my estate not consisting of money at such time or times, in such manner and upon such terms, and either for cash or credit or for part cash and part credit as thwithstanding any fluctuation in market value and notwithstanding that one or more of the Executor or Trustee may be beneficially interested in the property or any part thereof so valued. 5. Sell, call estate or any part thereof for the purpose of making any such division, setting aside or payment and the decision of the Executor or Trustee shall be final and binding upon all persons concerned, not at the time of my death or at the time of such division, setting aside or payment, and I expressly will and declare that the Executor or Trustee shall in their absolute discretion fix the value of mynce at any time forming part of my estate. 4. Make any division of my real or personal estate or set aside or pay any share or interest therein either wholly or in part in the assets forming my estates __________ __________ Witness Witness Page 5 of ______ money on any such real estate upon the security of any mortgage or mortgages and to pay off any mortgage or mortgages which may be in existe also have the right to renew and keep renewed any mortgage or mortgages upon any real estate forming part of my estate or any part thereof, to borrow Initials: __________ Testator __________ Witnesdvisable. 3. To accept surrenders of leases and tenancies, to expend money in repairs, alterations, rebuilding and improvements and generally to manage any such property. The Executor or Trustee shallerefrom; and pay the taxes and expenses thereof, including the cost of keeping such property in adequate condition and repair, in the manner and to the extent that the Executor or Trustee shall deem aiscretionary and not mandatory. 2. Take charge of any real property as part of the probate administration of my estate for such period as the Executor or Trustee shall determine; collect any income thr to execute and deliver such deeds, mortgages, leases or other instruments and documents as may be necessary to effect such a sale, mortgage, lease or other disposition. The power of sale herein is dsuch purposes, for such prices, and upon such terms, credits and conditions as may be deemed advisable, without order of court and without notice to anyone. I also give to the Executor or Trustee powe1. Lease, sell, grant options, partition, exchange, mortgage, or otherwise encumber or dispose of all or part of any real or personal property that may be included in my estate in such manner and for addition to other powers and authority granted by law or necessary or appropriate for proper administration of my estate and the Trust, the Executor and the Trustee shall have the right and power to: RS OF EXECUTOR & TRUSTEE In addition to the existing authority of the Executor with regards to the Will and of any Trustee with regards to the administration of any Trust created by this Will, and in e or equivalent legislation designed to operate without unnecessary intervention by the probate court. No bond, security or surety shall be required of any Executor serving hereunder. ARTICLE IX POWExecutor shall have the right to administer my estate without adjudication, order or direction of the court having jurisdiction over my estate, using "informal", "unsupervised", or "independent" probat Representatives of my Will, my estate or any portion thereof who may be acting as such from time to time whether original or substituted and whether one or more. To the extent permitted by law, the E_______, , to be the Executor of this my Will in the place and stead of the first aforementioned Executor. References to "Executor" in this my Will shall include each Executor, Executrix, and Personal_, ("Executor") as the Executor of this my Will. If such person or entity cannot, does not or is unable to serve or continue to serve as Executor for any reason, I appoint ____________________________cable law. Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 4 of ______ ARTICLE VIII NOMINATION OF EXECUTOR I appoint __________________________________piration of ___ days from the date of my death the appointed Guardian apply to have custody of such child(ren) and act as the guardian of the property of such child pursuant to the provisions of applidian for any reason, I appoint ___________________________________, as the Guardian of my minor child(ren) in the place and stead of the first aforementioned Guardian. It is my wish that before the exder the age of eighteen years, I appoint ___________________________________, as the Guardian of my minor child(ren). If such person cannot, does not or is unable to serve or continue to serve as Guary, the Trustee may provide such accounting to that beneficiary's Guardian, Conservator or Trustee. ARTICLE VII GUARDIAN If it becomes necessary to appoint a Guardian for any of my minor child(ren) uny or surety shall be required of any Trustee serving hereunder. The Trustee shall provide an accounting to the beneficiaries under the Trust once a year. If a beneficiary is a minor or has a disabilitnue to serve as Trustee for any reason, I appoint ___________________________________, , to be the Trustee under this Will in the place and stead of the first aforementioned Executor. No bond, securite or other legal proceeding. ARTICLE VI TRUSTEE I appoint ___________________________________, as the Trustee under this Will. If such person or entity cannot, does not or is unable to serve or contihhold the distribution of any income or principal to any beneficiaries under the Trust if Trustee, in Trustee's own opinion and judgment, feels that the `proceeds' may be subject to any type of seizury predeceased me if the beneficiary's renunciation occurred within nine months following the date of my death and the beneficiary has not accepted any of the benefits so renounced. The Trustee may witfor the benefit of such beneficiary, or upon any power of appointment herein granted. As to any interest in the trust renounced by a beneficiary, the trust shall be construed as though such beneficiarure, attachment or other manner of legal process. this provision shall not be deemed to be a limitation upon the right of any beneficiary to renounce, in whole or in part, any provisions of the trust of the state of ___________________ at such time and owning such property. 5. The interest of any beneficiary in the Trust shall not be subject to any assignment, anticipation, creditor's claim, seizt is living, the Trustee shall distribute the property to whomever and in the same proportions as, my Executor would have been required to distribute it had I died intestate, unmarried, and a resident__________ Witness Witness Page 3 of ______ 4. If at any time prior to the termination of the Trust created under this Will or when the trust is ended, none of the intended beneficiaries of the trushall be divided among any of my other children, who shall be living at the time of the death of such child, in equal shares per stirpes. Initials: __________ Testator __________ Witness __________ efore receiving the whole of his or her share under the Trust created by this Will, and if such child leaves no descendants surviving him or her, then such share or the amount thereof then remaining sr stirpes. The Trustee shall administer such shares for any descendants under the age of _____________ years as directed by this Will for any of my minor children. If any of my child(ren) should die bceiving the whole of his or her share under the Trust created by this Will, then such share or the amount thereof then remaining shall be divided among the descendants of such child in equal shares pest child reaches the age of _______ years, this Trust will terminate and the Trustee shall give that child any remaining income and principal of the Trust. If any of my child(ren) should die before ree age of _______ years, the Trust will terminate as to that child alone and the Trustee shall give that child his or her share of the Trust, including any share of undistributed income. When my younge 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) such portion shall be added to the principal. 3. As each minor child reaches thability of assets in the trust. Any such payments shall not be deducted from or charged to the child(ren)'s share of the final distribution at the termination of the trust. If during any year that theined herein. If deemed necessary by the Trustee, such amounts paid to my child(ren) need not be equal among my children, but should be based on the individual need(s) of my child(ren) and on the availthe Trust as the Trustee deems appropriate for their maintenance, support, health and education (including college and professional education) until such time as each child is no longer a minor as defed into cash or other instruments in order to make the administration of the Trust easier. 2. The Trustee shall pay any minor child(ren) or their descendants such sums from the income or principal of ion plan, contract or other policy passing to any minor children shall be held in trust by the Trustee and treated as part of the Trust assets. In Trustee's discretion, the Trust assets may be convertovisions of this Will, in order to provide for the care, health, support, maintenance and education of any minor child(ren). The share of the proceeds of any life insurance policy on my life, any pensin referred to as "Trust" or "Trust assets") for the benefit of my child(ren). 1. The Trust assets shall be retained, held, managed, invested, administered and distributed by the Trustee, under the prreby. I direct the Executor to transfer all assets that have passed under this Will to any minor child(ren) to the Trustee named in this Will, to invest and to hold in trust, as a private trust, (heretime of my death, any of my child(ren) are under the age of ____________ years, those children shall be deemed and referred to as "minor child(ren)" for purposes of this Will and the Trust created thether person the Executor may consider to be a proper recipient thereof. Receipt of any such distribution shall be a sufficient discharge to the Executor. ARTICLE V TRUST FOR MINOR CHILDREN If at the erson, person with whom the beneficiary resides at Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 2 of ______ the time of the distribution or to any oility, I authorize the Executor to nevertheless make any distribution for any such person directly to the beneficiary or to a parent, guardian, conservator, committee of such person, trustee of such p specifically otherwise provided herein or directed otherwise by law, if any person should become entitled to any share in my estate before attaining the age of majority or while under any other disabve shares to be determined under the laws of the State of ________________________, then in effect, as if I had died intestate at the time fixed for distribution under this provision. Except as may be________________________________________________________________ If any such beneficiary does not survive me, my residuary estate shall be distributed to my heirs-at-law, their identities and respectimy residuary estate be distributed in equal shares per stirpes to: ___________________________________________ ____________________________________________________________________________ ___________________________ (name(s)). If more than one child is named, then the distribution shall be in equal shares per stirpes. If none of the named child(ren) or their descendants, survive me, I direct that state I direct that my residuary estate, including any real property and personal property, be distributed, bequeathed and given to my child(ren) ______________________________________________________d, if any, shall be distributed to my child(ren) ___________________________________ (name(s)). If more than one child is named, then the distribution shall be in equal shares per stirpes. Residuary E____________________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. Primary Residence All my interest in my primary residence or homestea____________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. _____________________________________________ shall be distributed to ___________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. _____________________________________________ shall be distributed to _______________SITION OF PROPERTY Specific Bequests I direct that the following specific bequests be made from my estate. _____________________________________________ shall be distributed to _______________________ transferee in connection with any property transferred to or acquired by such purchaser or transferee upon or after my death pursuant to any agreement with respect to such property. ARTICLE IV DISPOls: __________ Testator __________ Witness __________ __________ Witness Witness Page 1 of ______ This direction shall not extend to or include any such taxes that may be payable by a purchaser orhe taxes shall be made regardless of whether the taxes are owed by my estate or by any beneficiary. The Executor shall not seek reimbursement from any beneficiary for the payment of the taxes. Initia or any codicil hereto, outside of this Will, in connection with any insurance on my life or any gift or benefit given or conferred by me either during my lifetime or by survivorship. The payment of t paying any inheritance taxes in the amount necessary to pay said inheritance taxes. The payment of the taxes shall be made regardless of whether the taxes are owed on property passing under this Will taxes) and any interest and penalties thereon owed because of my death shall be paid out of the residue of my estate. The Executor shall create, out of the residue, a separate fund for the purpose of I direct that my just debts, testamentary expenses and expenses of last illness be first paid out of and charged to the capital of my general estate. All taxes (including income taxes and inheritance site and the erection and engraving of monuments and markers, regardless of any limitation fixed by statute or rule of court and without order of any court. ARTICLE III PAYMENT OF DEBTS AND EXPENSESthorize the Executor of my Will to pay such sums as the Executor deems proper for my funeral, cremation or burial and interment, including the disposition of the ashes or the acquisition of any burial_____________ Name: _______________________________________ Born on _________________ Name: _______________________________________ Born on _________________ ARTICLE II FUNERAL & BURIAL EXPENSES I auhis to be my Last Will and Testament. ARTICLE I MARRIAGE & CHILDREN I am single. I have never been married. I have the following child(ren): Name: _______________________________________ Born on ______________________ I, _________________________________________ (name), of ____________________ (county), _______________________ (state), revoke my former Wills and Codicils and publish and declare ts always recommended when dealing with estate planning matters. Any possible tax consequences arising out of this document should be discussed with a tax professional. Last Will And Testament Of ____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 a local attorney ition is limited (it was $100,000 in 2006). This information and 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. e an unlimited amount to his or her spouse upon death without any federal estate tax liability. This is referred to as the "Marital Deduction". If the recipient spouse is not a U.S. citizen, the deducnt accounts and qualified employee benefit plans; [] the face value of any life insurance policy; [] property you are holding in trust; any joint property you own In addition, each individual may leav and bonds; [] bank accounts; [] tangible personal property (household furnishings and furniture, jewelry, art, and other personal effects); [] partnership (business) interests; [] individual retiremeith tax professionals and an attorney. Before using this Will, it may be helpful to determine the value of all of the assets in your estate. Assets may include the following: [] real estate; [] stocksgreater your need for professional estate tax planning advice. If your assets come near the $2,000,000 level, Information about Wills ­ Page 2 you really shouldn't use this will and should consult wilable to each individual and his or her spouse. Estates totaling $2,000,000 or more could be subject to federal estate tax. As your estate approaches $2,000,000 in value and exceeds that amount, the dividual, 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 from 2006 to 2008, that credit is $2,000,000. The credit is avaou 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 provides that upon the death of an inffidavit 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 principal estate-planning document. If y, 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 permits self-proving, but requires the avalidate 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, California and the District of Columbiaaryland, Ohio and Vermont (as of 2003) do not have statutes permitting self proving wills. The affidavit will be of no use in those states. However, including the affidavit in those states will not ineeded. 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 revocation. A few states like Louisiana, M 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 witnesses are not available when they are nng 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 formalities for signing a Will were followed. 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 laws, all wills were proved by havicontains the Testator's acknowledgment and the affidavit of the witnesses, made before a Notary, that all required formalities were observed when the Will was signed. The Affidavit does not affect theurance 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 enclosed self-proving affidavit, which erely directs how the assets, which are individually owned by the Testator, will be distributed. Assets held jointly with rights of survivorship, assets with beneficiary designations (such as life ins 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 probate for the Testator's estate. It monsequences 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 of Use found at findlegalforms.comed 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 planning matters. Any possible tax ct 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 or signprovided "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 completeness. [_]These forms are nohe 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 & Instructions ­ Page 5 [_] These forms are 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 lawyer before they are signed. If t 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 beneficiaries' percentages equal 100%. Check thee 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 of the estate. Consult an attorney ifould 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 one of the Executors dies. Most stateleting, 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 destroyed and an entirely new Will she 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 Will, do not modify it by adding, dd 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 based on the size of the total taxablthe 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 benefits, life insurance proceeds anr / 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 law or by any contract. For example, y 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 provided to the person named as Executo lawyer's office. Unlike other legal instruments where multiple originals are prepared, only one original "copy" of a will should be prepared. While photocopies may be used for reference purposes, onln 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 such as a safe deposit box at a bank orge 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 make sure that they are willing and caen), 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 trust company) that can be trusted to manathe Testator's child(ren). It is also very important to pick a person that can be trusted to take care of the child(ren). It is best to talk to people before naming them as the Guardian of the child(r 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 carefully as this person may have custody of eal 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 that they are willing and can serve. If 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 trusted to handle financial matters and to dhat 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 entered by hand in the bottom right offfidavit contains the Testator's acknowledgment and the affidavit of the witnesses, made before a Notary or other person authorized to take acknowledgments and administer oaths. The affidavit states 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 attach it to the end of the Will. The Andicate 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 included, should not be counted because tably 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 an earlier Will). The Witnesses should inotary 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 requested, the date should be filled in (prefer 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 the Testator and each other and of the nt. 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 each page of the Will. This can preventr'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 about to sign is my Last Will and TestameWill. 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 be signed, is intended to be the Testatod. The witnesses should not be beneficiaries under the Will. For example children, spouses, heirs or executors should not be witnesses. All witnesses and the notary should watch the Testator sign the ry 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 if one of the witnesses can't be locatenstructions ­ Page 3 Although most states only require two witnesses, the Testator should sign the Will in the presence of three (3) qualified, competent, disinterested and adult witnesses and a notahe 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 to a share of the estate. Checklist & IThe 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). Being of "sound mind" usually means that tWill) 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 front of each other. Witnesses must provide and fill out: [] name of state; [] number of pages; [] name of testator; [] witness signatures and info Affidavit: The enclosed Affidavit (although technically not part of the operty, and making distributions to the beneficiaries Article X: Contains miscellaneous provisions. Signature Block: Testator needs to fill out: [] day month year city; [] Signature; []name Witnesses:st 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, taking care of the prministration 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 the will. Testator munnot 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 outstanding debts, ade 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 case the first choice ca 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). Article VIII: Deals with thr 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. Testator must provide and/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 certain age. Testatopurposes 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 Trustee's specific duties 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 & Instructions ­ Page 2 for 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 Article V: 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 whom the 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/entityments 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 personsh 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: Authorizes payTestator 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 for eache 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 will. ss than $2,000,000. 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 North CarolinaNorth Carolina ar) __________________________________________________ Clerk (Assistant Clerk) of Superior Court or Notary Public (circle one as appropriate) for the County of ____________________________ 2 did not have a claim against the declarant. I further certify that I am satisfied as to the genuineness and due execution of the declaration. This the ____ day of ___________, _________.(month and yeof an attending physician or an employee of a health facility in which the declarant was a patient or an employee of a nursing home or any group-care home in which the declarant resided, and (iv) theyny will of the declarant or codicil thereto then existing or under the Intestate Succession Act as it provides at that time, and (iii) they were not a physician attending the declarant or an employee t or to the declarant's spouse, and (ii) they did not know or have a reasonable expectation that they would be entitled to any portion of the estate of the declarant upon the declarant's death under arant, sign the attached declaration, believing him to be of sound mind; and also swore that at the time they witnessed the declaration (i) they were not related within the third degree to the declaran_________________________ and __________________________________________________________ witnesses, appeared before me and swore that they witnessed ____________________________________________, decla For A Natural Death, and that he had willingly and voluntarily made and executed it as his free act and deed for the purposes expressed in it. I further certify that _________________________________at __________________________________________________________, the declarant, appeared before me and swore to me and to the witnesses in my presence that this instrument is his Declaration Of A Desirellows: Certificate I, _________________________________________, Clerk (Assistant Clerk) of Superior Court or Notary Public (circle one as appropriate) for __________________ County hereby certify th________________________ (Witness Signature) Print Name: ___________________________________ The clerk or the assistant clerk, or a notary public may, upon proper proof, certify the declaration as fo state that I do not now have any claim against the declarant. _____________________________________________ (Witness Signature) Print Name: ___________________________________ _____________________clarant's attending physician, or an employee of a health facility in which the declarant is a 1 patient or an employee of a nursing home or any group-care home where the declarant resides. I furtherhe declarant or as an heir under the Intestate Succession Act if the declarant died on this date without a will. I also state that I am not the declarant's attending physician or an employee of the dehe declarant by blood or marriage and that I do not know or have a reasonable expectation that I would be entitled to any portion of the estate of the declarant under any existing will or codicil of tant's Signature) I hereby state that the declarant, ___________________________________________________, being of sound mind signed the above declaration in my presence and that I am not related to thhold or discontinue either artificial nutrition or hydration, or both. This the ________ day of _______________, ________________ (month and year) __________________________________________ (Declarg: _________ My physician may withhold or discontinue extraordinary means only. _________ In addition to withholding or discontinuing extraordinary means if such means are necessary, physician may wit, my physician may withhold or discontinue either artificial nutrition or hydration, or both. _________ If my physician determines that I am in a persistent vegetative state, I authorize the followinhorize the following: _________ My physician may withhold or discontinue extraordinary means only. _________ In addition to withholding or discontinuing extraordinary means if such means are necessaryal nutrition or hydration, in accordance with my specifications set forth below: (Initial any of the following, as desired): _________ If my condition is determined to be terminal and incurable, I aut incurable or if I am diagnosed as being in a persistent vegetative state. I am aware and understand that this writing authorizes a physician to withhold or discontinue extraordinary means or artifici________, being of sound mind, desire that, as specified below, my life not be prolonged by extraordinary means or by artificial nutrition or hydration if my condition is determined to be terminal and of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Living Will Declaration Of A Desire For A Natural Death I, _________________________________________________torney 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 purchase and use 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 a local ator 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 from state tonessed, and proved in accordance with the provisions of this section. [_] These forms are provided "as is" and no implied or express warranties have been made or are provided as to their suitability f or incorporated into a health care power of attorney form meeting the requirements of Article 3 of Chapter 32A of the General Statutes; provided, however, that the resulting form shall be signed, witerpose this section as a defense. (i) Any certificate in the form provided by this section prior to July 1, 1979, shall continue to be valid. (j) The form provided by this section may be combined withs nor shall it be considered unprofessional conduct. Any person, institution or facility against whom criminal or civil liability is asserted because of conduct in compliance with this section may intd/or the withholding or discontinuance of either artificial nutrition or hydration, or both in accordance with this section shall not be considered the cause of death for any civil or criminal purpose accordance with subsection (c) as a condition for becoming insured under any insurance contract or for receiving any medical treatment. (h) The withholding or discontinuance of extraordinary means anarations made in accordance with subsection (c) shall not constitute suicide for any purpose. Living Will Information & Instructions ­ Page 3 (g) No person shall be required to sign a declaration in revocation shall become effective only upon communication to the attending physician by the declarant or by an individual acting on behalf of the declarant. (f) The execution and consummation of declion (2) above. (e)The above declaration may be revoked by the declarant, in any manner by which he is able to communicate his intent to revoke, without regard to his mental or physical condition. Such be proved by the clerk or assistant clerk, or a notary public a. Upon proof of the handwriting of the two witnesses whose testimony is unavailable, and b. Upon compliance with paragraph c of subdivisr assistant clerk of the superior court, or a notary public as to the genuineness and due execution of the declaration. (3) If the testimony of none of the witnesses is available, such declaration may or whose testimony is otherwise unavailable, and c. Upon proof of the handwriting of the declarant, unless he signed by his mark; or upon proof of such other circumstances as will satisfy the clerk ohe testimony of the two witnesses; or (2) If the testimony of only one witness is available, then a. Upon the testimony of such witness, and b. Upon proof of the handwriting of the witness who is dead is specifically determined to meet the requirements above: (See Below) The . . . declaration may be proved by the clerk or the assistant cle rk, or a notary public in the following manner: (1) Upon teclaration; and (4) Which has been proved before a clerk or assistant clerk of superior court, or a notary public who certifies substantially as set out in subsection (d) below. (d) The following form a patient, or an employee of a nursing home or any group-care home in which the declarant resides, and (iv) do not have a claim against any portion of the estate of the declarant at the time of the d under the Intestate Succession Act as it then provides, (iii) are not the attending physician, or an employee of the attending physician, or an employee of a health facility in which the declarant is not know or have a reasonable expectation that they would be entitled to any portion of the estate of the declarant upon his death under any will of the declarant or codicil the reto then existing orn the presence of two witnesses who believe the declarant to be of sound mind and who state that they (i) are not related within the third degree to the declarant or to the declarant's spouse, (ii) dodeclarant is aware that the declaration authorizes a physician to withhold or discontinue the extraordinary means or artificial nutrition or hydration; and (3) Which has been signed by the declarant iis determined to be Living Will Information & Instructions ­ Page 2 terminal and incurable, or if the declarant is diagnosed as being in a persistent vegetative state; and (2) Which states that the 1 of Chapter 130A of the General Statutes; (1) Which expresses a desire of the declarant that extraordinary means or artificial nutrition or hydration not be used to prolong his life if his condition pon a signed, witnessed, dated and proved declaration, or a copy of that declaration obtained from the Advance Health Care Directive Registry maintained by the Secretary of State pursuant to Article 2l nutrition or hydration, as specified by the declarant, may be withheld or discontinued upon the direction and under the supervision of the attending physician. (c) The attending physician may rely utate; and (2) There is confirmation of the declarant's present condition as set out above in subdivision (b)(1) by a physician other than the attending physician; then extraordinary means or artificiadetermined by the attending physician that the declarant's present condition is a. Terminal and incurable; or b. Repealed by Session Laws 1993, c. 553, s. 28; c. Diagnosed as a persistent vegetative selow, a desire that his life not be prolonged by extraordinary means or by artificial nutrition or hydration, and the declaration has not been revoked in accordance with subsection (e); and (1) It is and, without the use of extraordinary means or artificial nutrition or hydration, will succumb to death within a short period of time. (b) If a person has declared, in accordance with subsection (c) b North Carolina; (4) "Persistent vegetative state" is a medical condition whereby in the judgment of the attending physician the patient suffers from a sustained complete loss of self-aware cognition the moment of death by sustaining, restoring, or supplanting a vital function; (3) "Physician" means any person licensed to practice medicine under Article 1 of Chapter 90 of the laws of the State ofaccordance with subsection (c); (2) "Extraordinary means" is defined as any medical procedure or intervention which in the judgment of the attending physician would serve only to postpone artificiallyts from the North Carolina Statutes relating to Living Wills. § 90-321. Right to a natural death. (a) As used in this Article the term: (1) "Declarant" means a person who has signed a declaration in ill; (2) North Carolina Living Will. This North Carolina Living Will is based on Chapter 90 Section 90-321 et. Seq. of the North Carolina Statutes. For your convenience, we have included useful excerper of attorney, and to your physician and family members.) 7 Information and Instructions North Carolina Living Will This package contains (1) Information and Instruction for North Carolina Living W________________________________ Notary Public My Commission Expires: _______________________________ (A copy of this form should be given to your health care agent and any alternate named in this pow(iv) they did not have a claim against him/her. I further certify that I am satisfied as to the genuineness and due execution of the instrument. This the __________ day of _______________, 20____. ___r, nor an employee of an attending physician, nor an employee of a health facility in which he/she was a patient, nor an employee of a nursing home or any group-care home in which he/she resided, and is/her estate upon his/her death under any will or codicil thereto then existing or under the Intestate Succession Act as it provided at that time, and (iii) they were not a physician attending him/hethe signing (i) they were not related within the third degree to him/her or his/her spouse, and (ii) they did not know nor have a reasonable expectation that they would be entitled to any portion of hefore me and swore that they witnessed _________________________ sign the attached health care power of attorney, believing him/her to be of sound mind; and also swore that at the time they witnessed luntarily made and executed it as his/her free act and deed for the purposes expressed in it. I further certify that ____________________________ and ___________________________, witnesses, appeared bhat _______________________________ appeared before me and swore to me and to the witnesses in my presence that this 6 instrument is a health care power of attorney, and that he/she willingly and vo_____________ STATE OF North Carolina COUNTY OF _______________________ CERTIFICATE I, _________________________________, a Notary Public for _________________ County, North Carolina, hereby certify tI further state that I do not nave any claim against the principal. Witness: ______________________________________ Date: __________________ Witness: ______________________________________ Date: _____ the principal's attending physician, nor an employee of the health facility in which the principal is a patient, nor an employee of a nursing home or any group care home where the principal resides. of the principal or as an heir under the Intestate Succession Act, if the principal died on this date without a will. I also state that I am not the principal's attending physician, nor an employee of attorney in my presence, and that I am not related to the principal by blood or marriage, and I would not be entitled to any portion of the estate of the principal under any existing will or codicil ________ Date _______________ (SEAL) 9. Signatures of Witnesses. I hereby state that the Principal, ____________________________________, being of sound mind, signed the foregoing health care power oflert and competent, fully informed as to the contents of this document, and understand the full import of this grant of powers to my health care agent. Signature of Principal__________________________ty is asserted because of conduct authorized by this health care power of attorney may interpose this document as a defense. 8. Signature of principal. By signing here, I indicate that I am mentally afor any civil or criminal purposes, nor shall it be considered unprofessional conduct or as lack of professional competence. Any person, institution, or facility against whom criminal or civil liabilinstitution, or facility acting in good faith in reliance on the authority of my health care agent pursuant to this health care power of attorney shall be considered suicide, nor the cause of my death of the acts or omissions of my health care agent pursuant to this document, except for willful misconduct or gross negligence. D. No act or omission of my health care agent, or of any other person, is are hereby released and forever discharged by me, my estate, my heirs, successors, and assigns and personal representatives from all liability and from all claims or demands of all kinds arising outto my health care, my health care agent shall not have any authority over my property or financial affairs. 5 C. My health care agent and my health care agent's estate, heirs, successors, and assign incur reasonable costs on my behalf incident to the exercise of these powers; provided, however, that except as shall be necessary in order to exercise the powers described in this document relating , deliver, and acknowledge any contract or other document that may be necessary, desirable, convenient, or proper in order to exercise and carry out any of the powers described in this document and toand binding upon my family, relatives, friends, and others. 7. Miscellaneous provisions. A. I revoke any prior health care power of attorney. B. My health care agent shall be entitled to sign, executere to the benefit of and bind me, my estate, my heirs, successors, assigns, and personal representatives. The authority of my health care agent pursuant to this power of attorney shall be superior to ith by my health care agent pursuant to this power of attorney are done with my consent and sha ll have the same validity and effect as if I were present and exercised the powers myself, and shall inu document may be accepted by persons as fully authorized by me and with the same force and effect as if I were personally present, competent, and acting on my own behalf. All acts performed in good fa agent. B. The powers conferred on my health care agent by this document may be exercised by my health care agent alone, and my health care agent's signature or act under the authority granted in thisthe authority of or any representations by my health care agent shall be liable to me, my estate, my heirs, successors, assigns, or personal representatives, for actions or omissions by my health care person, to serve without bond or security. The guardian shall act consistently with G.S. 35A-1201(a)(5). 6. Reliance of third parties on health care agent. A. No person who relies in good faith upon _________________ 5. Guardianship provision. If it becomes necessary for a court to appoint a guardian of my person, I nominate my health care agent acting under this document to be the guardian of my_______________________________________________________________________ ________________________________________________________________________ _______________________________________________________advance instruction, you should indicate here whether you have executed an advance instruction for mental health treatment.): ________________________________________________________________________ _ing or capacity to make or communicate mental health treatment decisions. Because your health care agent's decisions about decisions must be consistent with any 4 statements you have expressed in an accordance with Part 2 of Article 3 of Chapter 122C of the General Statutes, which you may use to state your instructions regarding mental health treatment in the event you lack sufficient understand_____________________________________________________ C. (Notice: This health care power of attorney may incorporate or be combined with an advance instruction for mental health treatment, executed inent that are unacceptable to you): ________________________________________________________________________ ________________________________________________________________________ ___________________ electroconvulsive treatment (ECT), instructions regarding your admission to and retention in a health care facility for mental health treatment, or instructions to refuse any specific types of treatmm appropriate such as: limiting the grant of authority to make only mental health treatment decisions, your own instructions regarding the administration or withholding of psychotropic medications and make mental health decisions on my behalf, the authority of my health care agent is subject to the following special provisions and limitations. (Here you may include any specific limitations you dee____________________ ________________________________________________________________________ ________________________________________________________________________ B. In exercising the authority toith your religious beliefs, or unacceptable to you for any other reason.): ________________________________________________________________________ ____________________________________________________ou deem appropriate such as: your own definition of when life-sustaining treatment should be withheld or discontinued, or instructions to refuse any specific types of treatment that are inconsistent wority to make health care decisions on my behalf, the authority of my health care agent is subject to the fo llowing special provisions and limitations (Here you may include any specific limitations yny decisions you could make to obtain or terminate any type of health care. If you wish to limit the scope of your health care agent's powers, you may do so in this section.) A. In exercising the authility to medical providers. 4. Special provisions and limitations. (Notice: The above grant of power is intended to be as broad as possible so that your health care agent will have authority to make a, to authorize an autopsy, and to direct the disposition of my remains. 3 I. To take any lawful actions that may be necessary to carry out these decisions, including the granting of releases of liab COMA, SUFFER SEVERE DEMENTIA, OR AM IN A PERSISTENT VEGETATIVE STATE. H. To exercise any right I may have to make a disposition of any part or all of my body for medical purposes, to donate my organs-sustaining procedures do not include care necessary to provide comfort or alleviate pain. I DESIRE THAT MY LIFE NOT BE PROLONGED BY LIFE-SUSTAINING PROCEDURES IF I AM TERMINALLY ILL, PERMANENTLY IN A and may include mechanical ventilation, dialysis, antibiotics, artificial nutrition and hydration, and other forms of medical treatment which sustain, restore or supplant vital bodily functions. Lifemanently in a coma, suffer severe dementia, or am in a persistent vegetative state. Life-sustaining procedures are those forms of medical care that only serve to artificially prolong the dying processludes the power to consent to measures for relief of pain. G. To authorize the withholding or withdrawal of life-sustaining procedures when and if my physician determines that I am terminally ill, perhesia, medication, surgery, and all other diagnostic and treatment procedures ordered by or under the authorization of a licensed physician, dentist, or podiatrist. This authorization specifically incs for mental health treatment and electroconvulsive treatment (ECT) commonly referred to as "shock treatment". F. To give consent for, to withdraw consent for, or to withhold consent for, X ray, anesther institution. D. To consent to and authorize my admission to and retention in a facility for the care or treatment of mental illness. E. To consent to and authorize the administration of medicationhe disclosure of this information. B. To employ or discharge my health care providers. C. To consent to and authorize my admission to and discharge from a hospital, nursing or convalescent home, or otllowing: A. To request, review, and receive any information, verbal or written, regarding my physical or mental health, including, but not limited to, medical and hospital records, and to consent to tereby grant to my health care agent named above full power and authority to make health care decisions, including mental health treatment decisions, on my behalf, including, but not limited to, the fo_____________________________________ 2 ________________________________________________________________________ 3. General statement of authority granted. Except as indicated in section 4 below, I hcomes effective.): ________________________________________________________________________ ________________________________________________________________________ ___________________________________ligible psychologist. You may also name two or more physicians or eligible psychologists, if desired, both of whom must make this determination before the authority granted to the health care agent bee made by the following physician or eligible psychologist. (You may include here a designation of your choice, including your attending physician or eligible psychologist, or any other physician or e in effect during my incapacity, until my death. This determination shall be made by the following physician or physicians. For decisions related to mental health treatment, this determination shall bective when and if the physician or physicians designated below determine that I lack sufficient understanding or capacity to make or communicate decisions relating to my health care and will continueny manner by which you are able to communicate your intent to revoke to your health care agent and your attending physician.) Absent revocation, the authority granted in this document shall become effested with the same power and duties as if originally named as my health care agent. 2. Effectiveness of appointment. (Notice: This health care power of attorney may be revoked by you at any time in a___________________________________________________________ Home Telephone Number ____________________ Work Telephone Number ____________________ Each successor health care agent designated shall be v________________________ Home Telephone Number _____________________ Work Telephone Number _____________________ B. Name: _______________________________________________________________ Home Address: and successively, in the order named), to serve in that capacity: (Optional) A. Name: _______________________________________________________________ Home Address: ___________________________________ized in this document. 1 If the person named as my health care agent is not reasonably available or is unable or unwilling to act as my agent, then I appoint the following persons (each to act alone______ as my health care attorney- in-fact (herein referred to as my "health care agent") to act for me and in my name (in any way I could act in person) to make health care decisions for me as author_______________________________________________ Home Address: ______________________________________________________________ Home Telephone Number __________________ Work Telephone Number ____________health care that meets the statutory requirements.) 1. Designation of health care agent. I, __________________________________________, being of sound mind, hereby appoint Name: ______________________se of this form is an optional and nonexclusive method for creating a health care power of attorney and North Carolina law does not bar the use of any other or different form of power of attorney for and other health care decisions with your health care agent. Use of this form in the creation of a health care power of attorney is lawful and is authorized pursuant to North Carolina law. However, ud act if you were making the decision. Because the powers granted by this document are broad and sweeping, you should discuss your wishes concerning lifesustaining procedures, mental health treatment,care to act in your best interests and in accordance with this document. For mental health treatment decisions, your health care agent will act according to how the health care agent believes you woul are unable to give informed consent. This form does not impose a duty on your health care agent to exercise granted powers, but when a power is exercised, your health care agent will have to use due nt or stopping treatment necessary to keep you alive, admit you to a facility, and administer certain treatments and medications. This power exists only as to those health care decisions for which your you. Except to the extent that you express specific limitations or restrictions on the authority of your health care agent, this power includes the power to consent to your doctor not giving treatmeney Statutory Form, G.S. 32A-25 (Notice: This document gives the person you designate your health care agent broad powers to make health care decisions, including mental health treatment decisions, foould 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 North Carolina Health Care Power of Attormake 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 shal 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 attorney first to warranties 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 legwn as an Advance Health 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 North Carolina Advance Health Care Directive This package contains both a North Carolina Power of Attorney for Health Care and a North Carolina Living Will. Together these forms are also sometimes kno North CarolinaNorth Carolina ______________________ My Commission Expires:_________________________________ before me this day and acknowledged the execution Of the foregoing instrument. Witness my hand and official stamp or seal, this _______day of ______________, 20____. Notary Public _________________________COUNTY. I, a Notary Public of the County and State aforesaid, certify that _______________ ______________________________________________________________________, Grantor(s), personally appeared (seal) _______________________________________ (seal) _______________________________________ (seal) _______________________________________ SEAL-STAMP NORTH CAROLINA, _____________________________ct to the following exceptions if any: IN TESTIMONY WHEREOF, said Grantors have hereunto set their hands and seals the day and year first above written. (seal) _______________________________________rs and assigns free and discharged from all right, title, claim or interest of the said grantors or anyone claiming by, and through or under them. Title to the property hereinabove described is subjeed property is recorded in Map/Cabinet ___________ at Page_________ TO HAVE AND TO HOLD the aforesaid tract or parcel of land and all privileges thereunto belonging to him the said Grantee and his heid by Grantor by instrument recorded in ................................................................................................................................. A map showing the above-describ being in the County of ___________________, and State of North Carolina, in ______________Township, and more particularly described as follows: GRANTEE The property hereinabove described was acquirets do remise, release, and forever quitclaim into the Grantee and his heirs and assigns all right, title, claim, and interest of the said Grantors in and to a certain tract or parcel of land lying andid Grantors, for and in consideration of the sum of ten dollars and other consideration to them in hand paid, the receipt of which is hereby acknowledged, have remised and released and by these presene as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular, plural, masculine, feminine, or neuter as may be required by context. WITNESSETH, that sa____________ NORTH CAROLINA QUITCLAIM DEED THIS DEED made this the _____ day of _______________________, in the year 20 ____, by and between GRANTOR + + + + + + + + The designation Grantor and Granteument prepared by _________________________________________________________________________________ Brief description for the index ____________________________________________________________________ers and Terms of Use found at findlegalforms.com NORTH CAROLINA QUITCLAIM DEED Mail after recording to _____________________________________________________________________________________ This instre used without consulting with an attorney first. An Attorney should be consulted before negotiating any document with another party. [_] The purchase and use of these forms is subject to the Disclaime returned unrecorded or may be charged additional fees [_] These 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 bed with it. Please check your local requirements with your local Recorder's (or similar) office. [_] Depending on the type of document, additional requirements may apply. Nonconforming documents may bt third parties. [_] Documents referencing land should include a legal description of the land. Verify that the legal description is correct. [_] A Quitclaim Deed may require other documents to be filign the Quitclaim Deed before a notary. Among other things, notarization will allow the Quitclaim Deed to be recorded as a public record. Without filing, the Quitclaim Deed may not be effective againsInstructions & Checklist for Quitclaim Deed North Carolina (Individual) [_] This package contains (1) Instructions and Checklist for Quitclaim Deed (2) Quitclaim Deed [_] The Grantor should date and s North CarolinaNorth Carolina _____________ 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 North Carolina