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Texas king acknowledgment (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 ta________ State of __________________________ ) ) 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: _________evoke this Power of Attorney at any time by providing written notice to my Agent. Signed on ________________ (date), at _______________________ (city), __________________________ (state). ___________e 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 Attorney. I may rerson 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 judgment errors madto 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 operation of law, any py 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 revocation. I agree 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. Any third parto 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) my Agent to have 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 proceeds paid tn 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 remain in full forcey 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 powers granted herei 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 Power of Attornered 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 so requested byd 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 reasonable expenses incur 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 capacity to receive an 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- authority of this, 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 Agent's estate.ime 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, or other entity 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 exists at the tmy 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 of support whichor 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 favor of my Agent, lative 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 assets, interests o 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 shall be non-cumu 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 shall be limited tor 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. Gifts to minors mayo 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, to such persons d 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 agencies, relating tessionals, 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, but not limiteor 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, investment profg 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 an interest in 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 rights, includinl 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 owned or leased afts, 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, negotiate, seln 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 statements, passbooks, dr of deposit, investment accounts, brokerage accounts, retirement plan accounts, and other similar accounts with financial institutions; to conduct any business with any banking or financial institutioentative 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 accounts, certificatesor 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 act as my "Represe 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 any government 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 plans, insurancurchase, 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 elections and nts 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. To apply for, pto 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 right to remove tenat 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 future by me) and y 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 such terms and ait, 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 which I have or mald, 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, certificates of deposnecessary 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. To receive, hoents, 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 all legal steps , 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 mortgages, lien, judgmes, insurance policies, receipts, title documents, checks, drafts, letters of credit, stock certificates, proxies, warrants, commercial papers, withdrawal and deposit slips, certificates of deposit ofent, including but not limited to applications, assignments, bills of sale or lading, bonds, contracts, covenants, conveyances, deeds, options, trust deeds, security agreements, leases, mortgages, noton 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 contract and/or agreemney 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 kind or nature, 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 power of attortsoever 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 matter whatsoever _______________ 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 or obligation whadress at _______________________________________________ do hereby make and appoint ________________________________________ ("Agent") maintaining an address at: ______________________________________ the fiduciary and other legal responsibilities of an agent. -3- GENERAL POWER OF ATTORNEY KNOW ALL PERSONS BY THESE PRESENTS: I, ____________________________________ ("Principal") maintaining an adnyone 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, the agent assumesagent, 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 not authorize ading 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 undertaken by your structions. -2- CAUTION! PRINCIPAL: The Powers granted by this power of attorney document are broad and sweeping. Before signing this document, consider its consequences. You ("principal") are provirmore, this information is general information that is not state specific. Whenever appropriate, the instructions included with the forms packages offered for sale, generally include state specific inalforms.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 legal advice. Furthestates 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 (available at findlege 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. Although, some orney 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. Notarization will makld 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 General Power of Att 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" instrument and shoueath 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 for the Principalpal" 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 effective until the dto 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 (called the "Princind 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 forms is subject 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 point for you a 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 the Agent has thehould 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 attorney-in-fact)g 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. [_] The Principal sa 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 Agent will be dealinncipal (i.e. the person granting the Power of Attorney; sometimes called the Grantor) should sign the document before a Notary. Notarization will allow the General Power of Attorney to be recorded as er of Attorney [_] This General Power of Attorney becomes effective immediately and remains effective until the death of the Grantor or until the Grantor becomes disabled or incapacitated. [_] The PriInstructions & Checklist General Power of Attorney [_] This package contains (1) Instructions & Checklist for General Power of Attorney; (2) Information for General Power of Attorney; (3) General Pow TexasTexas his _______ day of__________________, 20____. Signed:_______________________________________ _____________________________________________ Official Capacity of Officer Self-proved Will Affidavit nd sworn to before me by _____________________________________, the testator, and by ___________________________, and _____________________________, and _____________________________, the witnesses, t___________________________________ _____________________________________________ (Witness) Print Name: ___________________________________ Address: ______________________________________ Subscribed a___________________________________ Address: ______________________________________ _____________________________________________ (Witness) Print Name: ___________________________________ Address: ___; and that each of said witnesses was then at least fourteen years of age. _____________________________________________ (Testator) _____________________________________________ (Witness) Print Name: over (or being under such age, was or had been lawfully married, or was then a member of the armed forces of the United States or an auxiliary thereof or of the Maritime Service) and was of sound mindheir oaths each witness stated further that they did sign the same as witnesses in the presence of the said testator and at his or her request; that he or she was at the time eighteen years of age or the said testator had declared to them that said instrument is his or her last will and testament, and that he or she executed same as such and wanted each of them to sign it as a witness; and upon td that he or she had willingly made and executed it as his or her free act and deed, and the said witnesses, each on his or her oath stated to me in the presence and hearing of the said testator, thatre duly sworn by me. _____________________________________________, the Testator, declared to me and to the said witnesses in my presence that said instrument is his or her last will and testament, an______________, known to me to be the testator and the witnesses, respectively, whose names are subscribed to the annexed or foregoing instrument in their respective capacities. All of said persons weundersigned authority, on this day personally appeared ______________________________________, and _______________________________, and ______________________________________, and ____________________Initials: __________ Testator __________ Witness __________ __________ Witness Witness Page 7 of ______ Self-Proved Will Affidavit STATE OF TEXAS COUNTY OF ________________________ Before me, the __________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ __ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ _________________ity: State: Witness Signature: Name: Address: City: State: ___________________________________ ___________________________________ ___________________________________ _________________________________ a competent witness, and resides at the address set forth after his or her name. Dated: ____________________, ______ Witness Signature: Name: Address: City: State: Witness Signature: Name: Address: Clieve the maker is of sound mind and memory; We believe that this Will was not procured by duress, menace, fraud or undue influence; The maker is age 18 or older. Each of us is now age 18 or older, is______ Testator __________ Witness __________ __________ Witness Witness Page 6 of ______ subscribe our names as witnesses on the date shown above. We understand this is the Testator's Will; We beher 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, do hereby Initials: _________ pages, including the page(s) which contain the witness signatures, was signed in our sight and presence by _____________________________ (the "Testator"), who declared this instrument to be his/eive 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 instrument, which consists of Name: _________________________________________ (Notice to Witnesses: Three (3) adults must sign as witnesses. Each witness must read the following clause before signing. The witnesses should not recnd 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: _______________________________________________ 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, that I am of legal age atermined that I survived my Spouse. In that case, the terms of this Will shall then take precedence over any Will or Codicils of my Spouse, except where otherwise directed by law. IN WITNESS WHEREOF, d I die under circumstances whereby it is difficult or impractical to determine the order of deaths or to determine who survived the death of the other Spouse or who died first, I direct that it be deeclared invalid, illegal or unenforceable, any invalidity, illegality or unenforceability should affect only that provision and all other provision should remain effective. 7. Survival If my Spouse ane 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 any provision of this Will is dted, 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, and every gift together with the 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 Will shall be assigned or anticipanduct 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 property comprising the respectiv Witness Page 5 of ______ connection with or arising out of that fiduciary's good faith actions or non-actions as the fiduciary, except for such actions or non-actions which constitute fraudulent coany beneficiary of my estate, and my estate shall indemnify such natural person from any and all claims or expenses in Initials: __________ Testator __________ Witness __________ __________ Witnessng 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 faith, be liable individually to Thirty Day Survival Requirement. For the purposes of determining the appropriate distributions under this Will, Each beneficiary shall be deemed not to have survived me unless the beneficiary is livihall 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 order granting such adoption. 2., 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 terms "child" and "descendant" sor 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 be deemed to include all gendersONS 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 paragraphs of this Will are inserted fding 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. ARTICLE VII MISCELLANEOUS PROVISIer 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, authority and discretion shall be binbeneficiaries, 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 foregoing, be considered as being oth the exercise of such discretion. The Executor shall exercise the powers, authority and discretion granted herein in what Executor deems to be the best interest, whether monetary or otherwise, of the fees. The Executor 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 reason ofe. 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 t others for such consideration or no consideration and upon such terms and conditions as the Executor may deem advisable and to refer to arbitration all such claims if the Executor deem same advisabl __________ Witness __________ __________ Witness Witness Page 4 of ______ 10. Compromise, settle, waive or pay any claim or claims at any time owing by my estate or which my estate may have againsentered into by the Executor 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 ficiary or otherwise, by reason of any loss, claim, tax or other cost experienced by any such person or by my estate resulting from any election, determination, designation or exercise of discretion, try, state or territory, and such exercise of discretion by the Executor shall be conclusive and binding upon all the beneficiaries hereof. The Executor shall not be liable to any person, whether beneatute or regulation enacted by the federal government of the United States of America, by the legislature or government of any state, or by any other legislative or governmental body of any other couny injury to, consumption of or loss of any such property so used. 8. Make or refrain from making, in Executor's absolute discretion, any elections, determinations, and designations permitted by any stle personal property or real property, without paying any rent, without giving any bond or security and without liability for any loss or damage. The Executor shall not be liable or responsible for anerest shall be sold prior to falling into possession and no such interest not actually producing income shall be treated as producing income. 7. Permit any beneficiaries of my estate to use any tangib discretion without responsibility for loss to the intent that investments or assets so retained shall be deemed to be authorized investments for all purposes of my Will. No reversionary or future intuse any share to be composed of money, property or undivided fractional share in property. 6. Retain any of my investments or assets in the form existing at the date of my death at Executor's absolutereof for such length of time as they may think best. Make any division or distribution of my residuary estate in money or in other property or partly in both upon the basis of fair market value and caon such terms, and either for cash or credit or for part cash and part credit as they may in their absolute discretion decide upon, or to postpone such conversion of my estate or any part or parts theeneficially interested in the property or any part thereof so valued. 5. Sell, call in and convert into money any part of my estate not consisting of money at such time or times, in such manner and upnt and the decision of the Executor shall be final and binding upon all persons concerned, notwithstanding any fluctuation in market value and notwithstanding that one or more of the Executor may be band I expressly will and declare that the Executor shall in their absolute discretion fix the value of my estate or any part thereof for the purpose of making any such division, setting aside or paymeal estate or set aside or pay any share or interest therein either wholly or in part in the assets forming my estate at the time of my death or at the time of such division, setting aside or payment, state upon the security of any mortgage or mortgages and to pay off any mortgage or mortgages which may be in existence at any time forming part of my estate. 4. Make any division of my real or person Page 3 of ______ shall 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 money on any such real ey in repairs, alterations, rebuilding and improvements and generally to manage any such property. The Executor Initials: __________ Testator __________ Witness __________ __________ Witness Witness cost of keeping such property in adequate condition and repair, in the manner and to the extent that the Executor shall deem advisable. 3. To accept surrenders of leases and tenancies, to expend moneny real property as part of the probate administration of my estate for such period as the Executor shall determine; collect any income therefrom; and pay the taxes and expenses thereof, including theses 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 discretionary and not mandatory. 2. Take charge of a 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 power to execute and deliver such deeds, mortgages, lea, 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 such purposes, for such prices, and upono other powers and authority granted by law or necessary or appropriate for proper administration of my estate, the Executor shall have the right and power to: 1. Lease, sell, grant options, partitionhe probate court. No bond, security or surety shall be required of any Executor serving hereunder. ARTICLE VI POWERS OF EXECUTOR In addition to the existing authority of the Executor and in addition tirection of the court having jurisdiction over my estate, using "informal", "unsupervised", or "independent" probate or equivalent legislation designed to operate without unnecessary intervention by tch from time to time whether original or substituted and whether one or more. To the extent permitted by law, the Executor shall have the right to administer my estate without adjudication, order or dd stead of my Spouse. References to "Executor" in this my Will shall include each Executor, Executrix, and Personal Representatives of my Will, my estate or any portion thereof who may be acting as suIf my Spouse cannot, does not or is unable to serve or continue to serve as Executor for any reason, I appoint ___________________________________, , to be the Executor of this my Will in the place an__________ Witness __________ __________ Witness Witness Page 2 of ______ ARTICLE V NOMINATION OF EXECUTOR I appoint my Spouse ___________________________________, as the Executor of this my Will. on or to any other person the Executor may consider to be a proper recipient thereof. Receipt of any such distribution shall be a sufficient discharge to the Executor. Initials: __________ Testator such person directly to the beneficiary or to a parent, guardian, conservator, committee of such person, trustee of such person, person with whom the beneficiary resides at the time of the distributiperson should become entitled to any share in my estate before attaining the age of majority or while under any other disability, I authorize the Executor to nevertheless make any distribution for any_____, then in effect, as if I had died intestate at the time fixed for distribution under this provision. Except as may be specifically otherwise provided herein or directed otherwise by law, if any beneficiary does not survive me, my residuary estate shall be distributed to my heirs-at-law, their identities and respective shares to be determined under the laws of the State of ________________________________________________________________________________(name(s) beneficiary(ies)). If more than one beneficiary is named, then the distribution shall be in equal shares per stirpes. If any such t survive me, then my residuary estate and any other property not otherwise disposed of by this Will, shall be distributed to: ________________________________________________________________ ________te I direct that my residuary estate, including any real property and personal property, be distributed, bequeathed and given to my Spouse. ______________________________________. If my Spouse does nor homestead, if any, shall be distributed to my Spouse ___________________________________. If my Spouse does not survive me, this bequest shall be distributed with my residuary estate. Residuary Estated to ___________________________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. Primary Residence My interest in my primary residence o__________________________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. _____________________________________________ shall be distribu__________________________. If this beneficiary does not survive me, this bequest shall be distributed with my residuary estate. _____________________________________________ shall be distributed to _TICLE IV DISPOSITION OF PROPERTY Specific Bequests I direct that the following specific bequests be made from my estate. _____________________________________________ shall be distributed to _______________ Testator __________ Witness __________ __________ Witness Witness Page 1 of ______ purchaser or transferee upon or after my death pursuant to any agreement with respect to such property. ARe taxes. This direction shall not extend to or include any such taxes that may be payable by a purchaser or transferee in connection with any property transferred to or acquired by such Initials: ____The payment of the 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 th under this Will 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. r the purpose of 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 and inheritance 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 foBTS AND EXPENSES 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 taxesion of any burial 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 DEIAL EXPENSES I authorize 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 acquisitto _____________________________________ (name of spouse). All references to "my Spouse" refer to ________________________________ (name of spouse). I don't have any children. ARTICLE II FUNERAL & BUR of _______________________ (county), _______________________ (state), revoke my former Wills and Codicils and publish and declare this to be my Last Will and Testament. ARTICLE I SPOUSE I am married possible tax consequences arising out of this document should be discussed with a tax professional. Last Will And Testament Of ______________________ I, _____________________________________ (name),be used or signed without consulting an attorney first to make sure it fits your particular situation. Advice from a local attorney is always recommended when dealing with estate planning matters. Anyse forms are not intended and are not a substitute for legal and/or tax advice. Laws vary from time to time and from state to state. These forms should only be a starting point for you and should not ederal estate tax liability. This is referred to as the "Marital Deduction". If the recipient spouse is not a U.S. citizen, the deduction is limited (it was $100,000 in 1999). This information and the of any life insurance policy; [] property you are holding in trust; any joint property you own In addition, each individual may leave an unlimited amount to his or her spouse upon death without any fold furnishings and furniture, jewelry, art, and other personal effects); [] partnership (business) interests; [] individual retirement accounts and qualified employee benefit plans; [] the face valueay be helpful to determine the value of all of the assets in your estate. Assets may include the following: [] real estate; [] stocks and bonds; [] bank accounts; [] tangible personal property (househInformation about Wills ­ Page 2 your assets come near the $1,000,000 level, you really shouldn't use this will and should consult with tax professionals and an attorney. Before using this Will, it m$1,000,000 or more could be subject to federal estate tax. As your estate approaches $1,000,000 in value and exceeds that amount, the greater your need for professional estate tax planning advice If . For a person dying in 2003, that credit is $1,000,000. The amount of the credit increases over the next few years. The credit is available to each individual and his or her spouse. Estates totaling an understanding of tax laws. Federal tax law provides that upon the death of an individual, there is a credit against the estate tax otherwise due on a portion of the value of an individual's estateuation where this Will is to be used as the principal estate planning document. If you have a large estate, you may need more complicated planning to reduce or limit death taxes. Testators should haveire the witnesses to testify. New Hampshire permits self proving, but requires the affidavit to be in a specific format similar to the one included in our wills. The Will is for anyone in any life siturt, like any other will. In Ohio, Maryland, California and the District of Columbia, the courts have some latitude to accept a will as self proved, to require an affidavit of the witnesses or to requno use in those states. However, including the affidavit in those states will not invalidate the Will (since it is a separate document from the Will). In those states it will have to be "proven" in co, lack of testamentary capacity, or prior revocation. A few states like Louisiana, Maryland, Ohio and Vermont (as of 1999).do not have statutes permitting self proving wills. The affidavit will be of ed. The Affidavit can also be useful if witnesses are not available when they are needed.. However, even with the Affidavit, the Will may still be subject to contest on such grounds as undue influencee Testator sign the will and that the formalities for signing a Will were followed. The Affidavit may eliminate the need to have witnesses testify, that the formalities in signing the Will were followhe Testator. Before the adoption of more modern laws, all wills were proved by having one or more of the witnesses come into court and testify under oath, or through sworn affidavits, that each saw thrmalities were observed when the Will was signed. The Affidavit does not affect the validity or legality of the Will. However, it can speed up the admission of the Will to probate after the death of tt be governed by this Will. The Will has an enclosed self-proving affidavit, which contains the Testator's acknowledgment and the affidavit of the witnesses, made before a Notary, that all required fowith rights of survivorship, assets with beneficiary designations (such as life insurance or employee benefit plans), and assets held in trust generally will not be required to be probated and will noied by the Testator. This Will does not avoid probate for the Testator's estate. It merely directs how the assets which are individually owned by the Testator will be distributed. Assets held jointly hese forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Information about Wills This Will distributes the assets of the person making the Will (the "Testator") as specify 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 of te. 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 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 to statyer in their new state to make sure it meets local requirements. [_] These forms are provided "as is" and no implied or express warranties have been made or are provided as to their suitability for anlanning can vary over time and from place to place. All wills should be reviewed by a lawyer before they are signed. If the Testator moves to another state, the current will should be checked by a lawls for distribution in percentages, make sure that the total of all of the beneficiary's percentage's equal 100%. Check the totals before signing the Will. State and federal laws which affect estate pse dies. The Will may be invalid if a spouse receives nothing or only a small portion of the estate. Consult an attorney if you wish to disinherit a spouse or any children. If any part of the Will calor's marital status changes, if the Testator has a child or if a named beneficiary or one of the Executors dies.. Most state laws guarantee a minimum share of an estate to a spouse when the other spoudisregarded. Instead when changes are desired, the original and all copies should be destroyed and an entirely new Will should be signed. New wills are commonly necessary when, for example, the Testathould be discussed with a competent tax advisor. If it becomes necessary to change the Will, do not modify it by adding, deleting, or modifying words on the face of the Will. Such changes are usually tions ­ Page 4 This Will is not designed to reduce taxes. Estate taxes, if any, are based on the size of the total taxable estate and other matters. The tax results of the choices made in this Will s In addition, the distribution of retirement plan benefits, life insurance proceeds and survivor benefits arising in other contracts and plans are not normally governed by a will. Checklist & Instrucmatically pass to another person by operation of law or by any contract. For example, the Will does not dispose of property held in joint tenancy with rights of survivorship or property held in trust.stator and may also (if Testator so wishes) be provided to the person named as Executor / Personal Representative. This Will does not dispose of property that, on the death of the Testator, would auto" of a will should be prepared. While photocopies may used for reference purposes, only the original can be admitted to probate. Copies are rarely accepted. A copy of the Will should be kept by the Tel of the Will should be kept in a secure location such as a safe deposit box at a bank or lawyer's office. Unlike other legal instruments where multiple originals are prepared, only one original "copyefore naming them as a Personal Representative, to make sure that they are willing and can serve. If you select a bank or trust company, be sure to check into their fees for such services. The originato pick a person (or bank or trust company) that can be trusted to handle financial matters and to deal appropriately with family members. It is best to talk to people (and banks or trust companies) bding i.e. not counting the self-proving affidavit) should be entered by hand in the bottom right of each page. The Personal Representative / Executor, should be picked carefully. It is very important ary or other person authorized to take acknowledgments and administer oaths. The affidavit states that all required formalities were observed when the Will was signed. The total number of pages (excluoving affidavit (called "Proof of Will" in some states) and attach it to the end of the Will. The Affidavit contains the Testator's acknowledgment and the affidavit of the witnesses, made before a Note Witnesses. The page with the self-proving affidavit, if included, should not be counted because the affidavit is not a part of the Will itself. The Testator and the witnesses should sign the self-prhe Will at a later date (i.e. if this Will revokes an earlier Will). The total number of pages in the Will, including the page(s) on which the witness signature lines appear, should be indicated by thing the Will freely and willingly. Wherever requested, the date should be filled in (preferably by hand), with the date of the actual signing. This step could be crucial to determine the validity of t witnesses must sign their names in the presence of the Testator and each other and of the notary public. The witnesses must be satisfied that the Testator is an adult of sound mind and he/she is signgood idea for the Testator to initial the bottom of each page of the Will. This can prevent subsequent substitution of pages. The witnesses should also initial the bottom of each page of the Will. Alldocument I am about to sign is my Last Will and Testament. I am signing it freely and voluntarily", or similar words. Checklist & Instructions ­ Page 3 Although not required in most states, it is a at is about to be signed, is intended to be the Testator's Last Will and Testament. However, the witnesses don't need to read or know the contents of the Will. For example, the Testator can say: "The sses and the notary should watch the Testator sign the Will. The notary public is needed for the self proved affidavit. Before signing the Will, the Testator should orally declare that the document thr any reason or if one of the witnesses can't be located. The witnesses should not be beneficiaries under the Will. For example children, spouses, heirs or executors should not be witnesses. All witnecompetent, disinterested and adult witnesses and a notary public. The signature of a third witness can provide additional protection if the signature of one of the witnesses is deemed to be invalid forelatives and others who might be entitled to a share of the estate. Although most states only require two witnesses, the Will should be signed by the Testator in the presence of three (3) qualified, egal age (i.e. eighteen in most states). Being of "sound mind" usually means that the Testator knows that he/she is signing a Will, is familiar with the property and the value thereof and knows about gned , by the Testator, all Witnesses and a Notary in front of each other. · · · The Testator (i.e. the person who is writing the Will) must be of "sound mind" when signing the Will and must be of lfo Affidavit: The enclosed Affidavit (although technically not part of the Will) states that all required formalities were observed when the Will was signed. The Affidavit needs to be completed and sior needs to fill out: [] day month year city; []Signature; []name Witnesses: Witnesses must provide and fill out: [] name of state; [] number of pages; [] name of testator; []witness signatures and inagraph 7 (Survival) in this Will; but (b) if your husband or wife has a will which contains a similar paragraph or wording, then delete , Paragraph 7 (Survival) from this Will. Signature Block: Testatis always recommended) then only one of the Wills should have this (or this type) of paragraph. Basically: (a) if your husband or wife has a will and there is no similar paragraph in it, then keep Parns to the beneficiaries Article VII: Contains miscellaneous provisions. IMPORTANT NOTE: Paragraph 7 (Survival) in this section is important. If both spouses (i.e. husband and wife) have a Will (which of executor (spouse); [] name of alternate executor. · · Article VI: Powers of Executor empowers the representative to deal with matters like taxes, taking care of the property, and making distributioof 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 must provide and fill out [] the name death) of managing the testator's property. The Personal Representative is also responsible for paying outstanding debts, · Checklist & Instructions ­ Page 2 administration expenses and taxes out alternate; It allows the Testator to name an Executor to administer the estate, and an alternate in case the first choice cannot serve. The Executor will have the responsibility (after the testator'state is given in event Spouse does not survive Testator; [] state under whose laws the will is made. Article V: Deals with the appointment of the Testator's Personal Representative (i.e. Executor) andme of Spouse to whom Testator's interest in any primary residence is given; [] name of Spouse to whom the Residuary Estate is given to; [] name of beneficiary or beneficiaries to whom the residuary es provide and fill out: [] description of property (or dollar amount); [] name(s) of person/entity property is given to (three blank paragraphs are provided, but you can add as many as you need). [] na. Article IV: Disposes of specific property, primary residence and residuary property. Allows Testator to give specific dollar amounts or other property to specific persons or charities. Testator must the spouse. Testator must provide and fill out [] name of spouse (in two places); Article II: Authorizes payment of funeral and Burial expenses. Article III: Authorizes payments of debts and expenses under title "Last Will and Testament of". Introduction: Contains preliminary information about the will. Testator must provide and fill out: []name, [] county and []state Article I: Gives the name ofelow. Some sections require information to be provided and filled out in the space provided. The enclosed Affidavit also needs to be completed. · · · · · · Title: Enter name of Testator in blank space Testator to make specific gifts to others as well. This Will is suitable for estates worth less than $1,000,000. This Will is divided into various sections. The content of each section is explained b of the Testator (i.e. person making the will) to the spouse if he/she survives the Testator. Otherwise the assets will go to the specific named beneficiary or beneficiaries. This Will also allows the­ Married Person with No Children with self-proved affidavit. This Will is for use by a married person (husband or wife) with no children and includes a selfproved affidavit. It distributes the assetsChecklist and Instructions Will - Married Person with No Children This package contains (1) Checklist and Instruction for Will ­ Married Person with No Children; (2) Information about Wills; (3) Will TexasTexas inted Name of Notary My commission expires: _________________________ Quitclaim Deed - 2 ment was acknowledged before me on ______________________ by ___________________________________________ _______________________________ Signature of Notary Public _______________________________ Pr__________________ ___________________________________ (Witness Signature) Print Name: ___________________________ State of TEXAS ) ) County of __________________________ ) ss The foregoing instru_____________________ Signed in our presence: Grantors Address: _____________________________ _____________________________ ________________________________ (Witness Signature) Print Name: _________s day of ________, 20 _______ . ____________________________________________ ____________________________________________ Quitclaim Deed - 1 Grantee's Address: _____________________________ ________tor's heirs, administrators, executors, successors and/or assigns shall have, claim or demand any right or title to the aforesaid property, premises or appurtenances or any part thereof. EXECUTED thi right, title and interest in and to the above described property unto the said Grantee, Grantee's heirs, administrators, executors, successors and/or assigns forever; so that neither Grantor nor Granowing real property in the City of __________________________, County of ___________________________________, State of Texas with the following legal description: TO HAVE AND TO HOLD all of Grantor's__________________ ("Grantor"), hereby REMISES, RELEASES, AND FOREVER QUITCLAIMS to ______________________________________________________ ("Grantee"), all right, title, interest and claim to the folln the amount of TEN AND NO/100 DOLLARS ($10.00) in hand and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned, _______________________M THIS INSTRUMENT BEFORE IT IS FILED FOR RECORD IN THE PUBLIC RECORDS: YOUR SOCIAL SECURITY NUMBER OR YOUR DRIVER'S LICENSE NUMBER. KNOW ALL MEN BY THESE PRESENTS THAT: FOR A VALUABLE CONSIDERATION, ind tax statements to: Above reserved for official use only QUITCLAIM DEED NOTICE OF CONFIDENTIALITY RIGHTS: IF YOU ARE A NATURAL PERSON, YOU MAY REMOVE OR STRIKE ANY OF THE FOLLOWING INFORMATION FROith another party. The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Recording requested by: and when recorded, please return this deed aor legal advice. These forms should only be a starting point for you and should not be used without consulting with an attorney first. An Attorney should be consulted before negotiating any document w a Quitclaim Deed, make sure that it satisfies your needs. Consult a real estate attorney and title insurance company to protect your interests. These forms are not intended and are not a substitute fhe only form of conveyance when buying a property. Quitclaim deeds are mainly used in family situations or to correct possible technical defects in the title to the property. If you are a buyer takingerest exists at all. This type of deed may be useful in cases where a party is unable to transfer a fee simple estate or make promises about the title. A buyer will rarely accept a Quitclaim Deed as tonvey an interest in real estate. A Quitclaim Deed does not include any promise or guarantee by the person making it (i.e. the Grantor) about the nature or quality of that interest, or even if any int another party. [_] The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Information for Quitclaim Deed This Quitclaim Deed form is used to clegal advice. These forms should only be a starting point for you and should not be used without consulting with an attorney first. An Attorney should be consulted before negotiating any document withtype of document, additional requirements may apply. Nonconforming documents may be returned unrecorded or may be charged additional fees [_] These forms are not intended and are not a substitute for description is correct. [_] A Quitclaim Deed may require other documents to be filed with it. Please check your local requirements with your local Recorder's (or similar) office. [_] Depending on the rties. Although witnesses are not required in all states, it is generally a good idea to use them. [_] Documents referencing land should include a legal description of the land. Verify that the legal e a Notary and two witnesses. 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 against third paInstructions & Checklist for Quitclaim Deed [_] This package contains (1) Instructions and Checklist for Quitclaim Deed (2) Quitclaim Deed [_] The Grantor should date and sign the Quitclaim Deed befor TexasTexas and discuss your wishes with your physician, family, or other important persons in your life. 4 may not be considered terminal until the disease is fairly advanced. In thinking about terminal illness and its treatment, you again may wish to consider the relative benefits and burdens of treatmentstaining treatment provided in accordance with the prevailing standard of medical care. Explanation: Many serious illnesses may be considered irreversible early in the course of the illness, but they "Terminal Condition" means an incurable cond ition caused by injury, disease, or illness that according to reasonable medical judgment will produce death within six months, even with available life-suclude the administration of 3 pain management medication, the performance of a medical procedure necessary to provide comfort care, or any other medical care provided to alleviate a patient's pain. erm includes both life-sustaining medications and artificial life support such as mechanical breathing machines, kidney dialysis treatment, and artificial hydration and nutrition. The term does not inther important persons in your life. "Life-sustaining treatment means treatment that, based on reasonable medical judgment, sustains the life of a patient and without which the patient will die. The t which burdens of treatment you would be willing to accept in an effort to achieve a particular outcome. This is a very personal decision that you may wish to discuss with your physician, family, or o receives life-sustaining treatments. Late in the course of the same illness, the disease may be considered terminal when, even with treatment, the patient is expected to die. You may wish to consider lung), and serious brain disease such as Alzheimer's dementia may be considered irreversible early on. There is no cure, but the patient may be kept alive for prolonged periods of time if the patientustaining treatment provided in accordance with the prevailing standard of medical care, is fatal. Explanation: Many serious illnesses such as cancer, failure of major organs (kidney, heart, liver, orition, injury, or illness; 1) that may be treated, but is never cured or eliminated; 2) that leaves a person unable to care for or make decisions for the person's own self; and 3) that, without life-s" means the provision of nutrients or fluids by a tube inserted in a vein, under the skin in the subcutaneous tissues, or in the stomach (gastrointestinal tract). "Irreversible condition" means a cond: ____________________________________________________________________ Witness 2: ____________________________________________________________________ Definitions "Artificial nutrition and hydrationnot be an officer, director, partner, or business office employee of a health care facility in which the patient is being cared for or of any parent organization of the health care facility. Witness 1n. If this witness is an employee of a health care facility in which the patient is being cared for, this witness may not be involved in providing direct patient care to the patient. This witness may tness may not be entitled to any part of the estate and may not have a claim against the estate of the patient. This witness may not be the attending physician or an employee of the attending physiciaure of the decrement The witness designated as Witness 1 may not be a person designated to make a treatment decision for the patient and may not be related to the patient by blood or marriage. This wi________________ Date: ____________________ City, County, State of Residence: __________________________________________________ Two competent adult witnesses must sign below, acknowledging the signatxas law this directive has no effect if I have been 2 diagnosed as pregnant. This directive will remain in effect until I revoke it. No other person may do so. Signed: ______________________________e medical treatment provided within the prevailing standard of care, I acknowledge that all treatments may be withheld or removed except those needed to maintain my comfort. I understand that under Tekesperson will be chosen for me following standards specified in the laws of Texas. If, in the judgment of my physician, my death is imminent within minutes to hours, even with the use of all availabl an agent already has been named and you should not list additional names in this document.) If the above persons are not available, or it I have not designated a spokesperson, I understand that a spo_________________________________________________________________ 2. ___________________________________________________________________________ (If a Medical Power of Attorney has been executed, then Medical Power of Attorney, and I am unable to make my wishes known, I designate the following person(s) to make treatment decisions with my physician compatible with my personal values: 1. __________ elect hospice care, I understand and agree that only those treatments needed to keep me comfortable would be provided and I would not be given available life-sustaining treatments. If I do not have a_________________________________________________________________ _____________________________________________________________________________ After signing this directive, if my representative or Iwant the particular treatment.) _____________________________________________________________________________ _____________________________________________________________________________ ____________ticular treatments in this space that you do or do not want in specific circumstances, such as artificial nutrition and fluids, intravenous antibiotics, etc. Be sure to state whether you do or do not ible condition using available lifesustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE) Additional requests: (After discussion with your physician you may wish to consider listing parments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR ____________ I request that I be kept alive in this irreverself or make decisions for myself and am expected to die without life-sustaining treatment provided in accordance with prevailing standards of care (initial one):: ____________ I request that all treat available lifesustaining treatment. (THIS SELECTION DOES NOT APPLY TO HOSPICE CARE) 1 If, in the judgment of my physician, I am suffering with an irreversible condition so that I cannot care for mys those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR ____________ I request that I be kept alive in this terminal condition usinge within six months, even with available life-sustaining treatment provided in accordance with prevailing standards of medical care (initial one): ____________ I request that all treatments other thanbecause of illness or injury, I direct that the following treatment preferences be honored: If, in the judgment of my physician, I am suffering with a terminal condition from which I am expected to di physician and I will make health care decisions together as long as I am of sound mind and able to make my wishes known. If there comes a time that I am unable to make medical decisions about myself ns and tissues. DIRECTIVE I__________________________________________________________, recognize that the best health care is based upon a partnership of trust and communication with my physician. My-Not-Resuscitate Order. You may wish to discuss these with your physician, family, hospital representative, or other advisers. You may also wish to complete a directive related to the donation of orgadition to this advance directive, Texas law provides for two other types of directives that can be important during a serious illness. These are the Medical Power of Attorney and the Outof-Hospital Do to your physician, usual hospital, and family or spokesperson. Consider a periodic review of this document. By periodic review, you can best assure that the directive reflects your preferences. In adBrief definitions are listed below and may aid you in your discussions and advance planning. Initial the treatment choices that best reflect your personal preferences. Provide a copy of your directive spokesperson, as well as your physician. Your physician, other health care provider, or medical institution may provide you with various resources to assist you in completing your advance directive. ships of treatment you would be willing to accept for a particular amount of benefit obtained if you were seriously ill. You are encouraged to discuss your values and wishes with your family or chosenn the future when you are unable to make your wishes known because of illness or injury. These wishes are usually based on personal values. in particular, you may want to consider what burdens or hards Instructions For Co mpleting This Document This is an important legal document known as an Advance Directive. It is designed to help you communicate your wishes about medical treatment at sometime iussed with a tax professional. [_] The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Texas Directive To Physicians And Family Or Surrogate 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 should be discx 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 make sure itave been made or are provided as to their suitability for any specific purpose or as to their legal effect or completeness. [_]These forms are not intended and are not a substitute for legal and/or taliable for failure to act on a revocation made under this section unless the person has actual knowledge of the revocation. [_] These forms are provided "as is" and no implied or express warranties h shall also enter the word "VOID" on each page of the copy of the directive in the patient's medical record. (d) Except as otherwise provided by this subchapter, a person is not civilly or criminally ord the time, date, and place of the revocation, and, if different, the time, date, and place that the physician received notice of the revocation. The attending physician or the physician's designeeseclarant or a person acting on behalf of the declarant notifies the attending physician of the revocation. The attending physician or the physician's designee shall record in the patient's medical recand shall enter the word "VOID" on each page of the copy of the directive in the patient's medical record. (c) An oral revocation issued as prescribed by Subsection (a)(3) takes effect only when the dhe attending physician. The attending physician or the physician's designee shall record in the patient's medical record the time and date when the physician received notice of the written revocation ted as prescribed by Subsection (a)(2) takes effect only when the declarant or a person acting on behalf of the declarant notifies the attending physician of its existence or mails the revocation to tg a written revocation that expresses the declarant's intent to revoke the directive; or (3) the declarant orally stating the declarant's intent to revoke the directive. (b) A written revocation execu or someone in the declarant's presence and at the declarant's direction canceling, defacing, obliterating, burning, tearing, or otherwise destroying the directive; (2) the declarant signing and datinrant may revoke a directive at any time without regard to the declarant's mental state or competency. A directive may be revoked by: Living Will Information & Instructions ­ Page 3 (1) the declarantnot require that: (1) a directive be notarized; or (2) a person use a form provided by the physician, health care facility, or health care professional. § 166.042. Revocation of Directive (a) A declatten directive executed under Section 166.033 or 166.035 is effective without regard to whether the document has been notarized. (b) A physician, health care facility, or health care professional may ten directive. The attending physician shall make the directive a part of the declarant's medical record. § 166.036. Notarized Document Not Required; Requirement of Specific Form Prohibited (a) A wrie of a written directive. If the declarant is incompetent or otherwise mentally or physically incapable of communication, another person may notify the attending physician of the existence of the writon for the declarant in the event the declarant becomes incompetent or otherwise mentally or physically incapable of communication. (d) A declarant shall notify the attending physician of the existenctnesses must sign the directive. (c) A declarant may include in a directive directions other than those provided by Section 166.033 and may designate in a directive a person to make a treatment decisiive. (b) The declarant must sign the directive in the presence of two witnesses who qualify under Section 166.003, at least one of whom must be a witness who qualifies under Section 166.003(2). The wibeen diagnosed and certified in writing by the attending physician. § 166.032. Written Directive by Competent Adult; Notice to Physician (a) A competent adult may at any time execute a written directister, withhold, or withdraw life-sustaining treatment in the event of a terminal or irreversible condition. (2) "Qualified patient" means a patient with a terminal or irreversible condition that has ant's death. § 166.031. Definitions Living Will Information & Instructions ­ Page 2 In this subchapter: (1) "Directive" means an instruction made under Section 166.032, 166.034, or 166.035 to adminecuted or, if the directive is a nonwritten directive issued under this chapter, at the time the nonwritten directive is issued, has a claim against any part of the declarant's estate after the declarrector, partner, or business office employee of the health care facility or of any parent organization of the health care facility; or (G) a person who, at the time the written advance directive is exmployee of the attending physician; (F) an employee of a health care facility in which the declarant is a patient if the employee is providing direct patient care to the declarant or is an officer, di(C) a person entitled to any part of the declarant's estate after the declarant's death under a will or codicil executed by the declarant or by operation of law; (D) the attend ing physician; (E) an e; and (2) at least one of the witnesses must be a person who is not: (A) a person designated by the declarant to make a treatment decision; (B) a person related to the declarant by blood or marriage; s In any circumstance in which this chapter requires the execution of an advance directive or the issuance of a nonwritten advance directive to be witnessed: (1) each witness must be a competent adultll) is based on Chapter 166 Section 166.001 et. Seq. of the Texas Statutes. For your convenience, we have included useful excerpts from the Texas Statutes relating to Living Wills. § 166.003. Witnessee To Physicians And Family Or Surrogates (Living Will); (2) Texas Directive To Physicians And Family Or Surrogates (Living Will). This Texas Directive To Physicians And Family Or Surrogates (Living Wi______ Page 3 Living Will Information and Instructions Texas Directive To Physicians And Family Or Surrogates (Living Will) This package contains (1) Informa tion and Instruction for Texas Directiv_____________________________ Print Name: _____________________________________________________________ Date: ______________________ Address: _________________________________________________________________________________ Date: ______________________ Address: ________________________________________________________________ Signature of Second Witness Signature: _________________________________ealth care facility or of any parent organization of the health care facility. Signature: _______________________________________________________________ Print Name: __________________________________th care facility in which the principal is a patient, I am not involved in providing direct patient care to the principal and am not an officer, director, partner, or business office employee of the hphysician of the principal or an employee of the attending physician. I have no claim against any portion of the principal's estate on the principal's death. Furthermore, if I am an employee of a healed as agent by this document. I am not related to the principal by blood or marriage. I would not be entitled to any portion of the principal's estate on the principal's death. I am not the attending Signature) ____________________________________________________________ (Print Name) ___________________________________________________________ Statement of First Witness I am not the person appointr of Attorney) Page 2 I sign my name to this medical power of attorney on _____________ day of _________ (month, year) at _________________________________________________________, (City and State) (e been provided with a disclosure statement explaining the effect of this document. I have read and understand the information contained in this disclosure statement. (You Must Date and Sign This Poweplicable) This power of attorney ends on the following date: __________________ Prior Designations Revoked I revoke any prior medical power of attorney. Acknowledgement of Disclosure Statement I havth care decisions for myself when this power of attorney expires, the authority I have granted my agent continues to exist until the time I become able to make health care decisions for myself. (If Apration I understand that this power of attorney exists indefinitely from the date I execute this document unless I establish a shorter time or revoke the power of attorney. If I am unable to make heal________________________________________________ Name: __________________________________________________________________ Address: ________________________________________________________________ Du______________________________________ The following individuals or institutions have signed copies: Name: __________________________________________________________________ Address: ______________________________ Phone: ________________________________________________________________ The original of the document is kept at _______________________________________ ________________________________ame: _________________________________________________________________ Address: _______________________________________________________________ ________________________________________________________________________________ ______________________________________________________________________ Phone: ________________________________________________________________ Page 1 Second Alternate Agent Nrized by this document, who serve in the following order: First Alternate Agent Name: _________________________________________________________________ Address: _______________________________________f the person designated as my agent is unable or unwilling to make health care decisions for me, I designate the following person(s), to serve as my agent to make health care decisions for me as authoed agent if the designated agent is unable or unwilling to act as your agent. If the agent designated is your spouse, the designation is automatically revoked by law if your marriage is dissolved.) I________________ Designation of an Alternate Agent: (You are not required to designate an alternate agent but you may do so. An alternate agent may make the same health care decisions as the designat______________________________________________________________________ ________________________________________________________________________ ________________________________________________________takes effect if I become unable to make my own health care decisions and this fact is certified in writing by my physician. Limitations On The Decision Making Authority Of My Agent Are As Follows: __________________________________________________ as my agent to make any and all health care decisions for me, except to the extent I state otherwise in this document. This medical power of attorne y ________________________________ Address: _______________________________________________________________ ______________________________________________________________________ Phone: ________________ TEXAS MEDICAL POWER OF ATTORNEY FOR HEALTH CARE Designation of Health Care Agent: I, _____________________________________________ (insert your name) appoint: Name: _________________________________ty or of any parent organization of the health care facility; or (7) a person who, at the time this power of attorney is executed, has a claim against any part of your estate after your death. Page 2 of a health care facility in which you are a patient if the employee is providing direct patient care to you or is an officer, director, partner, or business office employee of the health care facili to any part of your estate after your death under a will or codicil executed by you or by operation of law; (4) your attending physician; (5) an employee of your attending phys ician; (6) an employeeNT ADULT WITNESSES. THE FOLLOWING PERSONS MAY NOT ACT AS ONE OF THE WITNESSES: (1) the person you have designated as your agent; (2) a person related to you by blood or marriage; (3) a person entitledct as your agent. Any alternate agent you designate has the same authority to make health care decisions for you. THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS SIGNED IN THE PRESENCE OF TWO COMPETEfied. If you want to make changes in the document, you must make an entirely new one. You may wish to designate an alternate agent in the event that your agent is unwilling, unable, or ineligible to awriting or by your execution of a subsequent medical power of attorney. Unless you state otherwise, your appointment of a spouse dissolves on divorce. Page 1 This document may not be changed or modiannot be given to you or stopped over your objection. You have the right to revoke the authority granted to your agent by informing your agent or your health or residential care provider orally or in e decisions made in good faith on your behalf. Even after you have signed this document , you have the right to make health care decisions for yourself as long as you are able to do so and treatment c with your agent and your phys ician and give each a signed copy. You should indicate on the document itself the people and institutions who have signed copies. Your agent is not liable for health carprovider; the law does not permit a person to do both at the same time. You should inform the person you appoint that you want the person to be your health care agent. You should discuss this documentmployee of a home health agency, hospital, nursing home, or residential care home, other than a relative), that person has to choose between acting as your agent or as your health or residential care st be 18 years of age or older or a person under 18 years of age who has had the disabilities of minority removed. If you appoint your health or residential care provider (e.g., your physician or an e but if there is anything in this document that you do not understand, you should ask a lawyer to explain it to you. The person you appoint as agent should be someone you know and trust. The person muf you do not have a physician, you should talk with someone else who is knowledgeable about these issues and can answer your questions. You do not need a lawyer's assistance to complete this document,hat you discuss this document with your physician or other health care provider before you sign it to make sure that you understand the nature and range of decisions that may be made on your behalf. I your instructions when making decisions on your behalf. Unless you state otherwise, your agent has the same authority to make decisions about your health care as you would have had. It is important tallow you to be transferred to another physician. Your agent's authority begins when your doctor certifies that you lack the competence to make health care decisions. Your agent is obligated to followaining treatment. Your agent may not consent to voluntary inpatient mental health services, convulsive treatment, psychosurgery, or abortion. A physician must comply with your agent's instructions or ake a broad range of health care decisions for you. Your agent may consent, refuse to consent, or withdraw consent to medical treatment and may make decisions about withdrawing or withholding lifesustonger capable of making them yourself. Because "health care" means any treatment, service, or procedure to maintain, diagnose, or treat your physical or mental condition, your agent has the power to mnt gives the person you name as your agent the authority to make any and all health care decisions for you in accordance with your wishes, including your religious and moral beliefs, when you are no ledical Power of Attorney for Health Care This is an important legal document. Before signing this document, you should know these important facts: Except to the extent you state otherwise, this documeax professional. [_] The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com Power of Attorney for Health Care Disclosure Statement for Texas Mticular situation. Advice from a local attorney is always recommended when dealing with estate planning matters. Any possible tax consequences arising out of this document should be discussed with a t vary from time to time and from state to state. These forms should only be a starting point for you and should not be used or signed without consulting an attorney first to make sure it fits your paror are provided as to their suitability for any specific purpose or as to their legal effect or completeness. [_]These forms are not intended and are not a substitute for legal and/or tax advice. Lawsre Directive. The first form is the Power of Attorney for Health Care and the second form is the Living Will. [_] These forms are provided "as is" and no implied or express warranties have been made Texas Advance Health Care Directive This package contains both a Texas Power of Attorney for Health Care and a Texas Living Will. Together these forms are also sometimes known as an Advance Health Ca TexasTexas _____________ 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 Texas