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EXECUTE a SEPARATE DOCUMENT for that PURPOSE Form
DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE
MEDICAL OR OTHER HEALTH CARE DECISIONS FOR YOU.
YOU MAY
EXECUTE A SEPARATE DOCUMENT FOR THAT PURPOSE.
IF THERE IS
ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU
SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU.
KNOWN BY ALL PERSONS PRESENT, THAT:
I,
__________________________________
(name),
_____________________________
(address), “Principal”, execute this Durable Power of Attorney and do hereby make,...
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