Fill and Sign the Devise Personal Form

Agreement to Devise or Bequeath Property to a Person Performing the Personal Services of Lifetime Care for a Future Testator at the Residence of Promisee Agreement made (date) , between (Name of Testator) , of (street address, city, county, state, zip code) , hereinafter called the Testator, and Promisee, of (street address, city, county, state, zip code) , hereinafter called the Promisee. I. Place Where Services to be Performed. Promisee agrees to permit Testator to live and reside in Promisee's residence at (street address, city, county, state, zip code) , or in any other reasonable residence which may be selected and used by Promisee as (his/her) residence, commencing on (date) , and continuing for the remainder of Testator's life, without any charge, except as otherwise specified in this Agreement. II. Care and Maintenance. Promisee agrees to furnish Testator with reasonable living accommodations at Promisee's residence, including clothing, food, and medical care, and to perform necessary household duties, including, but not limited to, cooking and the washing of clothes, and, in general, to care for Testator, commencing on (date) , and continuing for as long as Testator shall live, without any charge or compensation, except as otherwise specified in this Agreement. III. Burial. Promisee agrees that on Testator's death, (he/she) will provide Testator with a proper funeral and burial. IV. Retirement Plan, Medicare, and Health Insurance. Testator agrees to endorse and deliver, and transfer all rights to the funds represented by, (his/her) (description of retirement plan) , Medicare and (description of health insurance and other benefits) checks, to Promisee, commencing on (date of commencement of services) . V. Execution of Will. Testator agrees to make and execute a valid will bequeathing and devising ) to Promisee (the following described property): (description) or [all of the real and personal property which Testator may own at the time of (his/her) death)] . VI. Revocation of Prior Wills and Codicils. T estator agrees to include a clause in the will revoking any and all wills and codicils previously made by (him/her) . VII. When Will to be Executed; Approval by Attorney. Testator agrees to make and execute the will on or before (date) , and agrees to submit the will to Promisee on or before (date) for examination and approval of Promisee and (his/her) attorney. VIII. Restriction on Revocation of Will. Testator agrees that (he/she) will not revoke, in whole or in part, the will executed pursuant to this Agreement. IX. Custody of Will. The will is to be (kept in the custody of (name of custodian) at (street address, city, county, state, zip code) . X. Evidence of Ownership. On or before (date) , Testator agrees to submit to Promisee documentary evidence showing Testator's right, title, and interest in and to the property. XI. Sales, Mortgages, Transfers, Etc, of Property. Testator agrees not to sell, pledge, encumber, or transfer any interest in and to the property, unless the written consent of Promisee to the same has been obtained. XII. Preservation and Protection of Property. (Testator/Promisee) agrees to do everything necessary to protect and preserve the property, including, but not limited to, the obtaining, or keeping in force and effect, appropriate insurance policies covering the property; making all payments for taxes, liens, assessments, mortgages and other encumbrances as they become due; where appropriate, providing for the safekeeping of the property; and, where appropriate, keeping the property in reasonable repair. XIII. Death or Inability to Perform Services. If Promisee should predecease Testator, or, if Promisee, because of illness or for any other reason, is unable to perform the promises on (his/her) part to be performed, Promisee is not to receive or be entitled to receive any property under and by virtue of the will, or to receive any compensation for the services previously performed under this Agreement. The parties have executed this Agreement on the date and at the place designated above. ___________________________ (Signature of Testator) (Printed Name of Testator) ___________________________ (Signature of Promisee) (Printed Name of Promisee) (Acknowledgments)