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Fill and Sign the Illinois Anatomical Gift Form

Fill and Sign the Illinois Anatomical Gift Form

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Open the document and fill out all its fields.
Apply your legally-binding eSignature.
Save and invite other recipients to sign it.

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DONATION PURSUANT TO THE UNIFORM ANATOMICAL GIFT ACT (755 ILCS 50/) In the event of my death, I donate the following part(s) of my body for the purposes identified in 755 ILCS 50/10: TISSUE:       Eyes       Bone and connective tissue       Skin       Heart Other: _______________________________________________________________ Limitations: _____________________________________________________________________ ORGAN:       Heart       Kidney(s)       Liver       Lung(s)       Pancreas Other: _______________________________________________________________ Limitations: _______________________________________________________________ Signed this day of       , ___________________ , 20       , Signature ______________________________________________________________ Place _______________________________________________________________ If another person is to sign for the declarant at the declarant's direction, the person signing for the declarant must sign in the presence of two persons or a person who is qualified to take acknowledgments. The witness form below may be used for the two witnesses. The acknowledgement form below may be used for the person qualified to take acknowledgements. WITNESS FORM The following witnesses, at least one of whom is a disinterested witness, sign this form at the donor’s request: Witness Signature: ________________________________________________________ Witness Name: ___________________________________________________________ Address: ________________________________________________________________ Witness Signature: ________________________________________________________ Witness Name: ___________________________________________________________ Address: ________________________________________________________________ State of _________________________ Judicial District _________________________ ACKNOWLEDGEMENT FORM The foregoing instrument was acknowledged before me this _______________________(date) by _______________________________ (name of person who acknowledged). Signature of Person Taking Acknowledgement: _______________________________________________ Title or Rank: ___________________________________ Serial Number, if any: _____________________________

Useful advice on finishing your ‘Illinois Anatomical Gift’ online

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Adhere to these comprehensive steps:

  1. Sign in to your account or sign up for a free trial with our service.
  2. Click +Create to upload a document from your device, cloud storage, or our form library.
  3. Access your ‘Illinois Anatomical Gift’ in the editor.
  4. Click Me (Fill Out Now) to prepare the document on your end.
  5. Add and assign fillable fields for additional participants (if needed).
  6. Proceed with the Send Invite settings to solicit eSignatures from others.
  7. Download, print your version, or transform it into a reusable template.

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The best way to complete and sign your illinois anatomical gift form

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