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Fill and Sign the Pennsylvania Living Wills Laws Findlaw Form

Fill and Sign the Pennsylvania Living Wills Laws Findlaw Form

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REVOCATION OF DECLARATION (Living Will) (Pennsylvania Consolidated Statutes §5406) I, ___________________________________________________________________, Declarant, executed a Declaration (Living Will) on the ________ day of ________________________, 20____. Pennsylvania Consolidated Statutes §5404 provides " A declaration may be revoked at any time and in any manner by the declarant without regard to the declarant's mental or physical condition. A revocation is effective upon communication to the attending physician or other health care provider by the declarant or a witness to the revocation."This is my written revocation of my Declaration (Living Will) and is provided to all persons to whom I have provided a copy of my Declaration.DATED this the _________ day of ______________________________, 20____.Signature of Declarant: __________________________________________________________Printed Name of Declarant: _______________________________________________________Address of Declarant: ___________________________________________________________

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