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Fill and Sign the Proxy Form 481373215

Fill and Sign the Proxy Form 481373215

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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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REVOCATION OF HEALTH CARE PROXY I, , Declarant, having executed a Health Care Proxy on the day of , 20 . New York Consolidated Laws, Public Health, § 2985 (a) provides that, "A competent adult may revoke a health care proxy by notifying the agent or a health care provider orally or in writing or by any other act evidencing a specific intent to revoke the proxy." This is my written revocation of my Health Care Proxy and is provided to all persons to whom I have provided a copy of my Health Care Proxy. DATED this the day of , 20 . Signature of Declarant: __________________________________________ Printed Name of Declarant: Address of Declarant:

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The best way to complete and sign your proxy form 481373215

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How to Sign a PDF on a Mobile Device How to Sign a PDF on a Mobile Device How to Sign a PDF on a Mobile Device

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How to Sign a PDF on Android How to Sign a PDF on Android

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