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Fill and Sign the Vt Advance 497429051 Form

Fill and Sign the Vt Advance 497429051 Form

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REVOCATION OF VERMONT ADVANCE DIRECTIVE I,       , Declarant, having executed an Advance Directive for Health Care on the       day of       , 20       . 18-9704 VSA provides that I can revoke this document by executing a new advance directive, by signing a revocation statement, by personally informing my physician or other health care provider, by burning, tearing or obliterating the document, or by causing the document to be destroyed by some other person at my direction and in my presence. This is my written revocation of the above referenced Document and I am providing a copy of it to all interested parties. DATED this the       day of       , 20       . Signature of Declarant: __________________________________________________________ Printed Name of Declarant:       Address of Declarant:      

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  4. Press Me (Fill Out Now) to set up the form on your end.
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