YOU'RE ONLY FOUR
EASY STEPS FROM GETTING YOUR STATE SPECIFIC, SIGNATURE-READY LIVING
WILL
1. Enter
your information in the brief form below. 2. Pay $8.95 for your living will using your
credit card.
3. Print out your living will and sign before two
witnesses and/or a notary public.
4. Breathe a sigh of relief--you have your affairs in
order!
Below
is a description of the information we need from you.
Type
your information in the boxes below.
Below
are helpful descriptions to guide you through this simple
process.
Enter the SSN
in this format: 555-55-5555
The social security number will not be released to any third parties.
Some states require it on the living will form.
Enter the declarant's
birthdate
Enter the date
in this format: 10/13/1969
Enter the declarant's
street address:
Enter the address
like this:
1234 Main Street
Enter the declarant's
city:
Enter the declarant's
county:
Below,
tell us where the living will document will be signed.
Enter the city
where the document will be signed:
Enter
the county where the document will be signed:
Enter the state
where the document will be signed:
Finally,
tell us about your choice for health care agent(s).
In this box,
describe the Agent, not the declarant. For example, if the agent is
the son of the declarant, type "Son".
Enter the Agent's
street address:
Enter the Agent's
city:
Enter
the Agent's state:
Enter the Agent's
current telephone number:
The telephone
number will NOT be given to any third parties. It is included in your
living will just so the doctor can quckly reach your agent, if necessary.
