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y the day and year last above written.\n\nSeal\n\n_______________________________ Signature of Notary Public\n\n-2-\n\nhat I am not the attorney in fact or successor attorney in fact designated by this power of attorney for health care. Witness my hand and notarial seal at _______________________________ in such countncipal, and I declare that he or she appears in sound mind and not under duress or undue influence, that he or she acknowledges the execution of the same to be his or her voluntary act and deed, and t__________________ County, personally came ______________________________, personally to me known to be the identical person whose name is affixed to the above power of attorney for health care as priCounty of ___________________ ) On this _______________________________ day of ________ , 20 ___, before me, ________________________________________________________, a notary public in and for ______nt Name: ______________________________________ ______________________________________ Date: _________________________________ Date: _________________________________\n\nOR State of Nebraska, ) ) ss. rson appointed as attorney in fact by this document. Witnessed By: ______________________________________ ______________________________________ (Witness Signature) (Witness Signature) Print Name: Priorney for health care in our presence, that the principal appears to be of sound mind and not under duress or undue influence, and that neither of us nor the principal\'s attending physician is the pemaking designation/date)\n\n-1-\n\nDECLARATION OF WITNESSES We declare that the principal is personally known to us, that the principal signed or acknowledged his or her signature on this power of attTHAT I CAN REQUIRE IN THIS POWER OF ATTORNEY FOR HEALTH CARE THAT THE FACT OF MY INCAPACITY IN THE FUTURE BE CONFIRMED BY A SECOND PHYSICIAN. _____________________________________ Signature of person UNDERSTAND THAT I CAN REVOKE THIS POWER OF ATTORNEY FOR HEALTH CARE AT ANY TIME BY NOTIFYING MY ATTORNEY IN FACT, MY PHYSICIAN, OR THE FACILITY IN WHICH I AM A PATIENT OR RESIDENT. I ALSO UNDERSTAND ______________ I HAVE READ THIS POWER OF ATTORNEY FOR HEALTH CARE. I UNDERSTAND THAT IT ALLOWS ANOTHER PERSON TO MAKE LIFE AND DEATH DECISIONS FOR ME IF I AM INCAPABLE OF MAKING SUCH DECISIONS. I ALSOicially administered nutrition and hydration (optional): ______________________________________________________________________________ _______________________________________________________________________________________________________ ______________________________________________________________________________ I direct that my attorney in fact comply with the following instructions on artif______________________________________________ I direct that my attorney in fact comply with the following instructions on life-sustaining treatment (optional): _______________________________________I direct that my attorney in fact comply with the following instructions or limitations: ______________________________________________________________________________ ________________________________mined to be incapable of making my own health care decisions. I have read the warning which accompanies this document and understand the consequences of executing a power of attorney for health care. er is _______________________________, as my successor attorney in fact for health care. I authorize my attorney in fact appointed by this document to make health care decisions for me when I am deter, as my attorney in fact for health care. I appoint _____________________________________________________ ,whose address is __________________________________________________, and whose telephone numbre\nI appoint _____________________________________________________ , whose address is __________________________________________________, and whose telephone number is _______________________________iscussed with a tax professional.\n\n-2-\n\n[_] The purchase and use of these forms is subject to the Disclaimers and Terms of Use found at findlegalforms.com\n\n-3-\n\nPower of Attorney for Health Casure it fits your particular situation. You should also consult an attorney whenever a document is negotiated with another party. Any possible tax consequences arising out of this document should be dese forms should only be a starting point for you and should not be used without consulting with an attorney first. Before using or signing this document you should have an attorney review it to make cific purpose or as to their legal effect or completeness. [_]These forms are not intended and are not a substitute for legal and/or tax advice. Laws vary from time to time and from state to state. Thr attorney in fact withdraws pursuant to section 30-3407. [_] These forms are provided \"as is\" and no implied or express warranties have been made or are provided as to their suitability for any speattorney; duration. A power of attorney for health care shall continue in effect until the principal\'s death, until revoked pursuant to section 30-3420, or until the attorney in fact and any successoerms of section 30-3404. (4) A power of attorney for health care which is executed in another state and is valid under the laws of that state shall be valid according to its terms. 30-3410 - Power of torney or any other form fully complies with the terms of section 30-3404. (3) A power of attorney for health care executed prior to January 1, 1993, shall be effective if lAdult Datingskincare Naked Woman Dating Skin Care Nebraska Power Of Attorney For Health Care - FindLegalForms.comb e Porno Care zAdult Datingskincare Naked Woman Dating Skin Care Nebraska Power Of Attorney For Health Care - FindLegalForms.comv h h Dating Care Dating Personals