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Text File  |  1991-06-27  |  457b  |  12 lines
  1. #5880
  2. @001 State the name of the declarant
  3. #5881 Do you desire a "no-hydration" clause?
  4. #5882 Do you desire a "no-feeding" clause?
  5. #5883 Do you desire a release clause?
  6. #5884 Do you desire a transfer clause?
  7. #5885
  8. @448 State declarant's city of residence:
  9. @449 State the declarant's county of residence:
  10. @450 State the declarant's state of residence:
  11. @451 State the declarant's social security number:
  12. #5886 Do you desire a notarization clause?