Living Will - Advanced Legal Documents, LLC

Principal’s Information

Enter the information exactly as it should appear in the Living Will.

Signing date Leave blank if signing date is unknown

Notary county Leave blank if the signing county is not yet known.

State where notarization occurs Enter the state where the document will be signed and notarized.

Principal’s full name

FirstMiddleLast

Principal’s address

Address Line 1Address Line 2CityStateZIP

Principal’s county

Last four digits of principal’s Social Security number

Identification presented to the notary

Principal’s phone

Enter the primary agent and, if applicable, the successor agent.

Agent’s full name

FirstMiddleLast

Agent’s address

Address Line 1Address Line 2CityStateZIP

Agent’s county

Agent’s phone

Do you want to appoint a second agent?

Yes No

Successor agent’s full name

FirstMiddleLast

Successor agent’s address

Address Line 1Address Line 2CityStateZIP

Successor agent’s county

Successor agent’s phone