Indiana Living Will Declaration Form

Indiana Living Will Declaration Form

Life-Prolonging Procedures (Form 55315) – For an individual that wants their life prolonged and sustained as far as might be feasible.

Laws related to the Indiana living will declaration

• Signing Requirements – Two (2) witnesses (IC 16-36-4-10).

• Statute – IC 16-36-4-10

Step by step instructions to write 

Stage 1 – Declaration – The form should be downloaded, and then the following should be entered: 

• Declaration date in this pattern: dd/mm/yyyy 

Conversely, you can use our Indiana living will generator to create your living will in just a few moments. 

Stage 2 – Declarant/Principal Review of Statement – The assertions given in this document must then be reviewed by the Declarant (Principal) cautiously and in its entirety. If it is acceptable and understood properly by the declarant, the declarant should give a reaction to the assertion by indicating in the lines provided.  

Stage 3 – Declarant/Principal Signature – The last line must be carefully read by the declarant and if he or she agrees and understands the statement in the document, the following should be entered.

• The Signature of the Declarant

• The Residential City, County, and State

Stage 4 – Witness Signatures – The witnesses must be present as it is required by this document. Also the document requires the witnesses to sign. The witnesses are meant to review the assertions in the documents and if they are satisfied it is complete and are in agreement, then the following information below should be entered: 

First Witness 

• The signature of the witness

• The date in which the document was signed in this format: mm/dd/yyyy

Second Witness

• The signature of the witness

• The date in which the document was signed in this pattern: mm/dd/yyyy