The following declaration of disposition of last remains must be substantially in the following form:
DECLARATION OF DISPOSITION OF LAST REMAINS
I, ________________________________________________________________ (Name of Declarant), being of sound mind and lawful age, hereby revoke all prior declarations, wills, codicils, trusts, powers of appointment, and powers of attorney regarding the disposition of my last remains, and I declare and direct that after my death the following provisions be taken:
1. If permitted by law, my body shall be (Initial ONE choice):
________ Buried. I direct that my body be buried at ________________.
________ Cremated. I direct that my cremated remains be disposed of as follows:
________________.
________ Entombed. I direct that my body be entombed at ________________.
________ Other. I direct that my body be disposed of as follows:
________ Disposed of as ________________________ (Name of Designee) shall decide in writing. If ________________________ is unwilling or unable to act, I nominate ________________________ as my alternate designee.
2. I request that the following ceremonial arrangements be made (initial desired choice or choices):
________ I request ________________________ (Name of designee) make all arrangements for any ceremonies, consistent with my directions set forth in this declaration. If ________________________ is unwilling or unable to act, I nominate ________________________ as my alternate designee.
________ Funeral. I request the following arrangements for my funeral:
________________.
________ Memorial Service. I request the following arrangements for my memorial service:
________________.
3. Special Instructions. In addition to the instructions above, I request (on the following lines you may make special requests regarding ceremonies or lack of ceremonies):
________________
________________.
Note:
I may revoke or amend this declaration in writing at any time. I agree that a third party who receives a copy of this declaration may act according to it. Revocation of this declaration is not effective as to a third party until the third party learns of my revocation. My estate shall indemnify any third party for costs incurred as a result of claims that arise against the third party because of good-faith reliance on this declaration.
I execute this declaration as my free and voluntary act, on ________________________________.
__________________________ (Declarant) ________________________________________________________________.
The following section regarding organ and tissue donation is optional. To make a donation, initial the option you select and sign below.
In the hope that I might help others, I hereby make an anatomical gift, to be effective upon my death, of:
A. ________ Any needed organs/tissues.
B. ________ The following organs/tissues:
________________________________.
Donor signature:
Notarization Optional:
State of Delaware
County of ________________________________ :
Acknowledged before me by ________________________________________________________________, Declarant, on ________________, ________ . My commission expires:
*(Seal) Notary Public________________ .