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other names: advance directive revocation advance health care directive revocation advance medical directive revocation
living will revocation document preview

what is a living will revocation?

a living will revocation is a formal way to cancel your will if you've been having second thoughts or want to make substantial revisions. when you've decided you want to revoke your living will, for any reason, it's important that your paperwork stays up to date - a living will revocation can help you keep your last will and testament as current as your wishes. 
 
a living will revocation can undo a current living will. maybe you're not quite as sure about certain things as you were a few years ago or maybe you plan on making so many changes to the existing will you'd rather start from scratch. it's understandable as there's a lot that goes into making a will: choosing which assets to distribute, deciding upon end of life care, naming beneficiaries. you may also be considering getting married and weighing the benefits of having a joint living will. no matter the reasons, a living will revocation can help you if you're considering redoing your will. plans can change, and it's important that your paperwork changes along with them. when you sign a living will revocation, you're cancelling your current living will so that you can start with a clean slate.

when to use a living will revocation:

  • you want to revoke an existing living will.
  • you've changed your mind about life sustaining procedures.
  • you want to make substantial revisions to your current living will and believe starting over will be easier.

sample living will revocation

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i hereby witness this revocation and attest that:

 

(1) i personally know the maker of this revocation and believe the maker of this revocation to be of sound mind;

 

(2) to the best of my knowledge, at the time of the execution of this revocation, i:

(a) am not related to the maker of this revocation by blood or marriage;

(b) do not have any claim on the estate of the maker of this revocation;

(c) am not entitled to any portion of the estate of the maker of this revocation by any will or by operation of law; and

(d) am not a physician attending the maker of the revocation or a person employed by a physician attending the maker of this revocation.

 

i am not the principal's spouse or heir at the time of witnessing this document.

 

we declare that we have attained the age of majority and that the declarant signed and executed the instrument as his/her revocation of living will and that he/she signed willingly, or directed another to sign for him/her, and that he/she executed it as his/her free and voluntary act for the purposes expressed; and that each of the witnesses saw the declarant sign or another sign for him/her at his/ her direction and, in the presence of the declarant and in the presence of each other, signed the revocation of living will as witness and that to the best of his/her knowledge the declarant had reached the age of majority, was of sound mind and was under no constraint or undue influence.

 

i am not the principal's spouse nor related to the principal by blood or adoption at the time of witnessing this document.

witness name:

witness address:

  ,      

witness name: ______________________________

witness address: ______________________________

  ______________________________

  ______________________________

witness name:

witness address:

  ,

witness name: ______________________________

witness address: ______________________________

  ______________________________

  ______________________________

 

names of institutions/individuals who have been provided a copy of this revocation:

 

_____ you should sign this document in the presence of two disinterested witnesses who sign the document in your presence and in each other's presence.

_____ even though witnesses may not be technically required, the use of a witness formalizes the document and provides added assurance that the revocation will be recognized.

_____ the revocation should be filed with the mississippi bureau of vital statistics of the state board of health.

 

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