Kansas Living Will

Information you will need

• Principal Signing Day
• Principal Signing Month/Year
• Principal DOB
• Principal Street Address
• Principal City, State, ZIP Code
• Notary Only: County
• Notary Only: State
• Notary Only: Day
• Notary Only: Month/Year
• First Witness Name
• Second Witness Name
• First Witness Street Address
• Second Witness Street Address
• First Witness City, State, ZIP Code
• Second Witness City, State, ZIP Code
• Principal Name

Completed by the declarant.

The form includes a notary acknowledgment, a witness section.