As Amended
SEC. 41-41-159. Requirements for attorney in fact to make health care decisions; persons who may witness for power.
(1) An attorney in fact shall make health care decisions only if the following requirements are satisfied:
(a) The durable power of attorney specifically authorizes the attorney in fact to make health care decisions;
(b) The durable power of attorney contains the date of its execution and is witnessed by one (1) of the following methods:
(i) Be signed by at least two (2) individuals each of whom witnessed either the signing of the instrument by the principal or the principal's acknowledgement of the signature or of the instrument, each witness making the following declaration in substance: "I declare under penalty of perjury under the laws of ------ that the principal is personally known to me, that the principal signed or acknowledged this durable power of attorney in my presence, that the principal appears to be of sound mind and under no duress, fraud or undue influence, that I am not the person appointed as attorney in fact by this document, and that I am not a health care provider, nor an employee of a health care provider or facility." In addition, the declaration of at least one (1) of the witnesses must include the following: "I am not related to the principal by blood, marriage or adoption, and to the best of my knowledge, I am not entitled to any part of the estate of the principal upon the death of the principal under a will now existing or by operation of law."
(ii) Be acknowledged before a notary public at any place within this state, the notary public certifying to the substance of the following:
"State of ----- ----
"County of ----- ----
On this ----- day of -----, in the year -----, before me, ---- -----
(insert name of notary public)
appeared ______________________, personally known to me (or proved to me
on the basis of satisfactory evidence) to be the person whose name is
subscribed to this instrument, and acknowledged that he or she executed
it. I declare under the penalty of perjury that the person whose name
is subscribed to this instrument appears to be of sound mind and under
no duress, fraud or undue influence.
Notary Seal
----------------------------
(Signature of Notary Public)"
(2) None of the following may be used as witness for a durable power of attorney for health care:
(a) A health care provider;
(b) An employee of a health care provider or facility; or
(c) The attorney in fact.
(3) At least one (1) of the individuals used as a witness for a durable power of attorney for health care shall be someone who is not one of the following:
(a) A relative of the principal by blood, marriage or adoption;
(b) An individual who would be entitled to any portion of the estate of the principal upon his or her death under any will or codicil thereto of the principal existing at the time of execution of the durable power of attorney for health care or by operation of law then existing.
SOURCES: Laws, 1990, ch. 571, Sec. 5, eff from and after July 1, 1990.