(1) Form. The
following statutory declaration of disposition of last remains is legally sufficient:
DECLARATION OF DISPOSITION OF LAST REMAINS
I, (name of declarant), being of sound mind and lawful age, hereby revoke all
prior declarations concerning the disposition of my last remains and those
provisions concerning disposition of my last remains found in a will, codicil, or
power of attorney, 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 ____ .
_______ Naturally reduced. I direct that my reduced remains be given final
disposition as follows:
___________________________________________________________________ _
________________________________________________ .
_______ 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):
___________________________________________________________________ _
________________________________________________ .
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 COLORADO )
) ss.
COUNTY OF ___________________)
Acknowledged before me by __________, Declarant, on __________, ___.
My commission expires: ______________
[seal]
___________________________
Notary Public
(2) Requirements. The form set forth in subsection (1) of this section is not
exclusive, and a person may use another form of declaration if the wording of the
form complies substantially with subsection (1) of this section, the form is properly
completed, and the form is in writing, dated, and signed by the declarant. A
declaration may be witnessed or notarized by at least one person who attests that
he or she was present when the document was signed by the declarant.
(3) A declaration may be revoked by the declarant in writing or by burning,
tearing, canceling, obliterating, or destroying the declaration with the intent to
revoke such declaration.
(4) (a) Unless otherwise expressly provided in a declaration, a subsequent
divorce, dissolution of marriage, annulment of marriage, or legal separation
between the declarant and spouse automatically revokes a delegation to the
declarant's spouse to direct the disposition of the declarant's last remains or
ceremonies after the declarant's death. This paragraph (a) shall not be construed to
revoke the remaining provisions of the declaration.
(b) Unless otherwise specified in the declaration, if a declarant revokes a
delegation to a person to direct the disposition of the declarant's last remains or
ceremonies after the declarant's death, or if such person is unable or unwilling to
serve, the nomination of such person shall be ineffective as to such person. If an
alternate designee is not nominated by the declarant, section 15-19-106 shall
govern. This paragraph (b) shall not be construed to revoke the remaining provisions
of the declaration.