DECLARATION OF GUARDIAN IN THE EVENT OF LATER INCAPACITY OR NEED OF GUARDIAN

I, ______________________, make this Declaration of Guardian, to operate if the need for a guardian for me later arises.

1. I designate ____________________________ to serve as guardian of my person, ________________________________________ as first alternate guardian of my person, ________________________________________ as second alternate guardian of my person, and ________________________________________ as third alternate guardian of my person.

2. I designate ____________________________ to serve as guardian of my estate, ________________________________________ as first alternate guardian of my estate, ________________________________________ as second alternate guardian of my estate, and ________________________________________ as third alternate guardian of my estate.

3. If any guardian or alternate guardian dies, does not qualify, or resigns, the next named alternate guardian becomes my guardian.

4. I expressly disqualify the following persons from serving as guardian of my person: _____________________, ________________________, and _________________________.

5. I expressly disqualify the following persons from serving as guardian of my estate: _____________________, ________________________, and _________________________.

Signed this ___ day of __________, 19___.

___________________
Declarant

___________________
Witness

___________________
Witness

 

SELF-PROVING AFFIDAVIT

Before me, the undersigned authority, on this date personally appeared the declarant, and ______________________________ and ___________________________ as witnesses, and all being duly sworn, the declarant said that the above instrument was his or her Declaration of Guardian and that the declarant had made and executed it for the purposes expressed in the declaration. The witnesses declared to me that they are each 14 years of age or older, that they saw the declarant sign the declaration, that they signed the declaration as witnesses, and that the declarant appeared to them to be of sound mind.

__________________
Declarant

__________________
Affiant

__________________
Affiant

Subscribed and sworn to before me by the above named declarant and affiants on this ____ day of __________, 19__.

_____________________________________
Notary Public in and for the State of Texas

My Commission expires: _________________