Revocation of Statutory Equivalent of Living Will or Declaration - Illinois 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name in the space provided for the Declarant. This identifies you as the individual revoking the declaration.
3. Fill in the date when you originally executed your Declaration (Living Will) in the designated field.
4. In the section outlining methods of revocation, ensure you understand that this document serves as your written revocation. You may also refer to other methods if applicable.
5. Complete the date at the bottom of the form where indicated, confirming when this revocation is being made.
6. Sign and print your name in the respective fields to validate your intent clearly.
7. Lastly, provide your address to ensure proper identification and communication regarding this revocation.

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