State of Nevada | } | |
} | ss | |
County of ................................ | } |
(Date) ...................................
I, .............................., (person authorizing another person to order the burial or cremation of his or her human remains in the event of his or her death) do hereby designate .............................. (person who is being authorized to order the burial or cremation of the human remains of a person in the event of his or her death) to order the disposition of my human remains upon my death.
Subscribed and sworn to before me this ........
day of the month of ......... of the year ........
......................................................................
(Notary Public)
NRS 451.024