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5 Wishes Document Template

The Five Wishes Document is a unique form that allows individuals to express their personal, emotional, and spiritual needs alongside their medical wishes. It empowers you to designate someone to make health care decisions on your behalf if you become unable to do so. By completing this straightforward document, you can ensure that your preferences are known and respected during difficult times.

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The Five Wishes document is a vital tool that empowers individuals to express their healthcare preferences in a clear and compassionate manner. This form addresses five key areas: the person designated to make medical decisions on your behalf when you are unable to do so, the specific types of medical treatments you wish to receive or decline, your comfort preferences during care, the manner in which you would like to be treated by others, and important messages you want your loved ones to know. By completing this straightforward document, individuals can ensure that their personal, emotional, and spiritual needs are honored alongside their medical wishes. The Five Wishes document stands out as the first living will that encompasses these broader aspects of care, making it easier for families to engage in meaningful conversations about healthcare decisions. It is designed to be accessible to everyone, allowing for simple choices, such as checking a box or writing a few sentences. Valid in many states, this document not only provides clarity and direction for healthcare providers but also alleviates the burden on family members during difficult times. In a world where many aspects of life are unpredictable, Five Wishes offers a way to take control of one of the most significant decisions one may face—how to receive care when it is needed most.

Key takeaways

Key Takeaways for Filling Out and Using the Five Wishes Document

The Five Wishes document allows you to express your medical, emotional, and spiritual preferences for care if you become seriously ill.
It is essential to choose a trusted person as your Health Care Agent who understands your wishes and can make decisions on your behalf.
Once completed and signed, the Five Wishes document is valid in most states, providing you with peace of mind regarding your health care choices.
Discuss your wishes with family and friends to ensure they know your preferences, which can alleviate stress during difficult times.
If you already have a living will or durable power of attorney, completing Five Wishes revokes those documents automatically.
Keep your Five Wishes document accessible and inform relevant parties, such as your doctor and family members, about your completed wishes.

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Documents used along the form

The Five Wishes document is an essential tool for expressing your healthcare preferences. However, it is often used alongside other important documents that help clarify your wishes and ensure they are honored. Below is a list of related forms that can complement the Five Wishes document.

Durable Power of Attorney for Health Care: This document allows you to designate a specific person to make healthcare decisions on your behalf if you become incapacitated. It provides legal authority for your chosen representative to act in your best interest.
Living Will: A living will outlines your preferences regarding medical treatments and interventions you wish to receive or avoid in the event you are unable to communicate your wishes. It focuses primarily on medical care rather than personal or emotional considerations.
Do Not Resuscitate (DNR) Order: A DNR order is a medical directive that specifies you do not want to receive CPR or other life-saving measures if your heart stops or you stop breathing. This document is typically signed by a physician and must be readily available to healthcare providers.
Health Care Proxy: Similar to a durable power of attorney, a health care proxy designates someone to make healthcare decisions for you when you are unable to do so. This document is often used interchangeably with the durable power of attorney for health care.
Power of Attorney for a Child: This essential legal document allows a parent or guardian to designate another adult to make decisions on behalf of their child when they cannot be present. For more details, visit https://californiadocsonline.com/power-of-attorney-for-a-child-form.
Organ Donation Consent Form: This form allows you to express your wishes regarding organ donation after your death. It ensures that your preferences are documented and can be honored by your family and medical professionals.
Advance Directive: An advance directive is a broader term that encompasses both living wills and durable powers of attorney for health care. It serves as a comprehensive guide for your healthcare preferences and the individuals you trust to make decisions on your behalf.

Using these documents in conjunction with the Five Wishes form can provide a more complete picture of your healthcare preferences. It is advisable to discuss these forms with your loved ones and healthcare providers to ensure your wishes are clearly understood and respected.

Dos and Don'ts

When filling out the Five Wishes Document form, it’s important to approach the task thoughtfully. Here are some guidelines to help you navigate the process effectively:

Do: Take your time to reflect on your wishes before starting the form.
Do: Clearly print your name and birthdate to ensure your identity is verified.
Do: Choose a health care agent who knows you well and can advocate for your wishes.
Do: Discuss your choices with your family and health care agent to avoid confusion later.
Don't: Rush through the form; making hasty decisions can lead to misunderstandings.
Don't: Select someone as your health care agent who may be emotionally compromised, such as a spouse in a difficult relationship.
Don't: Forget to sign and date the document; an unsigned form may not be considered valid.

Common mistakes

Filling out the Five Wishes Document is an important step in ensuring your health care preferences are honored. However, many people make common mistakes that can lead to confusion or invalidation of their wishes. Here are eight mistakes to avoid.

First, some individuals forget to clearly identify their health care agent. It’s crucial to choose someone who understands your values and can make decisions on your behalf. If you do not specify a name, your wishes may not be respected when it matters most.

Another mistake is failing to discuss your wishes with your chosen agent. This document should not be filled out in isolation. Engaging in an open conversation ensures your agent knows your preferences and is willing to advocate for you.

Many people also neglect to update their Five Wishes when their circumstances change. Life events such as marriage, divorce, or the death of a chosen agent can affect your decisions. Regularly reviewing and revising the document is essential for it to remain relevant.

Some individuals mistakenly believe that the Five Wishes Document is only about medical decisions. In reality, it encompasses emotional and spiritual needs as well. Failing to address these aspects may leave gaps in your care when you are unable to communicate.

Another common error is not signing the document properly. A signature is necessary for the document to be legally binding. Additionally, some forget to have witnesses or notarization if required by their state, which can invalidate the document.

People sometimes overlook the importance of specifying their preferences regarding comfort and treatment. Clear instructions on how you want to be treated can guide your agent and health care providers in making decisions that align with your values.

Moreover, failing to inform family members about the existence of the Five Wishes Document can create unnecessary confusion. Make sure your loved ones know where to find it and understand its significance in your care.

Lastly, individuals often fill out the document in haste, leading to incomplete or unclear responses. Take your time to ensure that every section is filled out thoughtfully and accurately. This document is a vital tool for ensuring your wishes are honored.

File Characteristics

Fact Name	Details
Purpose of Five Wishes	The Five Wishes document allows individuals to express their medical, emotional, and spiritual preferences for care in the event they cannot communicate their wishes due to illness.
Legal Validity	Once completed and signed, the Five Wishes document is valid in most states, serving as a legal advance directive.
Target Audience	Five Wishes is designed for anyone aged 18 or older, including married individuals, single adults, parents, and friends, allowing them to plan their health care preferences.
State-Specific Legislation	In states like Florida, California, and New York, Five Wishes complies with specific legal requirements outlined in state laws governing advance directives.

Form Sample

FIVE

WISH S®

M Y W I S H F O R :

The Person I Want too Make Car1e Decisions for Me When I Can’t

The Kind of Medical Treat2ment I Want or Don’t Want

How Comfortable3 I Want to Be

How I Want People4 to Treat Me

What I Want My Loved5 Ones to Know

print your name

birthdate

Five Wishes

There are many things in life that are out of our hands. This Five Wishes document gives you a way to control somethingg very

important—how you are treated if you get seriously ill. It is ann easy-to- complete form that lets you say exactly what you want. Once it is filled out and properly signed it is valid under the laws off most states.

What Is Five Wishes?

Five Wishes is the first living will that talks about your personal, emotional and spiritual needs as well as your medical wishes. It lets you choose the person you want to make health care decisions for you if you are not able to make them for yourselff. Five Wishes

lets you say exactly how you wish to be

treated if you get seriously ill. It was written with the help of The American Bar

$VVRFLDWLRQ·V&RPPLVVLRQRQ/DZDQG$JLQJ DQGWKHQDWLRQ·VOHDGLQJH[SHUWVLQHQGRIOLIH FDUH,W·VDOVRHDV\WRXVH$OO\RXKDYHWRGRLV check a box, circle a direction, or write a few

sentences.

How Five Wishes Can Help You And Your Family

•

It lets

you talk with your family,

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frie

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• You can know what your mom, dad,

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sly ill.

spouse, or friend wants. You can be

•

Your family membe

rs will not have to

there for them when they need you

t. It protects them

most. You will understand what they

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really want.

if you become seri

How Five Wishes Began

For 12 years, Jim Towey worked closely with Mother Teresa, and, for one year, he lived in a KRVSLFHVKHUDQLQ:DVKLQJWRQ'&,QVSLUHGE\ WKLVILUVWKDQGH[SHULHQFH0U7RZH\VRXJKWD way for patients and their families to plan ahead and to cope with serious illness. The result is

2Five Wishes and the response to it has been

RYHUZKHOPLQJ,WKDVEHHQIHDWXUHGRQ&11 DQG1%&·V7RGD\6KRZDQGLQWKHSDJHVRI Time and MoneyPDJD]LQHV1HZVSDSHUVKDYH called Five Wishes the first “living will with a heart and soul.” Today, Five Wishes is available in 27 languages.

Who Should Use Five Wishes

Five Wishes is for anyone 18 or older — married, single, parents, adult children, and friends. More than 19 million people of all ages have already used it. Because it

works so well, lawyers, doctors, hospitals and hospices, faith communities, employers, and retiree groups are handing outt this document.

Five Wishes States

If you live in the District of Columbia or one of the 42 states listed below, youu can use )LYH:LVKHVDQGKDYHWKHSHDFHRIPLQGWRNQRZWKDWLWVXEVWDQWLDOO\PHHWV\RXUVWDWH·V requirements under the law:

Alaska

Illinois

Montana

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Arizona

Iowa

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Arkansas

Kentucky

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Tennessee

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Vermont

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Maine

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Washington

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Delaware

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West Virginia

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Florida

Michigan

Wisconsin

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Georgia

Minnesota

Oklahoma

Wyoming

Hawaii

Mississippi

Pennsylvania

Idaho

Missouri

Rhode Island

If your state is not one of the 42 states listed here, Five Wishes does not meet the technical UHTXLUHPHQWVLQWKHVWDWXWHVRI\RXUVWDWH6RVRPHGRFWRUVLQ\RXUVWDWHPD\EHUHOXFWDQW to honor Five Wishes. However, many people from states not on this list do complete Five :LVKHVDORQJZLWKWKHLUVWDWH·VOHJDOIRUP7KH\ILQGWKDW)LYH:LVKHVKHOSVWKHPH[SUHVV all that they want and provides a helpful guide to family members, friends, care givers and doctors. Most doctors and health care professionals know they need to listen to your wishes no matter how you express them.

How Do I Change To Five Wishes?

You may already have a living will or a durable power of attorney for health care. If you want to use Five Wishes instead, all you need to do is fill out and sign a new Five Wishes as directed. As soon as you sign it, it takes away any advance directive you had before. To make sure the right form is used, please do the following:

•	D	estroy all copies of your old living will	•	7HOO\RXU+HDOWK&DUH$JHQWIDPLO\
	or durable power of attorney for health			members, and doctor that you have
	care. Or you can write “revoked” in large			filled out a new Five Wishes.
	letters across the copy you have. Tell			Make sure they know about your
	your lawyer if he or she helped prepare			new wishes.
	those old forms for you. AND

WISH 1

The Person I Want To Make Health Care Decisions For Me

When I Can’t Make Them For Myself.

f I am no longer able to make my own health care

• My attending or treating doctor finds I am no

I decisions, this form names the person I choose to

longer able to make health ca

es, AND

re choic

make these choices for me. This person will be my

• Another health care profe

ssional agrees

hat

Health Care Agent (or other term that may be used in

this is true.

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my state, such as proxy, representative, or surrogate).

If my state has a different

ay of finding that I am not

This person will make my health care choices if both

able to make health c

are choices, then my state’s way

of these things happen:

should be followe

The Person I Choose As My Health Care Agent Is:

First Choice Name

one

Address

City/State/Zip

If this person is not able or willing to make thesee choices for me, OR is divorced or legally separated from me, OR this person has died, then these people aree my next choices:

Second Choice Name

Third Choice Nam

Address

ddress

City/State/Zip

Phone

Picking The R

Your Health Care Agent

ight Person To Be

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Agent should be at least 18 years or older (in

cares about you, and who

ily member may

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decisions. A spouse or fam

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•

Your health care provider, including the

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or community care facility serving you.

ho is able to stand up for you so that your

wishes are followed. Also, choose someone who

•

An employee or spouse of an employee of

is likely to be nearby so that they can help when

your health care provider.

you need them. Whether you choose a spouse,

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Agent, make sure you talk about these wishes

more people unless he or she is your

and be sure that this person agrees to respect

spouse or close relative.

I understand that my Health Care Agent can make health care decisions for me. I want my Agent to be able to do the

following: (Please cross out anything you don’t want your Agent to do that is listed below.)

•	Make choices for me about my medical care		6HH DQGDSSURYHUHOHDVHRIP\PHGLFDOUHFRUGV
	or services, like tests, medicine, or surgery.		and personal files. If I need to sign my name to
	This care or service could be to find out what my		JHWDQ\RIWKHVHILOHVP\+HDOW				$JHQWFDQ
	This care or service could be to find out what my		JHWDQ\RIWKHVHILOHVP\+HDOW			K&DUH	$JHQWFDQ
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	include care to keep me alive. If the treatment or	•	Move me to another
	FDUHKDVDOUHDG\VWDUWHGP\+HDOWK&DUHAgent	•	Move me to another		state to get the care I need
	FDUHKDVDOUHDG\VWDUWHGP\+HDOWK&DUHAgent		or to carry out m	y wishes.
	can keep it going or have it stopped.		or to carry out m	y wishes.
	can keep it going or have it stopped.

•Interpret any instructions I have given in

this form or given in other discussions, according

WRP\+HDOWK&DUH$JHQW·VXQGHUVWDQGLQJRIP\ wishes and values.

&RQVHQWWRDGPLVVLRQWRDQDVVLVWHGOLYLQJIDFLOLW\ hospital, hospice, or nursing home for me. My +HDOWK&DUH$JHQWFDQKLUHDQ\NLQGRIKHDOWK care worker I may need to help me or take care of me. My Agent may also fire a health care worker, if needed.

•Make the decision to request, take away or not

JLYHPHGLFDOWUHDWPHQWVLQFOXGLQJDUWLILFLDOO\ provided food and water, andd any other treatments to keepp me alive.

•Authorize or refuse to authorize any medication or procedure needed to help with pain.

•Take any legal action needed to carry out my wishes.

•Donate useable organs or tissues of mine as allowed by law.

• Apply for Medicare, Medicaid, or other programs RULQVXUDQFHEHQHILWVIRUPH0\+HDOWK&DUH Agent can see my personal files, like bank records, to find out what is needed to fill out these forms.

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______________________________________________________________________________

If I Change My Mind About Having A Health Care Agent, I Will

•	Destroy all copies of this part of the	• Write the word “Revoked” in large
	Five Wishes form. OR	letters across the name of each agent
• Tell someone, such as my doctor or		whose authority I want to cancel.
• Tell someone, such as my doctor or		6LJQP\QDPHRQWKDWSDJH
	family, that I want to cancel or change	6LJQP\QDPHRQWKDWSDJH
	family, that I want to cancel or change
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WISH 2

My Wish For The Kind Of Medical Treatment

I Want Or Don’t Want.

I b elieve that my life is precious and I deserve to be treated with dignity. When the timee comes that

I am very sick and am not able to speak for myself, I want the following wishes, and any other directions I have given to my Health Care Agent, to be respected and followed.

What You Should Keep In Mind As My Caregiver

•I do not want to be in pain. I want my doctor to give me enough medicine to relieve my pain, even if that means that I will be drowsy or sleep more than I would otherwise.

•I do nott want anything done or omitted by my doctors or nurses with the intention of taking my life.

•I want to be offered food and fluids by mouth, and kept clean and warm.

What “Life-Support Treatment” Means To Me

/LIHVXSSRUWWUHDWPHQWPHDQVDQ\PHGLFDOSURFH dure, device or medication to keep me alive.

/LIHVXSSRUWWUHDWPHQWLQFOXGHVPHGLFDO devices put in me to help me breathe; food and ZDWHUVXSSOLHGE\PHGLFDOGHYLFHWXEHIHHGLQJ FDUGLRSXOPRQDU\UHVXVFLWDWLRQ&35PDMRU surgery; blood transfusions; dialysis; antibiotics;

and anything else meant to keep me alive.

,I,ZLVKWROLPLWWKHPHDQLQJRIOLIHVXSSRUW treatment because of my religious or personal beliefs, I write this limitation in the space below. I do this to make very clear what I want and under what conditions.

_________________________________________________________________________________________

In Case Of An Emergency

Iff you have a medical emergency and ambulance personnel arrive, they may look to see if you have a Do Not Resuscitate form or bracelet. Many states require a person to have a Do Not Resuscitate form filled out and

signed by a doctor. This form lets ambulance SHUVRQQHONQRZWKDW\RXGRQ·WZDQWWKHPWRXVH OLIHVXSSRUWWUHDWPHQWZKHQ\RXDUHG\LQJ3OHDVH check with your doctor to see if you need to have a Do Not Resuscitate form filled out.

Here is the kind of medical treatment that I want or don’t want in the four situations listed below. I want my Health Care Agent, my family, my doctors and other health care providers, my friends and all others to know these directions.

Close to death:

If my doctor and another health care professional both decide that I am likely to die within a short period of WLPHDQGOLIHVXSSRUWWUHDWPHQWZRXOGRQO\GHOD\WKH PRPHQWRIP\GHDWK&KRRVHoneRIWKHIROORZLQJ

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VWRSJLYLQJPHOLIHVXSSRUWWUHDWPHQWLILWLVQRW helping my health condition or symptoms.

In A Coma And Not Expected Too Wake Up Or Recover:

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VWRSJLYLQJPHOLIHVXSSRUWWUHDWPHQWLILWLVQRW helping my health condition or symptoms.

Permanent And Severe Brain Damage And Not Expected To Recover:

If my doctor and another health care professional both decide that I have permanentt and severe brain damage,

(for example, I can open myy eyes, but I can not speak RUXQGHUVWDQGDQG,DPQRWH[SHFWHGWRJHWEHWWHUDQG OLIHVXSSRUWWUHDWPHQWZRXOGRQO\GHOD\WKHPRPHQWRI P\GHDWK&KRRVHoneRIWKHIROORZLQJ

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In Another Condition Under Which I Do Not Wish To Be Kept Alive:

If there is another condition under which I do not wish WRKDYHOLIHVXSSRUWWUHDWPHQW,GHVFULEHLWEHORZ,Q this condition, I believe that the costs and burdens of

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________________________________________________________________________________________

Th e next three wishes deal with my personal, spiritual and emotional wishes. They are important to me. I want to be treated with dignity near the end of my life, so I would like people to do the things

written in Wishes 3, 4, and 5 when they can be done. I understand that my family, my doctors and other health care providers, my friends, and others may not be able to do these things or are not required by law to do these things. I do not expect the following wishes to place new or added legal duties on my doctors or other health care providers. I also do not expect these wishes to excuse my doctor or other health care providers from giving mee the proper care asked for by law.

WISH 3

My Wish For How Comfortable I Want To Bee.

(Please cross out anything that you don’t agree with.)

•I do not want to be in pain. I want my doctor to give me enough medicine to relieve my pain, even if that means I will be drowsy or sleep more than I would otherwise.

•If I show signs of depression, nausea, shortness of breath, or hallucinations, I want my care givers to do whatever they can to help me.

•I wish to have a cool moist cloth put onn my head if I have a fever.

•I want my lips and mouth kept moist to stop dryness.

•I wish to have warm baths often. I wish to be kept fresh and clean at all times.

•I wishh to be massaged with warm oils as often as I can be.

•I wish to have my favorite music played when possible until my time of death.

•I wish to have personal care like shaving, nail clipping, hair brushing, and teeth brushing, as long as they do not cause me pain or discomfort.

,ZLVKWRKDYHUHOLJLRXVUHDGLQJVDQGZHOO loved poems read aloud when I am near death.

•I wish to know about options for hospice care to provide medical, emotional and spiritual care for me and my loved ones.

WISH 4

My Wish For How I Want People To Treat Me.

(Please cross out anything that you don’t agree with.)

•I wish to have people with me when possible. I want someone to be with me when it seems that death may come at any time.

•I wish to have my hand held and to be talked

WRZKHQSRVVLEOHHYHQLI,GRQ·WVHHPWR respond to the voice or touch of others.

•I wish to have others by my side praying for me when possible.

•I wish to have the members of my faith community told that I am sick and asked to pray for me and visit me.

•I wish to be cared for with kindness and cheerfulness, and not sadness.

•I wish to have pictures of my loved ones in my room, near my bed.

•If I am not able to control my bowel or bladder functions, I wish for my clothes and bed linens to be kept clean, and for them to be changed as soon as they can be if they have been soiled.

•I want to die in my home, if that can be done.

WISH 5

My Wish For What I Want My Loved Ones To Know.

(Please cross out anything that you don’t agree with.)

•I wish to have my family and friends know that I love them.

•I wish to be forgiven for the times I have hurt my family, friends, and others.

•I wish to have my family, friends and others know that I forgive them for when they may have hurt me in my life.

•I wish for my family and friends to know that I do not fear death itself. I think it is not the end, but a new beginning for me.

•I wish for all of my family members to make peace with each other before my death, if they can.

•I wish for my family and friends to think about what I was like before I became seriously ill. I want them too remember me in this way after my death.

•I wish for my family and friends and caregivers to respect my wishes even if

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•I wish for my family and friends to look at my dying as a time of personal growth for everyone, including me. This will help me livee a meaningful life in my final days.

•I wish for my family and friends to get counseling if they have trouble with my death. I want memories of my life to give

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•After my death, I would like my body to

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•My body or remains should be put in the

following

location

•The following person knows my funeral

wishes:.

If anyone asks how I want to be remembered, please say the following about me:

_________________________________________________________________________________

If there is to bee a memorial service for me, I wish for this service to include the following

OLVWPXVLFVRQJVUHDGLQJVRURWKHUVSHFLILFUHTXHVWVWKDW\RXKDYH

_________________________________________________________________________________

(Please use the space below for any other wishes. For example, you may want to donate any or all parts of your body when you die. You may also wish to designate a charity to receive memorial contributions. Please attach a VH DUDWHVKHHWRI D HULI\RXQHHGPRUHVSDFH

______________________________________________________________________________________

Signing The Five Wishes Form

Please make sure you sign your Five Wishes form in the presence of the two witnesses.

I, _________________________________, ask that my family, my doctors, and other health care providers,

P\IULHQGVDQGDOORWKHUVIROORZP\ZLVKHVDVFRPPXQLFDWHGE\P\+HDOWK&DUH$JHQWLI,KDYHRQHDQGKH RUVKHLVDYDLODEOHRUDVRWKHUZLVHH[SUHVVHGLQWKLVIRUP7KLVIRUPEHFRPHVYDOLGZKHQ,DPXQDEOHWRPDNH decisions or speak for myself. If any part of this form cannot be legally followed, I ask that all other parts of this form be followed. I also revoke any health care advance directives I have made before.

Signature:		___
Address:
Phone:	Date:		__

Witness Statement • (2 witnesses needed):

,WKHZLWQHVVGHFODUHWKDWWKHSHUVRQZKRVLJQHGRUDFNQRZOHGJHGWKLVIRUPKHUHDIWHU´SHUVRQµLVSHUVRQDOO\NQRZQWR PHWKDWKHVKHVLJQHGRUDFNQRZOHGJHGWKLV>+HDOWK&DUH$JHQWDQGRU/LYLQJ:LOOIRUPV@LQP\SUHVHQFHDQGWKDWKHVKH appears to be of sound mind and under no duress, fraud, or undue influence.

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•The individual appointed as (agent/proxy/

VXUURJDWHSDWLHQWDGYRFDWHUHSUHVHQWDWLYHE\ this document or his/her successor,

•7KHSHUVRQ·VKHDOWKFDUHSURYLGHULQFOXGLQJ RZQHURURSHUDWRURIDKHDOWKORQJWHUPFDUH or other residential or community care facility serving the person,

•$QHPSOR\HHRIWKHSHUVRQ·VKHDOWKFDUH provider,

•)LQDQFLDOO\UHVSRQVLEOHIRUWKHSHUVRQ·V health care,

•An employee of a life or health insurance provider for the person,

•Related to the person by blood, marriage, or adoption, and,

•To the best of my knowledge, a creditor of the person or entitled to any part of his/her estate under a will or codicil, by operation of law.

(Some states may have fewer rules about who may be a witness. Unless you know your state’s rules, please follow the above.)


Signature of Witness				Signature of Witness #2
Signature of Witness			#1	Signature of Witness #2

Printed Name of Witn				Printed Name of Witness
Printed Name of Witn		ess		Printed Name of Witness

Address				Address

				Phone
	Phone
	Phone

Notarization • Only required for residents of Missouri, North Carolina, South Carolina and West Virginia

•If you live in Missouri, only your signature should be notarized.

•,I\RXOLYHLQ1RUWK&DUROLQD6RXWK&DUROLQDRU:HVW9LUJLQLD you should have your signature, and the signatures of your witnesses, notarized.

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