1. A declaration executed pursuant to this chapter may but need not be in the following form:

 I hereby designate …………………………………. as my designee. My designee shall have the sole responsibility for making decisions concerning the final disposition of my remains and the ceremonies to be performed after my death. This declaration hereby revokes all prior declarations. This designation becomes effective upon my death.  My designee shall act in a manner that is reasonable under the circumstances.  I may revoke or amend this declaration at any time. I agree that a third party (such as a funeral or cremation establishment, funeral director, or cemetery) who receives a copy of this declaration may act in reliance on it. Revocation of this declaration is not effective as to a third party until the third party receives notice of the revocation. My estate shall indemnify my designee and any third party for costs incurred by them or claims arising against them as a result of their good faith reliance on this declaration.  I execute this declaration as my free and voluntary act.

Terms Used In Iowa Code 144C.6

  • Declarant: means a competent adult who executes a declaration pursuant to this chapter. See Iowa Code 144C.2
  • Declaration: means a written instrument that is executed by a declarant in accordance with the requirements of this chapter, and that names a designee who shall have the sole responsibility and discretion for making decisions concerning the final disposition of the declarant's remains and the ceremonies planned after the declarant's death. See Iowa Code 144C.2
  • Department: means the Iowa department of public health. See Iowa Code 154A.1
  • Designee: means a competent adult designated under a declaration who shall have the sole responsibility and discretion for making decisions concerning the final disposition of the declarant's remains and the ceremonies planned after the declarant's death. See Iowa Code 144C.2
  • Final disposition: means the burial, interment, cremation, removal from the state, or other disposition of remains. See Iowa Code 144C.2
  • following: when used by way of reference to a chapter or other part of a statute mean the next preceding or next following chapter or other part. See Iowa Code 4.1
  • Person: means a natural person. See Iowa Code 154A.1
  • Reasonable under the circumstances: means consideration of what is appropriate in relation to the declarant's finances, cultural or family customs, and religious or spiritual beliefs. See Iowa Code 144C.2
  • Remains: means the body or cremated remains of a decedent. See Iowa Code 144C.2
  • Third party: includes but is not limited to a funeral director, funeral establishment, cremation establishment, cemetery, the state medical examiner, or a county medical examiner. See Iowa Code 144C.2
 2. A declaration executed pursuant to this chapter shall be in a written form that substantially complies with the form in subsection 1, is properly completed, and is dated and signed by the declarant or another person acting on the declarant’s behalf at the direction of and in the presence of the declarant. In addition, a declaration shall be either of the following:

 a. Signed by at least two individuals who are not named therein and who, in the presence of each other and the declarant, witnessed the signing of the declaration by the declarant, or another person acting on the declarant’s behalf at the direction of and in the presence of the declarant, and witnessed the signing of the declaration by each other.
 b. Acknowledged before a notarial officer as provided in chapter 9B.
 3. A declaration may include the location of an agreement for prearranged funeral services or funeral merchandise as defined in and executed under chapter 523A, cemetery lots owned by or reserved for the declarant, and special instructions regarding organ donation consistent with chapter 142C.
 4. A declaration for disposition of remains made by a service member who died while performing military duty as defined in section 29A.1, subsection 3, 8, or 12, on forms provided and authorized by the department of defense for service members for this purpose shall constitute a valid declaration of designee for purposes of this chapter.