POWER OF ATTORNEY FOR FINANCIAL MATTERS AND DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS

Nev. Rev. Stat. 162A
in effect

Nev. Rev. Stat. § 162A.010 Definitions.

As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 162A.020 to 162A.160, inclusive, have the meanings ascribed to them in those sections.

Nev. Rev. Stat. § 162A.020 “Acknowledged” defined.

“Acknowledged” means purportedly verified before a notary public or other individual authorized to take acknowledgments.

Nev. Rev. Stat. § 162A.030 “Agent” defined.

“Agent” means a person granted authority to act for a principal under a power of attorney, whether denominated an agent, attorney-in-fact or otherwise. The term includes an original agent, co-agent, successor agent and a person to which an agent’s authority is delegated.

Nev. Rev. Stat. § 162A.040 “Durable” defined.

“Durable,” with respect to a power of attorney, means not terminated by the principal’s incapacity.

Nev. Rev. Stat. § 162A.050 “Electronic” defined.

“Electronic” means relating to technology having electrical, digital, magnetic, wireless, optical, electromagnetic or similar capabilities.

Nev. Rev. Stat. § 162A.070 “Incapacity” defined.

“Incapacity” means the inability of an individual to manage property or business affairs because the individual: 1. Has an impairment in the ability to receive and evaluate information or make or communicate decisions even with the use of technological assistance; or 2. Is: (a) Missing; (b) Detained, including incarcerated in a penal system; or (c) Outside the United States and unable to return, Ê as determined by a court of competent jurisdiction or, if an instrument executed pursuant to this chapter specifically provides a different method for determining the incapacity of an individual for the purposes of this chapter, as determined by the method set forth in that instrument.

Nev. Rev. Stat. § 162A.075 “Nondurable” defined.

“Nondurable,” with respect to a power of attorney, means terminated by the principal’s incapacity.

Nev. Rev. Stat. § 162A.080 “Person” defined.

“Person” means an individual, corporation, business trust, estate, trust, partnership, limited-liability company, association, joint venture, public corporation, government or governmental subdivision, agency or instrumentality, or any other legal or commercial entity.

Nev. Rev. Stat. § 162A.090 “Power of attorney” defined.

“Power of attorney” means a writing or other record that grants authority to an agent to act in the place of the principal, whether or not the term “power of attorney” is used.

Nev. Rev. Stat. § 162A.100 “Presently exercisable general power of appointment” defined.

“Presently exercisable general power of appointment,” with respect to property or a property interest subject to a power of appointment, means power exercisable at the time in question to vest absolute ownership in the principal individually, the principal’s estate, the principal’s creditors or the creditors of the principal’s estate. The term includes a power of appointment not exercisable until the occurrence of a specified event, the satisfaction of an ascertainable standard, or the passage of a specified period only after the occurrence of the specified event, the satisfaction of the ascertainable standard or the passage of the specified period. The term does not include a power exercisable in a fiduciary capacity or only by will.

Nev. Rev. Stat. § 162A.110 “Principal” defined.

“Principal” means an individual who grants authority to an agent in a power of attorney.

Nev. Rev. Stat. § 162A.120 “Property” defined.

“Property” means anything that may be the subject of ownership, whether real or personal, or legal or equitable, or any interest or right therein.

Nev. Rev. Stat. § 162A.130 “Record” defined.

“Record” means information which is inscribed on a tangible medium or which is stored in an electronic or other medium and is retrievable in perceivable form.

Nev. Rev. Stat. § 162A.140 “Sign” defined.

“Sign” means, with present intent to authenticate or adopt a record: 1. To execute or adopt a tangible symbol; or 2. To attach to or logically associate with the record an electronic sound, symbol or process.

Nev. Rev. Stat. § 162A.150 “State” defined.

“State” means a state of the United States, the District of Columbia, Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject to the jurisdiction of the United States.

Nev. Rev. Stat. § 162A.160 “Stocks and bonds” defined.

“Stocks and bonds” means stocks, bonds, mutual funds, and all other types of securities and financial instruments, whether held directly or indirectly, or in any other manner. The term does not include commodity futures contracts and call or put options on stocks or stock indexes.

Nev. Rev. Stat. § 162A.200 Applicability.

NRS 162A.200 to 162A.660, inclusive, apply to all powers of attorney except: 1. A power to the extent it is coupled with an interest in the subject of the power, including a power given to or for the benefit of a creditor in connection with a credit transaction; 2. A power to make health care decisions; 3. A proxy or other delegation to exercise voting rights or management rights with respect to an entity; and 4. A power created on a form prescribed by a government or a governmental subdivision, agency or instrumentality for a governmental purpose.

Nev. Rev. Stat. § 162A.210 Power of attorney is durable; exceptions.

A power of attorney created under NRS 162A.200 to 162A.660, inclusive, is durable unless it expressly provides that it is terminated by the incapacity of the principal.

Nev. Rev. Stat. § 162A.220 Execution of power of attorney; certification of competency of principal required under certain circumstances; certain persons not to be named as agent; exceptions; penalty for misuse of power of attorney.

1. A power of attorney must be signed by the principal or, in the principal’s conscious presence, by another individual directed by the principal to sign the principal’s name on the power of attorney. A signature on a power of attorney is presumed to be genuine if the principal acknowledges the signature before a notary public or other individual authorized by law to take acknowledgments. 2. If the principal resides in a hospital, residential facility for groups, facility for skilled nursing or home for individual residential care, at the time of execution of the power of attorney, a certification of competency of the principal from an advanced practice registered nurse, a physician, psychologist or psychiatrist must be attached to the power of attorney. 3. If the principal resides or is about to reside in a hospital, assisted living facility or facility for skilled nursing at the time of execution of the power of attorney, in addition to the prohibition set forth in NRS 162A.840 and except as otherwise provided in subsection 4, the principal may not name as agent in any power of attorney for any purpose: (a) The hospital, assisted living facility or facility for skilled nursing; (b) An owner or operator of the hospital, assisted living facility or facility for skilled nursing; or (c) An employee of the hospital, assisted living facility or facility for skilled nursing. 4. The principal may name as agent any person identified in subsection 3 if that person is: (a) The spouse, legal guardian or next of kin of the principal; or (b) Named only for the purpose of assisting the principal to establish eligibility for Medicaid and the power of attorney complies with the provisions of subsection 5. 5. A person may be named as agent pursuant to paragraph (b) of subsection 4 only if: (a) A valid financial power of attorney for the principal does not exist; (b) The agent has made a good faith effort to contact each family member of the principal identified in the records of the hospital, assisted living facility or facility for skilled nursing, as applicable, to request that the family member establish a financial power of attorney for the principal and has documented his or her effort; (c) The power of attorney specifies that the agent is only authorized to access financial documents of the principal which are necessary to prove eligibility of the principal for Medicaid as described in the application for Medicaid and specifies that any request for such documentation must be accompanied by a copy of the application for Medicaid or by other proof that the document is necessary to prove eligibility for Medicaid; (d) The power of attorney specifies that the agent does not have authority to access money or any other asset of the principal for any purpose; and (e) The power of attorney specifies that the power of attorney is only valid until eligibility of the principal for Medicaid is determined or 6 months after the power of attorney is signed, whichever is sooner. 6. A person who is named as agent pursuant to paragraph (b) of subsection 4 shall not use the power of attorney for any purpose other than to assist the principal to establish eligibility for Medicaid and shall not use the power of attorney in a manner inconsistent with the provisions of subsection 5. A person who violates the provisions of this subsection is guilty of a category C felony and shall be punished as provided in NRS 193.130 . 7. As used in this section: (a) “Assisted living facility” has the meaning ascribed to it in NRS 422.3962 . (b) “Facility for skilled nursing” has the meaning ascribed to it in NRS 449.0039 . (c) “Home for individual residential care” has the meaning ascribed to it in NRS 449.0105 . (d) “Hospital” has the meaning ascribed to it in NRS 449.012 . (e) “Residential facility for groups” has the meaning ascribed to it in NRS 449.017 .

Nev. Rev. Stat. § 162A.230 Validity of power of attorney.

1. A power of attorney executed in this State on or after October 1, 2009, is valid if its execution complies with NRS 162A.220 . 2. A power of attorney executed in this State before October 1, 2009, is valid if its execution complied with the law of this State as it existed at the time of execution. 3. A power of attorney executed other than in this State is valid in this State if, when the power of attorney was executed, the execution complied with: (a) The law of the jurisdiction that determines the meaning and effect of the power of attorney pursuant to NRS 162A.240 ; or (b) The requirements for a military power of attorney pursuant to 10 U.S.C. § 1044b. 4. Except as otherwise provided by specific statute other than the provisions of NRS 162A.200 to 162A.660 , inclusive, a photocopy or electronically transmitted copy of an original power of attorney has the same effect as the original power of attorney. An agent shall furnish an affidavit to a third party on demand stating that the instrument relied on is a true copy of the power of attorney and that, to the best of the agent’s knowledge, the principal is alive and the relevant powers of the agent have not been altered or terminated.

Nev. Rev. Stat. § 162A.240 Meaning and effect of power of attorney.

The meaning and effect of a power of attorney is determined by the law of the jurisdiction indicated in the power of attorney and, in the absence of an indication of jurisdiction, by the law of the jurisdiction in which the power of attorney was executed.

Nev. Rev. Stat. § 162A.250 Nomination of guardian of estate; relation of agent to court-appointed guardian.

1. In a power of attorney, a principal may nominate a guardian of the principal’s estate for consideration by the court if guardianship proceedings for the principal’s estate or person are begun after the principal executes the power of attorney. 2. If, after a principal properly executes a nondurable power of attorney pursuant to NRS 162A.220 , a court appoints a guardian of the principal’s estate, the nondurable power of attorney is terminated. 3. If, after a principal properly executes a durable power of attorney pursuant to NRS 162A.220 , a court appoints a guardian of the principal’s estate, the durable power of attorney is suspended and the agent’s authority is not exercisable unless the court orders the termination of the guardianship, and the power of attorney has not otherwise been terminated pursuant to NRS 162A.270 . Upon the court ordering such a termination of the guardianship, the durable power of attorney is effective and no longer suspended pursuant to this subsection and the agent’s authority is exercisable. 4. Except as otherwise provided in subsection 3, the court may issue an order allowing the agent to retain specific powers conferred by the power of attorney. In the event the court allows the agent to retain specific powers, the agent shall file an accounting with the court and the guardian on a quarterly basis or such other period as the court may designate.

Nev. Rev. Stat. § 162A.260 Time at which power of attorney is effective.

1. A power of attorney is effective when executed unless the principal provides in the power of attorney that it becomes effective at a future date or upon the occurrence of a future event or contingency. 2. If a power of attorney becomes effective upon the occurrence of a future event or contingency, the principal, in the power of attorney, may authorize one or more persons to determine in a writing or other record that the event or contingency has occurred. 3. If a power of attorney becomes effective upon the principal’s incapacity and the principal has not authorized a person to determine whether the principal is incapacitated, or the person authorized is unable or unwilling to make the determination, the power of attorney becomes effective upon a determination in a writing or other record by an advanced practice registered nurse, a physician, psychiatrist or licensed psychologist that the principal is incapacitated. 4. A person authorized by the principal in the power of attorney to determine that the principal is incapacitated may act as the principal’s personal representative pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, as amended, and applicable regulations, to obtain a determination of incapacity.

Nev. Rev. Stat. § 162A.270 Termination of power of attorney or authority of agent.

1. A power of attorney terminates when: (a) The principal dies; (b) The principal becomes incapacitated, if the power of attorney is not durable; (c) The principal revokes the power of attorney; (d) The power of attorney provides that it terminates; (e) The limited purpose of the power of attorney is accomplished; or (f) The principal revokes the agent’s authority or the agent dies, becomes incapacitated or resigns, and the power of attorney does not provide for another agent to act under the power of attorney. 2. An agent’s authority terminates when: (a) The principal revokes the authority; (b) The agent dies, becomes incapacitated or resigns; (c) An action is filed for the dissolution or annulment of the agent’s marriage to the principal or their legal separation, unless the power of attorney otherwise provides; or (d) The power of attorney terminates. 3. Unless the power of attorney otherwise provides, an agent’s authority is exercisable until the authority terminates under subsection 2, notwithstanding a lapse of time since the execution of the power of attorney. 4. Termination of an agent’s authority or of a power of attorney is not effective as to the agent or another person that, without actual knowledge of the termination, acts in good faith under the power of attorney. An act so performed, unless otherwise invalid or unenforceable, binds the principal and the principal’s successors in interest. 5. Incapacity of the principal of a power of attorney that is not durable does not revoke or terminate the power of attorney as to an agent or other person that, without actual knowledge of the incapacity, acts in good faith under the power of attorney. An act so performed, unless otherwise invalid or unenforceable, binds the principal and the principal’s successors in interest. 6. The execution of a power of attorney does not revoke a power of attorney previously executed by the principal unless the subsequent power of attorney provides that the previous power of attorney is revoked or that all other powers of attorney are revoked.

Nev. Rev. Stat. § 162A.280 Co-agents and successor agents.

1. A principal may designate two or more persons to act as co-agents. Unless the power of attorney otherwise provides, each co-agent may exercise its authority independently. 2. A principal may designate one or more successor agents to act if an agent resigns, dies, becomes incapacitated, is not qualified to serve or declines to serve. A principal may grant authority to designate one or more successor agents to an agent or other person designated by name, office or function. Unless the power of attorney otherwise provides, a successor agent: (a) Has the same authority as that granted to the original agent; and (b) May not act until all predecessor agents have resigned, died, become incapacitated, are no longer qualified to serve or have declined to serve. 3. Except as otherwise provided in subsection 4 and in the power of attorney, an agent that does not participate in or conceal a breach of fiduciary duty committed by another agent, including a predecessor agent, is not liable for the actions of the other agent. 4. An agent that has actual knowledge of a breach or imminent breach of fiduciary duty by another agent shall notify the principal and, if the principal is incapacitated, take any action reasonably appropriate in the circumstances to safeguard the principal’s best interest. An agent that fails to notify the principal or take action as required by this subsection is liable for the reasonably foreseeable damages that could have been avoided if the agent had notified the principal or taken such action.

Nev. Rev. Stat. § 162A.290 Reimbursement of agent.

Unless the power of attorney otherwise provides, an agent is entitled to reimbursement of expenses reasonably incurred on behalf of the principal.

Nev. Rev. Stat. § 162A.300 Agent’s acceptance of appointment.

Except as otherwise provided in the power of attorney, a person accepts appointment as an agent under a power of attorney by exercising authority or performing duties as an agent or by any other assertion or conduct indicating acceptance.

Nev. Rev. Stat. § 162A.310 Duties of agent.

1. Notwithstanding provisions in the power of attorney, an agent that has accepted appointment shall: (a) Act in accordance with the principal’s reasonable expectations to the extent actually known by the agent and, otherwise, in the principal’s best interest; (b) Act in good faith; and (c) Act only within the scope of authority granted in the power of attorney. 2. Except as otherwise provided in the power of attorney, an agent that has accepted appointment shall: (a) Act loyally for the principal’s benefit; (b) Act so as not to create a conflict of interest that impairs the agent’s ability to act impartially in the principal’s best interest; (c) Act with the care, competence and diligence ordinarily exercised by agents in similar circumstances; (d) Keep a record of all receipts, disbursements and transactions made on behalf of the principal; (e) Cooperate with a person that has authority to make health care decisions for the principal; and (f) Attempt to preserve the principal’s estate plan, to the extent actually known by the agent, if preserving the plan is consistent with the principal’s best interest based on all relevant factors, including: (1) The value and nature of the principal’s property; (2) The principal’s foreseeable obligations and need for maintenance; (3) Minimization of taxes, including income, estate, inheritance, generation-skipping transfer and gift taxes; and (4) Eligibility for a benefit, a program or assistance under a statute or regulation. 3. An agent that acts in good faith is not liable to any beneficiary of the principal’s estate plan for failure to preserve the plan. 4. An agent that acts with care, competence and diligence for the best interest of the principal is not liable solely because the agent also benefits from the act or has an individual or conflicting interest in relation to the property or affairs of the principal. 5. If an agent is selected by the principal because of special skills or expertise possessed by the agent or in reliance on the agent’s representation that the agent has special skills or expertise, the special skills or expertise must be considered in determining whether the agent has acted with care, competence and diligence under the circumstances. 6. Absent a breach of duty to the principal, an agent is not liable if the value of the principal’s property declines. 7. An agent that exercises authority to delegate to another person the authority granted by the principal or that engages another person on behalf of the principal is not liable for an act, error of judgment or default of that person if the agent exercises care, competence and diligence in selecting and monitoring the person. 8. Except as otherwise provided in the power of attorney, an agent is not required to disclose receipts, disbursements or transactions conducted on behalf of the principal unless ordered by a court, or requested by the principal, a guardian or other fiduciary acting for the principal, a governmental agency having authority to protect the welfare of the principal or, upon the death of the principal, by the personal representative or successor in interest of the principal’s estate. If so requested, within 30 days the agent shall comply with the request or provide a writing or other record substantiating why additional time is needed and shall comply with the request within an additional 30 days.

Nev. Rev. Stat. § 162A.320 Exoneration of agent.

A provision in a power of attorney relieving an agent of liability for breach of duty is binding on the principal and the principal’s successors in interest, except to the extent the provision: 1. Relieves the agent of liability for breach of duty committed dishonestly, with an improper motive or with reckless indifference to the purposes of the power of attorney or the best interest of the principal; or 2. Was inserted as a result of an abuse of a confidential or fiduciary relationship with the principal.

Nev. Rev. Stat. § 162A.330 Judicial relief.

1. The following persons may petition a court to construe a power of attorney or review the agent’s conduct, and grant appropriate relief: (a) The principal or the agent; (b) A guardian or other fiduciary acting for the principal; (c) A person authorized to make health care decisions for the principal; (d) The principal’s spouse, parent or descendant; (e) An individual who would qualify as a presumptive heir of the principal; (f) A person named as a beneficiary to receive any property, benefit or contractual right on the principal’s death or as a beneficiary of a trust created by or for the principal that has a financial interest in the principal’s estate; (g) A governmental agency having regulatory authority to protect the welfare of the principal; (h) A person asked to accept the power of attorney; or (i) The principal’s caregiver or another person who demonstrates sufficient interest in the principal’s welfare. 2. Upon motion by the principal, the court shall dismiss a petition filed under this section, unless: (a) The court finds that the principal lacks capacity to revoke the agent’s authority or the power of attorney; or (b) A governmental agency has asserted abuse by the agent regarding the agent’s actions under the power of attorney.

Nev. Rev. Stat. § 162A.340 Liability of agent.

An agent that violates NRS 162A.200 to 162A.660, inclusive, is liable to the principal or the principal’s successors in interest for the amount required to: 1. Restore the value of the principal’s property to what it would have been had the violation not occurred; and 2. Reimburse the principal or the principal’s successors in interest for the attorney’s fees and costs paid on the agent’s behalf.

Nev. Rev. Stat. § 162A.350 Resignation of agent; notice.

Unless the power of attorney provides a different method for an agent’s resignation, an agent may resign by giving notice to the principal and, if the principal is incapacitated: 1. To a co-agent or successor agent; or 2. If there is no person described in subsection 1, to: (a) The principal’s spouse, parent or descendant; (b) The principal’s caregiver; (c) Another person reasonably believed by the agent to have sufficient interest in the principal’s welfare; or (d) A governmental agency having authority to protect the welfare of the principal.

Nev. Rev. Stat. § 162A.360 Acceptance of and reliance upon acknowledged power of attorney.

1. A person that in good faith accepts an acknowledged power of attorney without actual knowledge that the signature is not genuine may rely upon the presumption under NRS 162A.220 that the signature is genuine. 2. A person that in good faith accepts an acknowledged power of attorney without actual knowledge that the power of attorney is void, invalid or terminated, that the purported agent’s authority is void, invalid or terminated, or that the agent is exceeding or improperly exercising the agent’s authority may rely upon the power of attorney as if the power of attorney were genuine, valid and still in effect, the agent’s authority were genuine, valid and still in effect, and the agent had not exceeded and had properly exercised the authority. 3. A person that is asked to accept an acknowledged power of attorney may request, and rely upon, without further investigation: (a) An agent’s certification under penalty of perjury of any factual matter concerning the principal, agent or power of attorney; (b) An English translation of the power of attorney if the power of attorney contains, in whole or in part, language other than English; and (c) An opinion of counsel as to any matter of law concerning the power of attorney if the person making the request provides in a writing or other record the reason for the request. 4. An English translation or an opinion of counsel requested under this section must be provided at the principal’s expense unless the request is made more than 10 business days after the power of attorney is presented for acceptance. If the request is made more than 10 business days after presentation of the power of attorney, the party requesting the translation shall pay for the translation. 5. For purposes of this section, a person that conducts activities through employees is without actual knowledge of a fact relating to a power of attorney, a principal or an agent if the employee conducting the transaction involving the power of attorney is without actual knowledge of the fact.

Nev. Rev. Stat. § 162A.370 Liability for refusal to accept acknowledged power of attorney.

1. Except as otherwise provided in subsection 2: (a) A person shall either accept an acknowledged power of attorney, or request a certification, a translation or an opinion of counsel pursuant to NRS 162A.360 , not later than 10 business days after presentation of the power of attorney for acceptance; (b) If a person requests a certification, a translation or an opinion of counsel pursuant to NRS 162A.360 , the person shall accept the power of attorney not later than 5 business days after receipt of the certification, translation or opinion of counsel; and (c) A person may not require an additional or different form of power of attorney for authority granted in the power of attorney presented. 2. A person is not required to accept an acknowledged power of attorney if: (a) The person is not otherwise required to engage in a transaction with the principal in the same circumstances; (b) Engaging in a transaction with the agent or the principal in the same circumstances would be inconsistent with federal law; (c) The person has actual knowledge of the termination of the agent’s authority or of the power of attorney before exercise of the power; (d) A request for a certification, a translation or an opinion of counsel pursuant to NRS 162A.360 is refused; (e) The person in good faith believes that the power is not valid or that the agent does not have the authority to perform the act requested, whether or not a certification, a translation or an opinion of counsel has been requested or provided pursuant to NRS 162A.360 ; (f) The person makes, or has actual knowledge that another person has made, a report pursuant to NRS 200.5093 stating a good faith belief that the principal may be subject to abuse, neglect, exploitation, isolation or abandonment by the agent or a person acting for or with the agent; or (g) The person: (1) Makes, or has actual knowledge that another person has made, a report pursuant to NRS 657.290 of the known or suspected exploitation by the agent, or a person acting for or with the agent, of the principal who is an older person or vulnerable person; or (2) Is a designated reporter of a financial institution who, pursuant to NRS 657.290 , delays a requested disbursement or transaction involving a principal who is an older person or vulnerable person whom the designated reporter knows or has reasonable cause to believe is being exploited. 3. A person that refuses in violation of this section to accept an acknowledged power of attorney is subject to: (a) A court order mandating acceptance of the power of attorney; and (b) Liability for reasonable attorney’s fees and costs incurred in any action or proceeding that confirms the validity of the power of attorney or mandates acceptance of the power of attorney. 4. As used in this section: (a) “Designated reporter” has the meaning ascribed to it in NRS 657.230 . (b) “Older person” has the meaning ascribed to it in NRS 657.250 . (c) “Vulnerable person” has the meaning ascribed to it in NRS 657.270 .

Nev. Rev. Stat. § 162A.380 Principles of law and equity.

Unless displaced by a provision of NRS 162A.200 to 162A.660, inclusive, the principles of law and equity supplement NRS 162A.200 to 162A.660, inclusive.

Nev. Rev. Stat. § 162A.390 Laws applicable to financial institutions and entities.

NRS 162A.200 to 162A.660, inclusive, does not supersede any other law applicable to financial institutions or other entities, and the other law controls if inconsistent with NRS 162A.200 to 162A.660, inclusive.

Nev. Rev. Stat. § 162A.400 Remedies under other law.

The remedies under NRS 162A.200 to 162A.660, inclusive, are not exclusive and do not abrogate any right or remedy under the laws of this State other than NRS 162A.200 to 162A.660, inclusive.

Nev. Rev. Stat. § 162A.450 Grant of specific authority.

1. An agent under a power of attorney may do the following on behalf of the principal or with the principal’s property only if the power of attorney expressly grants the agent the authority and exercise of the authority is not otherwise prohibited by another agreement or instrument to which the authority or property is subject: (a) Create, amend, revoke or terminate an inter vivos trust; (b) Make a gift; (c) Create or change rights of survivorship; (d) Create or change a beneficiary designation; (e) Delegate authority granted under the power of attorney; (f) Waive the principal’s right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan; (g) Exercise fiduciary powers that the principal has authority to delegate; or (h) Disclaim property, including a power of appointment. 2. Notwithstanding a grant of authority to do an act described in subsection 1, unless the power of attorney otherwise provides, an agent that is not a spouse of the principal may not exercise authority under a power of attorney to create in the agent, or in an individual to whom the agent owes a legal obligation of support, an interest in the principal’s property, whether by gift, right of survivorship, beneficiary designation, disclaimer or otherwise.

Nev. Rev. Stat. § 162A.460 Grant of general authority; incorporation of authority; authority of principal to act continues after execution.

1. Except as otherwise provided in NRS 162A.450 , if a power of attorney grants to an agent authority to do all acts that a principal could do or refers to general authority or cites a section of NRS 162A.200 to 162A.660 , inclusive, in which the authority is described, the agent has the general authority described in NRS 162A.200 to 162A.660 , inclusive. 2. A reference in a power of attorney to any part of a section in NRS 162A.200 to 162A.660 , inclusive, incorporates the entire section as if it were set out in full in the power of attorney. 3. A principal may modify authority incorporated by reference. 4. Except as otherwise provided in NRS 162A.450 , if the subjects over which authority is granted in a power of attorney are similar or overlap, the broadest authority controls. 5. Authority granted in a power of attorney is exercisable with respect to property that the principal has when the power of attorney is executed or acquires later, whether or not the property is located in this State and whether or not the authority is exercised or the power of attorney is executed in this State. 6. An act performed by an agent pursuant to a power of attorney has the same effect and inures to the benefit of and binds the principal and the principal’s successors in interest as if the principal had performed the act. 7. Except as otherwise expressly provided in a power of attorney, the authority of a principal to act on his or her own behalf continues after executing a power of attorney and any decision or instruction communicated by the principal supersedes any inconsistent decision or instruction communicated by an agent pursuant to a power of attorney.

Nev. Rev. Stat. § 162A.470 Construction of authority generally.

Except as otherwise provided in the power of attorney, by executing a power of attorney that incorporates by reference a subject described in NRS 162A.200 to 162A.660, inclusive, or that grants to an agent authority to do all acts that a principal could do pursuant to this chapter, a principal authorizes the agent to: 1. Demand, receive and obtain, by litigation or otherwise, money or another thing of value to which the principal is, may become or claims to be entitled, and conserve, invest, disburse or use anything so received or obtained for the purposes intended; 2. Contract in any manner with any person, on terms agreeable to the agent, to accomplish a purpose of a transaction and perform, rescind, cancel, terminate, reform, restate, release or modify the contract or another contract made by or on behalf of the principal; 3. Execute, acknowledge, seal, deliver, file or record any instrument or communication the agent considers desirable to accomplish a purpose of a transaction, including creating at any time a schedule listing some or all of the principal’s property and attaching it to the power of attorney; 4. Initiate, participate in, submit to alternative dispute resolution, settle, oppose, propose or accept a compromise with respect to a claim existing in favor of or against the principal or intervene in litigation relating to the claim; 5. Seek on the principal’s behalf the assistance of a court or other governmental agency to carry out an act authorized in the power of attorney; 6. Engage, compensate and discharge an attorney, accountant, discretionary investment manager, expert witness or other advisor; 7. Prepare, execute and file a record, report or other document to safeguard or promote the principal’s interest under a statute or regulation; 8. Communicate with any representative or employee of a government or governmental subdivision, agency or instrumentality on behalf of the principal; 9. Access communications intended for, and communicate on behalf of, the principal, whether by mail, electronic transmission, telephone or other means; and 10. Do any lawful act with respect to the subject and all property related to the subject.

Nev. Rev. Stat. § 162A.480 Real property.

1. Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to real property authorizes: (a) The agent to demand, buy, lease, receive, accept as a gift or as security for an extension of credit, or otherwise acquire or reject an interest in real property or a right incident to real property; (b) The agent to: (1) Sell; (2) Exchange; (3) Convey with or without covenants, representations or warranties; (4) Quitclaim; (5) Release; (6) Surrender; (7) Retain title for security; (8) Encumber; (9) Partition; (10) Consent to partitioning; (11) Subject to an easement or covenant; (12) Subdivide; (13) Apply for zoning or other governmental permits; (14) Plat or consent to platting; (15) Develop; (16) Grant an option concerning; (17) Lease; (18) Sublease; (19) Contribute to an entity in exchange for an interest in that entity; or (20) Otherwise grant or dispose of, Ê an interest in real property or a right incident to real property; (c) The agent to pledge or mortgage an interest in real property or right incident to real property as security to borrow money or pay, renew or extend the time of payment of a debt of the principal or a debt guaranteed by the principal; (d) The agent to release, assign, satisfy or enforce by litigation or otherwise a mortgage, deed of trust, conditional sale contract, encumbrance, lien or other claim to real property which exists or is asserted; (e) The agent to manage or conserve an interest in real property or a right incident to real property owned or claimed to be owned by the principal, including: (1) Insuring against liability or casualty or other loss; (2) Obtaining or regaining possession of or protecting the interest or right by litigation or otherwise; (3) Paying, assessing, compromising or contesting taxes or assessments or applying for and receiving refunds in connection with them; and (4) Purchasing supplies, hiring assistance or labor, and making repairs or alterations to the real property; (f) The agent to use, develop, alter, replace, remove, erect or install structures or other improvements upon real property in or incident to which the principal has, or claims to have, an interest or right; (g) The agent to participate in a reorganization with respect to real property or an entity that owns an interest in or right incident to real property and receive, and hold, and act with respect to stocks and bonds or other property received in a plan of reorganization, including: (1) Selling or otherwise disposing of them; (2) Exercising or selling an option, right of conversion or similar right with respect to them; and (3) Exercising any voting rights in person or by proxy; (h) The agent to change the form of title of an interest in or right incident to real property; and (i) The agent to dedicate to public use, with or without consideration, easements or other real property in which the principal has, or claims to have, an interest. 2. Every power of attorney, or other instrument in writing, containing the power to convey any real property as agent or attorney for the owner thereof, or to execute, as agent or attorney for another, any conveyance whereby any real property is conveyed, or may be affected, must be recorded as other conveyances whereby real property is conveyed or affected are required to be recorded. 3. No such power of attorney or other instrument, recorded in the manner prescribed in subsection 2, shall be deemed to be revoked by any act of the principal, until the instrument containing such revocation is deposited for record in the same office in which the instrument containing the power is recorded.

Nev. Rev. Stat. § 162A.490 Tangible personal property.

Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to tangible personal property authorizes: 1. The agent to demand, buy, receive, accept as a gift or as security for an extension of credit, or otherwise acquire or reject ownership or possession of tangible personal property or an interest in tangible personal property; 2. The agent to: (a) Sell; (b) Exchange; (c) Convey with or without covenants, representations or warranties; (d) Quitclaim; (e) Release; (f) Surrender; (g) Create a security interest in; (h) Grant options concerning; (i) Lease; (j) Sublease; or (k) Otherwise dispose of, Ê tangible personal property or an interest in tangible personal property; 3. The agent to grant a security interest in tangible personal property or an interest in tangible personal property as security to borrow money or pay, renew or extend the time of payment of a debt of the principal or a debt guaranteed by the principal; 4. The agent to release, assign, satisfy or enforce by litigation or otherwise, a security interest, lien or other claim on behalf of the principal, with respect to tangible personal property or an interest in tangible personal property; 5. The agent to manage or conserve tangible personal property or an interest in tangible personal property on behalf of the principal, including: (a) Insuring against liability or casualty or other loss; (b) Obtaining or regaining possession of or protecting the property or interest, by litigation or otherwise; (c) Paying, assessing, compromising or contesting taxes or assessments, or applying for and receiving refunds in connection with taxes or assessments; (d) Moving the property from place to place; (e) Storing the property for hire or on a gratuitous bailment; and (f) Using and making repairs, alterations or improvements to the property; and 6. The agent to change the form of title of an interest in tangible personal property.

Nev. Rev. Stat. § 162A.500 Stocks and bonds.

Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to stocks and bonds authorizes the agent to: 1. Buy, sell and exchange stocks and bonds; 2. Establish, continue, modify or terminate an account with respect to stocks and bonds; 3. Pledge stocks and bonds as security to borrow, pay, renew or extend the time of payment of a debt of the principal; 4. Receive certificates and other evidences of ownership with respect to stocks and bonds; and 5. Exercise voting rights with respect to stocks and bonds in person or by proxy, enter into voting trusts and consent to limitations on the right to vote.

Nev. Rev. Stat. § 162A.510 Commodities and options.

Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to commodities and options authorizes the agent to: 1. Buy, sell, exchange, assign, settle and exercise commodity futures contracts and call or put options on stocks or stock indexes traded on a regulated option exchange; and 2. Establish, continue, modify and terminate option accounts.

Nev. Rev. Stat. § 162A.520 Banks and other financial institutions.

1. Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to banks and other financial institutions authorizes the agent to: (a) Continue, modify and terminate an account or other banking arrangement made by or on behalf of the principal; (b) Establish, modify and terminate an account or other banking arrangement with a bank, trust company, savings and loan association, savings bank, credit union, thrift company, brokerage firm or other financial institution selected by the agent; (c) Contract for services available from a financial institution, including renting a safe deposit box or space in a vault; (d) Withdraw, by check, order, electronic funds transfer or otherwise, money or property of the principal deposited with or left in the custody of a financial institution; (e) Receive statements of account, vouchers, notices and similar documents from a financial institution and act with respect to them; (f) Enter a safe deposit box or vault and withdraw or add to the contents; (g) Borrow money and pledge as security personal property of the principal necessary to borrow money or pay, renew or extend the time of payment of a debt of the principal or a debt guaranteed by the principal; (h) Make, assign, draw, endorse, discount, guarantee and negotiate promissory notes, checks, drafts and other negotiable or nonnegotiable paper of the principal or payable to the principal or the principal’s order, transfer money, receive the cash or other proceeds of those transactions, and accept a draft drawn by a person upon the principal and pay it when due; (i) Receive for the principal and act upon a sight draft, warehouse receipt or other document of title whether tangible or electronic, or other negotiable or nonnegotiable instrument; (j) Apply for, receive and use letters of credit, credit and debit cards, electronic transaction authorizations and traveler’s checks from a financial institution and give an indemnity or other agreement in connection with letters of credit; and (k) Consent to an extension of the time of payment with respect to commercial paper or a financial transaction with a financial institution. 2. An agent who is not the spouse of the principal must not be listed on any account as a cosigner with right of survivorship, but must be listed on the account solely as power of attorney.

Nev. Rev. Stat. § 162A.530 Operation of entity or business.

Subject to the terms of a document or an agreement governing an entity or an entity ownership interest, and unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to operation of an entity or business authorizes the agent to: 1. Operate, buy, sell, enlarge, reduce or terminate an ownership interest. 2. Perform a duty or discharge a liability and exercise in person or by proxy a right, power, privilege or option that the principal has, may have or claims to have. 3. Enforce the terms of an ownership agreement. 4. Initiate, participate in, submit to alternative dispute resolution, settle, oppose, propose or accept a compromise with respect to litigation to which the principal is a party because of an ownership interest. 5. Exercise in person or by proxy, or enforce by litigation or otherwise, a right, power, privilege or option the principal has or claims to have as the holder of stocks and bonds. 6. Initiate, participate in, submit to alternative dispute resolution, settle, oppose, propose or accept a compromise with respect to litigation to which the principal is a party concerning stocks and bonds. 7. With respect to an entity or business owned solely by the principal: (a) Continue, modify, renegotiate, extend and terminate a contract made by or on behalf of the principal with respect to the entity or business before execution of the power of attorney; (b) Determine: (1) The location of its operation; (2) The nature and extent of its business; (3) The methods of manufacturing, selling, merchandising, financing, accounting and advertising employed in its operation; (4) The amount and types of insurance carried; and (5) The mode of engaging, compensating and dealing with its employees and accountants, attorneys or other advisors; (c) Change the name or form of organization under which the entity or business is operated and enter into an ownership agreement with other persons to take over all or part of the operation of the entity or business; and (d) Demand and receive money due or claimed by the principal or on the principal’s behalf in the operation of the entity or business and control and disburse the money in the operation of the entity or business. 8. Put additional capital into an entity or business in which the principal has an interest. 9. Join in a plan of reorganization, consolidation, conversion, domestication or merger of the entity or business. 10. Sell or liquidate all or part of an entity or business. 11. Establish the value of an entity or business under a buy-out agreement to which the principal is a party. 12. Prepare, sign, file and deliver reports, compilations of information, returns or other papers with respect to an entity or business and make related payments. 13. Pay, compromise or contest taxes, assessments, fines or penalties and perform any other act to protect the principal from illegal or unnecessary taxation, assessments, fines or penalties with respect to an entity or business, including attempts to recover, in any manner permitted by law, money paid before or after the execution of the power of attorney.

Nev. Rev. Stat. § 162A.540 Insurance and annuities.

Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to insurance and annuities authorizes the agent to: 1. Continue, pay the premium or make a contribution on, modify, exchange, rescind, release or terminate a contract procured by or on behalf of the principal which insures or provides an annuity to either the principal or another person, whether or not the principal is a beneficiary under the contract; 2. Procure new, different and additional contracts of insurance and annuities for the principal and the principal’s spouse, children and other dependents, select the amount, type of insurance or annuity, and mode of payment and name one or more beneficiaries in accordance with the principal’s established estate plan and any restrictions to designate beneficiaries contained within the power of attorney; 3. Pay the premium or make a contribution on, modify, exchange, rescind, release or terminate a contract of insurance or annuity procured by the agent; 4. Apply for and receive a loan secured by a contract of insurance or annuity; 5. Surrender and receive the cash surrender value on a contract of insurance or annuity; 6. Exercise an election; 7. Exercise investment powers available under a contract of insurance or annuity; 8. Change the manner of paying premiums on a contract of insurance or annuity; 9. Change or convert the type of insurance or annuity with respect to which the principal has or claims to have authority described in this section; 10. Apply for and procure a benefit or assistance under a statute or regulation to guarantee or pay premiums of a contract of insurance on the life of the principal; 11. Collect, sell, assign, hypothecate, borrow against or pledge the interest of the principal in a contract of insurance or annuity; 12. Select the form and timing of the payment of proceeds from a contract of insurance or annuity; and 13. Pay, from proceeds or otherwise, compromise or contest, and apply for refunds in connection with, a tax or assessment levied by a taxing authority with respect to a contract of insurance or annuity or its proceeds or liability accruing by reason of the tax or assessment.

Nev. Rev. Stat. § 162A.550 Estates, trusts and other beneficial interests.

1. Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to estates, trusts and other beneficial interests authorizes the agent to: (a) Accept, receive, receipt for, sell, assign, pledge or exchange a share in or payment from the fund; (b) Demand or obtain money or another thing of value to which the principal is, may become or claims to be entitled by reason of the fund, by litigation or otherwise; (c) Exercise for the benefit of the principal a presently exercisable general power of appointment held by the principal; (d) Initiate, participate in, submit to alternative dispute resolution, settle, oppose, propose or accept a compromise with respect to litigation to ascertain the meaning, validity or effect of a deed, will, declaration of trust, or other instrument or transaction affecting the interest of the principal; (e) Initiate, participate in, submit to alternative dispute resolution, settle, oppose, propose or accept a compromise with respect to litigation to remove, substitute or surcharge a fiduciary; (f) Conserve, invest, disburse or use anything received for an authorized purpose; and (g) Transfer an interest of the principal in real property, stocks and bonds, accounts with financial institutions or securities intermediaries, insurance, annuities and other property to the trustee of a revocable trust created by the principal as settlor or grantor. 2. As used in this section, “estates, trusts and other beneficial interests” means a trust, probate estate, escrow, custodianship or fund from which the principal is, may become or claims to be entitled to a share or payment.

Nev. Rev. Stat. § 162A.560 Claims and litigation.

Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to claims and litigation authorizes the agent to: 1. Assert and maintain before a court or administrative agency a claim, claim for relief, cause of action, counterclaim, offset, recoupment or defense, including an action to recover property or other thing of value, recover damages sustained by the principal, eliminate or modify tax liability, or seek an injunction, specific performance or other relief; 2. Bring an action to determine adverse claims or intervene or otherwise participate in litigation; 3. Seek an attachment, garnishment, order of arrest or other preliminary, provisional or intermediate relief and use an available procedure to effect or satisfy a judgment, order or decree; 4. Make or accept a tender, offer of judgment or admission of facts, submit a controversy on an agreed statement of facts, consent to examination and bind the principal in litigation; 5. Submit to alternative dispute resolution, settle, and propose or accept a compromise; 6. Waive the issuance and service of process upon the principal, accept service of process, appear for the principal, designate persons upon which process directed to the principal may be served, execute and file or deliver stipulations on the principal’s behalf, verify pleadings, seek appellate review, procure and give surety and indemnity bonds, contract and pay for the preparation and printing of records and briefs, and receive, execute and file or deliver a consent, waiver, release, confession of judgment, satisfaction of judgment, notice, agreement or other instrument in connection with the prosecution, settlement or defense of a claim or litigation; 7. Act for the principal with respect to bankruptcy or insolvency, whether voluntary or involuntary, concerning the principal or some other person, or with respect to a reorganization, receivership or application for the appointment of a receiver or trustee which affects an interest of the principal in property or other thing of value; 8. Pay a judgment, award or order against the principal or a settlement made in connection with a claim or litigation; and 9. Receive money or other thing of value paid in settlement of or as proceeds of a claim or litigation.

Nev. Rev. Stat. § 162A.570 Personal and family maintenance.

Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to personal and family maintenance authorizes the agent to perform the acts necessary to maintain the customary standard of living of the principal, including, but not limited to, authorizing the agent to: 1. Make periodic payments of child support and other family maintenance required by a court or governmental agency or an agreement to which the principal is a party; 2. Provide normal domestic help, usual vacations and travel expenses, and funds for shelter, clothing, food, appropriate education, including postsecondary and vocational education, and other current living costs for the principal; 3. Pay expenses for necessary health care and custodial care on behalf of the principal; 4. Act as the principal’s personal representative pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, as amended, and applicable regulations, in making decisions related to the past, present or future payment for the provision of health care consented to by the principal or anyone authorized under the law of this State to consent to health care on behalf of the principal; 5. Continue any provision made by the principal for automobiles or other means of transportation, including registering, licensing, insuring and replacing them; 6. Maintain credit and debit accounts for the convenience of the principal and open new accounts; and 7. Continue payments incidental to the membership or affiliation of the principal in a religious institution, club, society, order or other organization or to continue contributions to those organizations.

Nev. Rev. Stat. § 162A.580 Benefits from governmental programs or civil or military service.

1. Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to benefits from governmental programs or civil or military service authorizes the agent to: (a) Enroll in, apply for, select, reject, change, amend or discontinue, on the principal’s behalf, a benefit or program; (b) Prepare, file and maintain a claim of the principal for a benefit or assistance, financial or otherwise, to which the principal may be entitled under a statute or regulation; (c) Initiate, participate in, submit to alternative dispute resolution, settle, oppose, propose or accept a compromise with respect to litigation concerning any benefit or assistance the principal may be entitled to receive under a statute or regulation; (d) Receive the financial proceeds of a claim, and conserve, invest, disburse or use for a lawful purpose anything so received; (e) Execute vouchers in the name of the principal for allowances and reimbursements payable by the United States or a foreign government or by a state or subdivision of a state to the principal, including allowances and reimbursements for transportation and for shipment of household effects; and (f) Take possession and order the removal and shipment of property of the principal from a post, warehouse, depot, dock or other place of storage or safekeeping, either governmental or private, and execute and deliver a release, voucher, receipt, bill of lading, shipping ticket, certificate or other instrument for that purpose. 2. As used in this section, “benefits from governmental programs or civil or military service” means any benefit, program or assistance provided under a statute or regulation including Social Security, Medicare and Medicaid.

Nev. Rev. Stat. § 162A.590 Retirement plans.

1. Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to retirement plans authorizes the agent to: (a) Select the form and timing of payments under a retirement plan and withdraw benefits from a plan; (b) Make a rollover, including a direct trustee-to-trustee rollover, of benefits from one retirement plan to another; (c) Establish a retirement plan in the principal’s name and name one or more beneficiaries in accordance with the principal’s established estate plan and any restrictions to designate beneficiaries contained within the power of attorney; (d) Make contributions to a retirement plan; (e) Exercise investment powers available under a retirement plan; and (f) Borrow from, sell assets to or purchase assets from a retirement plan. 2. As used in this section, “retirement plan” means a plan or account created by an employer, the principal or another individual to provide retirement benefits or deferred compensation of which the principal is a participant, beneficiary or owner, including a plan or account under the following sections of the Internal Revenue Code: (a) An individual retirement account under section 408 of the Internal Revenue Code, 26 U.S.C. § 408, as amended; (b) A Roth individual retirement account under section 408A of the Internal Revenue Code, 26 U.S.C. § 408A, as amended; (c) A deemed individual retirement account under section 408(q) of the Internal Revenue Code, 26 U.S.C. § 408(q), as amended; (d) An annuity or mutual fund custodial account under section 403(b) of the Internal Revenue Code, 26 U.S.C. § 403(b), as amended; (e) A pension, profit-sharing, stock bonus or other retirement plan qualified under section 401(a) of the Internal Revenue Code, 26 U.S.C. § 401(a), as amended; (f) A plan under section 457(b) of the Internal Revenue Code, 26 U.S.C. § 457(b), as amended; and (g) A nonqualified deferred compensation plan under section 409A of the Internal Revenue Code, 26 U.S.C. § 409A, as amended.

Nev. Rev. Stat. § 162A.600 Taxes.

Unless the power of attorney otherwise provides, language in a power of attorney granting general authority with respect to taxes authorizes the agent to: 1. Prepare, sign and file federal, state, local and foreign income, gift, payroll, property, Federal Insurance Contributions Act and other tax returns, claims for refunds, requests for extension of time, petitions regarding tax matters and any other tax-related documents, including receipts, offers, waivers, consents, including consents and agreements under section 2032A of the Internal Revenue Code, 26 U.S.C. § 2032A, as amended, closing agreements, and any power of attorney required by the Internal Revenue Service or other taxing authority with respect to a tax year upon which the statute of limitations has not run and the following 25 tax years; 2. Pay taxes due, collect refunds, post bonds, receive confidential information, and contest deficiencies determined by the Internal Revenue Service or other taxing authority; 3. Exercise any election available to the principal under federal, state, local or foreign tax law; and 4. Act for the principal in all tax matters for all periods before the Internal Revenue Service or other taxing authority.

Nev. Rev. Stat. § 162A.610 Gifts.

1. Unless the power of attorney otherwise provides, an agent has no authority to make a gift to any party on behalf of the principal. 2. If the power of attorney grants the agent the authority to make gifts, the agent may: (a) Make outright to, or for the benefit of, a person, a gift of any of the principal’s property, including by the exercise of a presently exercisable general power of appointment held by the principal, in an amount per donee not to exceed the annual dollar limits of the federal gift tax exclusion under section 2503(b) of the Internal Revenue Code, 26 U.S.C. § 2503(b), as amended, without regard to whether the federal gift tax exclusion applies to the gift or, if the principal’s spouse agrees to consent to a split gift pursuant to section 2513 of the Internal Revenue Code, 26 U.S.C. § 2513, as amended, in an amount per donee not to exceed twice the annual federal gift tax exclusion limit; and (b) Consent, pursuant to section 2513 of the Internal Revenue Code, 26 U.S.C. § 2513, as amended, to the splitting of a gift made by the principal’s spouse in an amount per donee not to exceed the aggregate annual gift tax exclusions for both spouses. 3. An agent may make a gift of the principal’s property only as the agent determines is consistent with the principal’s objectives if actually known by the agent and, if unknown, as the agent determines is consistent with the principal’s best interest based on all relevant factors, including: (a) The value and nature of the principal’s property; (b) The principal’s foreseeable obligations and need for maintenance; (c) Minimization of taxes, including income, estate, inheritance, generation-skipping transfer and gift taxes; (d) Eligibility for a benefit, a program or assistance under a statute or regulation; and (e) The principal’s personal history of making or joining in making gifts. 4. As used in this section, a gift “for the benefit of” a person includes a gift to a trust, an account under the Uniform Transfers to Minors Act, and a tuition savings account or prepaid tuition plan as defined under section 529 of the Internal Revenue Code, 26 U.S.C. § 529, as amended.

Nev. Rev. Stat. § 162A.620 Power of attorney.

A document substantially in the following form may be used to create a statutory form power of attorney that has the meaning and effect prescribed by NRS 162A.200 to 162A.660, inclusive: STATUTORY FORM POWER OF ATTORNEY THIS IS AN IMPORTANT LEGAL DOCUMENT. IT CREATES A DURABLE POWER OF ATTORNEY FOR FINANCIAL MATTERS. BEFORE EXECUTING THIS DOCUMENT, YOU SHOULD KNOW THESE IMPORTANT FACTS: 1. THIS DOCUMENT GIVES THE PERSON YOU DESIGNATE AS YOUR AGENT THE POWER TO MAKE DECISIONS CONCERNING YOUR PROPERTY FOR YOU. YOUR AGENT WILL BE ABLE TO MAKE DECISIONS AND ACT WITH RESPECT TO YOUR PROPERTY (INCLUDING YOUR MONEY) WHETHER OR NOT YOU ARE ABLE TO ACT FOR YOURSELF. 2. THIS POWER OF ATTORNEY BECOMES EFFECTIVE IMMEDIATELY UNLESS YOU STATE OTHERWISE IN THE SPECIAL INSTRUCTIONS. 3. THIS POWER OF ATTORNEY DOES NOT AUTHORIZE THE AGENT TO MAKE HEALTH CARE DECISIONS FOR YOU. 4. THE PERSON YOU DESIGNATE IN THIS DOCUMENT HAS A DUTY TO ACT CONSISTENT WITH YOUR DESIRES AS STATED IN THIS DOCUMENT OR OTHERWISE MADE KNOWN OR, IF YOUR DESIRES ARE UNKNOWN, TO ACT IN YOUR BEST INTERESTS. 5. YOU SHOULD SELECT SOMEONE YOU TRUST TO SERVE AS YOUR AGENT. UNLESS YOU SPECIFY OTHERWISE, GENERALLY THE AGENT’S AUTHORITY WILL CONTINUE UNTIL YOU DIE OR REVOKE THE POWER OF ATTORNEY OR THE AGENT RESIGNS OR IS UNABLE TO ACT FOR YOU. 6. YOUR AGENT IS ENTITLED TO REASONABLE COMPENSATION UNLESS YOU STATE OTHERWISE IN THE SPECIAL INSTRUCTIONS. 7. THIS FORM PROVIDES FOR DESIGNATION OF ONE AGENT. IF YOU WISH TO NAME MORE THAN ONE AGENT YOU MAY NAME A CO-AGENT IN THE SPECIAL INSTRUCTIONS. CO-AGENTS ARE NOT REQUIRED TO ACT TOGETHER UNLESS YOU INCLUDE THAT REQUIREMENT IN THE SPECIAL INSTRUCTIONS. 8. IF YOUR AGENT IS UNABLE OR UNWILLING TO ACT FOR YOU, YOUR POWER OF ATTORNEY WILL END UNLESS YOU HAVE NAMED A SUCCESSOR AGENT. YOU MAY ALSO NAME A SECOND SUCCESSOR AGENT. 9. YOU HAVE THE RIGHT TO REVOKE THE AUTHORITY GRANTED TO THE PERSON DESIGNATED IN THIS DOCUMENT. 10. THIS DOCUMENT REVOKES ANY PRIOR DURABLE POWER OF ATTORNEY. 11. IF THERE IS ANYTHING IN THIS DOCUMENT THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU. 1. DESIGNATION OF AGENT. I, ................................................................................................................................ (insert your name) do hereby designate and appoint: Name: ................................................................................................................ Address: ............................................................................................................ Telephone Number: ......................................................................................... as my agent to make decisions for me and in my name, place and stead and for my use and benefit and to exercise the powers as authorized in this document. 2. DESIGNATION OF ALTERNATE AGENT. (You are not required to designate any alternative agent but you may do so. Any alternative agent you designate will be able to make the same decisions as the agent designated above in the event that he or she is unable or unwilling to act as your agent. Also, if the agent designated in paragraph 1 is your spouse, his or her designation as your agent is automatically revoked by law if your marriage is dissolved.) If my agent is unable or unwilling to act for me, then I designate the following person(s) to serve as my agent as authorized in this document, such person(s) to serve in the order listed below: A. First Alternative Agent Name:..................................................................................................... Address:................................................................................................. Telephone Number:............................................................................. B. Second Alternative Agent Name:..................................................................................................... Address:................................................................................................. Telephone Number:............................................................................. 3. OTHER POWERS OF ATTORNEY. This Power of Attorney is intended to, and does, revoke any prior Power of Attorney for financial matters I have previously executed. 4. NOMINATION OF GUARDIAN. If, after execution of this Power of Attorney, proceedings seeking an adjudication of incapacity are initiated either for my estate or my person, I hereby nominate as my guardian or conservator for consideration by the court my agent herein named, in the order named. 5. GRANT OF GENERAL AUTHORITY. I grant my agent and any successor agent(s) general authority to act for me with respect to the following subjects: (INITIAL each subject you want to include in the agent’s general authority. If you wish to grant general authority over all of the subjects you may initial “All Preceding Subjects” instead of initialing each subject.) [.....] Real Property [.....] Tangible Personal Property [.....] Stocks and Bonds [.....] Commodities and Options [.....] Banks and Other Financial Institutions [.....] Safe Deposit Boxes [.....] Operation of Entity or Business [.....] Insurance and Annuities [.....] Estates, Trusts and Other Beneficial Interests [.....] Legal Affairs, Claims and Litigation [.....] Personal Maintenance [.....] Benefits from Governmental Programs or Civil or Military Service [.....] Retirement Plans [.....] Taxes [.....] All Preceding Subjects 6. GRANT OF SPECIFIC AUTHORITY. My agent MAY NOT do any of the following specific acts for me UNLESS I have INITIALED the specific authority listed below: (CAUTION: Granting any of the following will give your agent the authority to take actions that could significantly reduce your property or change how your property is distributed at your death. INITIAL ONLY the specific authority you WANT to give your agent.) [.....] Create, amend, revoke or terminate an inter vivos, family, living, irrevocable or revocable trust [.....] Make a gift, subject to the limitations of NRS and any special instructions in this Power of Attorney [.....] Create or change rights of survivorship [.....] Create or change a beneficiary designation [.....] Waive the principal’s right to be a beneficiary of a joint and survivor annuity, including a survivor benefit under a retirement plan [.....] Exercise fiduciary powers that the principal has authority to delegate [.....] Disclaim or refuse an interest in property, including a power of appointment 7. EXPRESSION OF INTENT CONCERNING LIVING ARRANGEMENTS. [.....] It is my intention to live in my home as long as it is safe and my medical needs can be met. My agent may arrange for a natural person, employee of an agency or provider of community-based services to come into my home to provide care for me. When it is no longer safe for me to live in my home, I authorize my agent to place me in a facility or home that can provide any medical assistance and support in my activities of daily living that I require. Before being placed in such a facility or home, I wish for my agent to discuss and share information concerning the placement with me. [.....] It is my intention to live in my home for as long as possible without regard for my medical needs, personal safety or ability to engage in activities of daily living. My agent may arrange for a natural person, an employee of an agency or a provider of community-based services to come into my home and provide care for me. I understand that, before I may be placed in a facility or home other than the home in which I currently reside, a guardian must be appointed for me. [.....] I desire for my agent to take the following actions relating to my care: .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... 8. LIMITATION ON AGENT’S AUTHORITY. An agent that is not my spouse MAY NOT use my property to benefit the agent or a person to whom the agent owes an obligation of support unless I have included that authority in the Special Instructions. 9. SPECIAL INSTRUCTIONS OR OTHER OR ADDITIONAL AUTHORITY GRANTED TO AGENT: 10. AUTHORITY OF PRINCIPAL. Except as otherwise expressly provided in this Power of Attorney, the authority of a principal to act on his or her own behalf continues after executing this Power of Attorney and any decision or instruction communicated by the principal supersedes any inconsistent decision or instruction communicated by an agent appointed pursuant to this Power of Attorney. 11. DURABILITY AND EFFECTIVE DATE. (INITIAL the clause(s) that applies.) [.....] DURABLE. This Power of Attorney shall not be affected by my subsequent disability or incapacity. [.....] SPRINGING POWER. It is my intention and direction that my designated agent, and any person or entity that my designated agent may transact business with on my behalf, may rely on a written medical opinion issued by a licensed medical doctor stating that I am disabled or incapacitated, and incapable of managing my affairs, and that said medical opinion shall establish whether or not I am under a disability for the purpose of establishing the authority of my designated agent to act in accordance with this Power of Attorney. [.....] I wish to have this Power of Attorney become effective on the following date: ..... [.....] I wish to have this Power of Attorney end on the following date: ..... 12. THIRD PARTY PROTECTION. Third parties may rely upon the validity of this Power of Attorney or a copy and the representations of my agent as to all matters relating to any power granted to my agent, and no person or agency who relies upon the representation of my agent, or the authority granted by my agent, shall incur any liability to me or my estate as a result of permitting my agent to exercise any power unless a third party knows or has reason to know this Power of Attorney has terminated or is invalid. 13. RELEASE OF INFORMATION. I agree to, authorize and allow full release of information, by any government agency, business, creditor or third party who may have information pertaining to my assets or income, to my agent named herein. 14. SIGNATURE AND ACKNOWLEDGMENT. YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY. THIS POWER OF ATTORNEY WILL NOT BE VALID UNLESS IT IS ACKNOWLEDGED BEFORE A NOTARY PUBLIC. I sign my name to this Power of Attorney on .............. (date) at .............................. (city), ......................... (state) ....................................................... (Signature) CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC (You may use acknowledgment before a notary public instead of the statement of witnesses.) State of Nevada } }ss. County of................................................ } On this .......... day of .........., in the year ....., before me, ............................... (here insert name of notary public) personally appeared .............................. (here insert name of principal) personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to this instrument, and acknowledged that he or she executed it. NOTARY SEAL ............................................................... (Signature of Notary Public) IMPORTANT INFORMATION FOR AGENT 1. Agent’s Duties. When you accept the authority granted under this Power of Attorney, a special legal relationship is created between you and the principal. This relationship imposes upon you legal duties that continue until you resign or the Power of Attorney is terminated or revoked. You must: (a) Do what you know the principal reasonably expects you to do with the principal’s property or, if you do not know the principal’s expectations, act in the principal’s best interest; (b) Act in good faith; (c) Do nothing beyond the authority granted in this Power of Attorney; and (d) Disclose your identity as an agent whenever you act for the principal by writing or printing the name of the principal and signing your own name as “agent” in the following manner: (Principal’s Name) by (Your Signature) as Agent 2. Unless the Special Instructions in this Power of Attorney state otherwise, you must also: (a) Act loyally for the principal’s benefit; (b) Avoid conflicts that would impair your ability to act in the principal’s best interest; (c) Act with care, competence, and diligence; (d) Keep a record of all receipts, disbursements and transactions made on behalf of the principal; (e) Cooperate with any person that has authority to make health care decisions for the principal to do what you know the principal reasonably expects or, if you do not know the principal’s expectations, to act in the principal’s best interest; and (f) Attempt to preserve the principal’s estate plan if you know the plan and preserving the plan is consistent with the principal’s best interest. 3. Termination of Agent’s Authority. You must stop acting on behalf of the principal if you learn of any event that terminates this Power of Attorney or your authority under this Power of Attorney. Events that terminate a Power of Attorney or your authority to act under a Power of Attorney include: (a) Death of the principal; (b) The principal’s revocation of the Power of Attorney or your authority; (c) The occurrence of a termination event stated in the Power of Attorney; (d) The purpose of the Power of Attorney is fully accomplished; or (e) If you are married to the principal, your marriage is dissolved. 4. Liability of Agent. The meaning of the authority granted to you is defined in NRS 162A.200 to 162A.660 , inclusive. If you violate NRS 162A.200 to 162A.660 , inclusive, or act outside the authority granted in this Power of Attorney, you may be liable for any damages caused by your violation. 5. If there is anything about this document or your duties that you do not understand, you should seek legal advice.

Nev. Rev. Stat. § 162A.650 Uniformity of application and construction.

In applying and construing NRS 162A.200 to 162A.660, inclusive, consideration must be given to the need to promote uniformity of the law with respect to its subject matter among the states that enact it.

Nev. Rev. Stat. § 162A.660 Relation to Electronic Signatures in Global and National Commerce Act.

NRS 162A.200 to 162A.660, inclusive, modifies, limits and supersedes the Electronic Signatures in Global and National Commerce Act, 15 U.S.C. §§ 7001 et seq., but does not modify, limit or supersede section 101(c) of that Act, 15 U.S.C. § 7001(c), or authorize electronic delivery of any of the notices described in section 103(b) of that Act, 15 U.S.C. § 7003(b).

Nev. Rev. Stat. § 162A.700 Applicability.

NRS 162A.700 to 162A.870, inclusive, apply to any power of attorney containing the authority to make health care decisions.

Nev. Rev. Stat. § 162A.710 Definitions.

As used in NRS 162A.700 to 162A.870, inclusive, unless the context otherwise requires, the words and terms defined in NRS 162A.715 to 162A.780, inclusive, have the meanings ascribed to them in those sections.

Nev. Rev. Stat. § 162A.715 “Advance health-care directive” defined.

“Advance health-care directive” means a power of attorney for health care.

Nev. Rev. Stat. § 162A.720 “Attending physician” defined.

“Attending physician” means the physician who has primary responsibility for the treatment and care of the patient.

Nev. Rev. Stat. § 162A.730 “Declaration” defined.

“Declaration” means a writing executed in accordance with the requirements of NRS 449A.433.

Nev. Rev. Stat. § 162A.733 Guardian” defined.

“Guardian” means a person appointed under other law by a court to make decisions regarding the personal affairs of an individual, including, without limitation, health care decisions. The term does not include a guardian ad litem.

Nev. Rev. Stat. § 162A.736 Health care” defined.

“Health care” means care, treatment, service or procedure to maintain, monitor, diagnose or otherwise affect the physical or mental illness, injury or condition of an individual.

Nev. Rev. Stat. § 162A.740 “Health care facility” defined.

“Health care facility” includes: 1. Any medical facility as defined in NRS 449.0151 ; 2. Any facility for the dependent as defined in NRS 449.0045 ; and 3. Any agency to provide personal care services in the home as defined in NRS 449B.015 .

Nev. Rev. Stat. § 162A.745 “Intellectual disability” defined.

“Intellectual disability” means significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period.

Nev. Rev. Stat. § 162A.750 “Life-sustaining treatment” defined.

“Life-sustaining treatment” means a medical procedure or intervention that, when administered to a patient, serves only to prolong the process of dying.

Nev. Rev. Stat. § 162A.755 Nursing home” defined.

“Nursing home” means a “nursing facility” as defined in 42 U.S.C. § 1396r(a), as amended, or “skilled nursing facility” as defined in 42 U.S.C. § 1395i–3(a), as amended.

Nev. Rev. Stat. § 162A.760 “Provider of health care” defined.

“Provider of health care” has the meaning ascribed to it in NRS 629.031.

Nev. Rev. Stat. § 162A.770 “Qualified patient” defined.

“Qualified patient” means a patient, 18 years of age or older, who has executed a declaration and who has been determined by the attending physician to be in a terminal condition.

Nev. Rev. Stat. § 162A.780 “Terminal condition” defined.

“Terminal condition” means an incurable and irreversible condition that cannot be cured or modified by any known current medical therapy or treatment, and which, without the administration of life-sustaining treatment, will in the opinion of the attending physician result in death within a relatively short time period.

Nev. Rev. Stat. § 162A.790 Execution of power of attorney; acknowledgment; witnesses; validity of power of attorney executed outside this State.

1. Any adult person may execute a power of attorney enabling the agent named in the power of attorney to make decisions concerning health care for the principal if that principal becomes incapable of giving informed consent concerning such decisions. 2. A power of attorney for health care must be signed by the principal. The principal’s signature on the power of attorney for health care must be: (a) Acknowledged before a notary public; or (b) Witnessed by two adult witnesses. 3. Neither of the witnesses to a principal’s signature may be the owner, operator or employee of a nursing home if the principal resides in the nursing home. 4. A power of attorney executed in a jurisdiction outside of this State is valid in this State if, when the power of attorney was executed, the execution complied with the laws of that jurisdiction or the requirements for a military power of attorney pursuant to 10 U.S.C. § 1044b.

Nev. Rev. Stat. § 162A.800 Nomination of guardian of person; relation of agent to court-appointed guardian; duties of guardian.

1. In a power of attorney for health care, a principal may nominate a guardian of the principal’s person for consideration by the court if guardianship proceedings for the principal’s person are begun after the principal executes the power of attorney. 2. If, after a principal properly executes a nondurable power of attorney for health care pursuant to NRS 162A.790 , a court appoints a guardian of the principal’s person, the nondurable power of attorney is terminated. The guardian shall follow any provisions contained in the nondurable power of attorney for health care delineating the principal’s wishes for medical and end-of-life care. 3. If, after a principal properly executes a durable power of attorney for health care pursuant to NRS 162A.790 , a court appoints a guardian of the principal’s person, the durable power of attorney for health care is suspended and the agent’s authority is not exercisable unless the court orders the termination of the guardianship, and the power of attorney has not otherwise been terminated pursuant to NRS 162A.270 . Upon the court ordering such a termination of the guardianship, the durable power of attorney for health care is effective and no longer suspended pursuant to this subsection and the agent’s authority is exercisable.

Nev. Rev. Stat. § 162A.810 Time at which power of attorney is effective.

1. A power of attorney for health care is effective when executed unless the principal provides in the power of attorney that it becomes effective at a future date or upon incapacity. 2. If a power of attorney for health care becomes effective upon the principal’s incapacity, the power of attorney becomes effective upon a determination in a writing or other record by an advanced practice registered nurse, a physician, psychiatrist or licensed psychologist that the principal is incapacitated. 3. An agent named in the power of attorney for health care may act as the principal’s personal representative pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, as amended, and applicable regulations, to obtain a determination of incapacity.

Nev. Rev. Stat. § 162A.815 Acceptance and reliance upon acknowledged power of attorney.

1. A physician, an advanced practice registered nurse, a health care facility or other provider of health care that in good faith accepts an acknowledged power of attorney for health care without actual knowledge that the signature is not genuine may rely upon the presumption that the signature is genuine. 2. A physician, an advanced practice registered nurse, a health care facility or other provider of health care that in good faith accepts an acknowledged power of attorney for health care without actual knowledge that the power of attorney for health care is void, invalid or terminated, or that the purported agent’s authority is void, invalid or terminated, may rely upon the power of attorney for health care as if the power of attorney for health care were genuine, valid and still in effect, and the agent’s authority was genuine, valid and still in effect. 3. A physician, an advanced practice registered nurse, a health care facility or other provider of health care that in good faith accepts an acknowledged power of attorney for health care is not subject to civil or criminal liability or discipline for unprofessional conduct for giving effect to a declaration contained within the power of attorney for health care or for following the direction of an agent named in the power of attorney for health care.

Nev. Rev. Stat. § 162A.820 Termination of power of attorney or authority of agent.

1. A power of attorney for health care terminates when: (a) The principal dies; (b) The principal revokes the power of attorney; (c) The power of attorney includes a termination date; or (d) The principal revokes the agent’s authority or the agent dies, becomes incapacitated or resigns, and the power of attorney does not provide for another agent to act under the power of attorney. 2. An agent’s authority under a power of attorney for health care terminates when: (a) The principal revokes the authority; (b) The agent dies, becomes incapacitated or resigns; (c) An action is filed for the dissolution or annulment of the agent’s marriage to the principal, unless the power of attorney otherwise provides; or (d) The power of attorney includes a termination date. 3. Unless the power of attorney for health care otherwise provides, an agent’s authority is exercisable until the authority terminates under subsection 2, notwithstanding a lapse of time since the execution of the power of attorney. 4. Termination of an agent’s authority or of a power of attorney for health care is not effective as to the agent or another person that, without actual knowledge of the termination, acts in good faith under the power of attorney. An act so performed, unless otherwise invalid or unenforceable, binds the principal and the principal’s successors in interest. 5. An execution of a power of attorney for health care automatically revokes any previous power of attorney to make health care decisions. 6. If a power of attorney for health care terminates while the principal is unable to make decisions concerning health care, the power of attorney for health care remains valid until the principal is again able to make such decisions.

Nev. Rev. Stat. § 162A.830 Co-agents and successor agents.

1. A principal may designate two or more persons to act as co-agents. Unless the power of attorney for health care otherwise provides, each co-agent may exercise its authority independently. 2. A principal may designate one or more successor agents to act if an agent resigns, dies, becomes incapacitated, is not qualified to serve or declines to serve. Unless the power of attorney for health care otherwise provides, a successor agent: (a) Has the same authority as that granted to the original agent; and (b) May not act until all predecessor agents have resigned, died, become incapacitated, are no longer qualified to serve or have declined to serve.

Nev. Rev. Stat. § 162A.840 Persons not eligible for designation as agent.

1. Except as otherwise provided in subsection 2, a principal may not name as agent in a power of attorney for health care: (a) His or her provider of health care; (b) An employee of his or her provider of health care; (c) An operator of a health care facility; or (d) An employee of a health care facility. 2. A principal may name as agent any person identified in subsection 1 if that person is the spouse, legal guardian or next of kin of the principal.

Nev. Rev. Stat. § 162A.850 Agents: Prohibited acts; decisions concerning use or nonuse of life-sustaining treatment.

1. The agent may not consent to: (a) Commitment or placement of the principal in a facility for treatment of mental illness; (b) Convulsive treatment; (c) Psychosurgery; (d) Sterilization; (e) Abortion; (f) Aversive intervention, as that term is defined in NRS 449A.203 ; (g) Experimental medical, biomedical or behavioral treatment, or participation in any medical, biomedical or behavioral research program; or (h) Any other treatment to which the principal, in the power of attorney for health care, states that the agent may not consent. 2. The agent must make decisions concerning the use or nonuse of life-sustaining treatment which conform to the known desires of the principal. The principal may make these desires known in the power of attorney for health care.

Nev. Rev. Stat. § 162A.855 Advance health-care directive: Form.

The following form may be used to create an advance health-care directive. ADVANCE HEALTH-CARE DIRECTIVE HOW YOU USE THIS FORM You can use this form if you wish to name someone to make health care decisions for you in case you cannot make them for yourself. This is called giving the person you name a power of attorney for health care. The person you name is called your agent. You can also use this form to state your wishes, preferences and goals for health care, and to say if you want to be an organ donor after you die. YOUR NAME AND DATE OF BIRTH Name:...................................................................................... Date of birth:.......................................................................... PART 1: NAMING AN AGENT This part lets you name someone else to make health care decisions for you. You may leave any item blank. (1) NAMING AN AGENT: I want the following person to make health care decisions for me if I cannot make decisions for myself: Name:...................................................................................... Optional contact information (It is helpful to include information such as the person’s address, phone number and email address.):......................................................................................................................... .......................................................................................................................................... (2) NAMING AN ALTERNATE AGENT: I want the following person to make health care decisions for me if I cannot and my agent is not willing, able or reasonably available to make them for me: Name:...................................................................................... Optional contact information (It is helpful to include information such as the person’s address, phone number and email address.):......................................................................................................................... .......................................................................................................................................... (3) LIMITING YOUR AGENT’S AUTHORITY: I give my agent the power to make all health care decisions for me if I cannot make those decisions for myself, except for the following:..................... .......................................................................................................................................... (If you do not add any limitations here, your agent will be able to make all health care decisions that an agent is permitted to make under state law.) PART 2: HEALTH CARE INSTRUCTION This part lets you state your priorities for health care and types of health care you do and do not want. (1) INSTRUCTIONS ABOUT LIFE-SUSTAINING TREATMENT This section gives you the opportunity to say how you want your agent to act while making decisions for you. You may mark or initial each item. You may also leave any item blank. Medical treatment needed to keep me alive but not needed for comfort or any other purpose should (mark all that apply): (__) Always be given to me. (__) Not be given to me if I have a condition that is not curable and is expected to cause my death soon, even if treated. (__) Not be given to me if I am unconscious and I am not expected to be conscious again. (__) Not be given to me if I have a medical condition from which I am not expected to recover that prevents me from communicating with people I care about, caring for myself and recognizing family and friends. (__) Other (write what you want or do not want): If I cannot swallow and staying alive requires me to get liquid or food through a tube or other means for the rest of my life, liquid or food should (mark all that apply): (__) Always be given to me. (__) Not be given to me if I have a condition that is not curable and is expected to cause my death soon, even if treated. (__) Not be given to me if I am unconscious and I am not expected to be conscious again. (__) Not be given to me if I have a medical condition from which I am not expected to recover that prevents me from communicating with people I care about, caring for myself and recognizing family and friends. (__) Other (write what you want or do not want): If I am in significant pain, care that will keep me comfortable but is likely to shorten my life should (mark all that apply): (__) Always be given to me. (__) Never be given to me. (__) Be given to me if I have a condition that is not curable and is expected to cause my death soon, even if treated. (__) Be given to me if I am unconscious and I am not expected to be conscious again. (__) Be given to me if I have a medical condition from which I am not expected to recover that prevents me from communicating with people I care about, caring for myself and recognizing family and friends. (__) Other (write what you want or do not want): (2) INSTRUCTION ABOUT PRIORITIES You can use this section to indicate what is important to you, and what is not important to you. This information can help your agent make decisions for you if you cannot. It also helps others understand your preferences. You may mark or initial each item. You also may leave any item blank. Staying alive as long as possible even if I have substantial physical limitations is: (__) very important (__) somewhat important (__) not important Staying alive as long as possible even if I have substantial mental limitations is: (__) very important (__) somewhat important (__) not important Being free from significant pain is: (__) very important (__) somewhat important (__) not important Being independent is: (__) very important (__) somewhat important (__) not important Having my agent talk with my family before making decisions about my care is: (__) very important (__) somewhat important (__) not important Having my agent talk with my friends before making decisions about my care is: (__) very important (__) somewhat important (__) not important (3) OTHER INSTRUCTIONS You can use this section to provide any other information about your goals, values and preferences for treatment, including care you want or do not want. You can also use this section to name anyone who you do not want to make decisions for you under any conditions. PART 3: OPTIONAL SPECIAL POWERS AND GUIDANCE This part allows you to give your agent additional powers and to provide your agent with more guidance about your wishes. You may mark or initial each item. You also may leave any item blank. (1) OPTIONAL SPECIAL POWERS My agent can do the following things ONLY if I have initialed or marked them below: (__) Admit me as a voluntary patient to a facility for mental health treatment for up to 7 days, 14 days or 30 days (circle one). (If I do not mark or initial this, my agent MAY NOT admit me as a voluntary patient to this type of facility.) (__) Place me in a nursing home for more than 100 days even if my needs can be met somewhere else, I am not terminally ill and I object. (If I do not mark or initial this, my agent MAY NOT do this.) (2) ACCESS TO MY HEALTH INFORMATION My agent may obtain, examine and share information about my health needs and health care if I am not able to make decisions for myself. If I initial or mark below, my agent may also do this at any time he or she thinks it will help me. (__) I give my agent permission to obtain, examine and share information about my health needs and health care whenever he or she thinks it will help me. (3) GUIDANCE FOR MY AGENT The instructions I have stated in this document should guide my agent in making decisions for me (initial or mark one of the below items to tell your agent more about how to use these instructions): (__) I give my agent permission to be flexible in applying these instructions if he or she thinks it would be in my best interest based on what they know about me. (__) I want my agent to follow these instructions exactly as written if possible, even if he or she thinks something else is better. (4) NOMINATION OF GUARDIAN Here you can say who you would want as your guardian if you need one. A guardian is a person appointed by a court to make decisions for someone who cannot make decisions. Filling this out does NOT mean you want or need a guardian right now. If a court appoints a guardian to make personal decisions for me, I want the court to choose: (__) My agent named in this form. If my agent cannot be a guardian, I want my alternate agent named in this form. (__) Other (write who you would want and their contact information):...... PART 4: ORGAN DONATION This part allows you to donate your organs when you die. You may mark or initial each item. You also may leave any item blank. Even if it requires maintaining treatments that could prolong my dying process and might be in conflict with other instructions I have put in this form, upon my death: (__) I donate my organs, tissues and other body parts, except for those listed below (list any body parts you do not want to donate):.................................................................................................... (__) I do not want my organs, tissues or body parts donated to anybody for any reason. Organs, tissues or body parts that I donate may be used for: (__) transplant (__) therapy (__) research (__) education (__) all of the above PART 5: SIGNATURES REQUIRED ON THIS FORM YOUR SIGNATURE Sign your name:..................................................................... Today’s date:.......................................................................... SIGNATURE OF WITNESSES You need two witnesses if you are using this form to name an agent. The witnesses must be adults and cannot be the person you are naming as agent. If you live in a nursing home, the witness cannot be an employee of the home or someone who owns or runs the home. Witness name:........................................................................ Witness signature:................................................................. .................................................................................................. Date witness signed:............................................................. (Only sign as a witness if you think that the person signing above is doing it voluntarily.) Witness name:........................................................................ Witness signature:................................................................. .................................................................................................. Date witness signed:............................................................. (Only sign as a witness if you think that the person signing above is doing it voluntarily.) PART 6: INFORMATION FOR AGENTS (1) If this form names you as an agent, you can make decisions about health care for the person who named you when they cannot make their own. (2) If you make a decision for the person, follow any instructions the person gave, including any in this form. (3) If you make a decision for the person and you don’t know what the person would want, make the decision that you think is in the person’s best interest. To figure out what is in the person’s best interest, consider the person’s values, preferences and goals if you know them or can learn them. Some of those preferences might be in this form. You should also consider any behaviors or communications from the person that indicate what they currently want. (4) If this form names you as an agent, you can also get and share the individual’s health information. But unless the person has said so in this form, you can only get or share this information when the person cannot make their own decisions about their health care.

Nev. Rev. Stat. § 162A.865 Power of attorney for adult with intellectual disability: Form.

1. The form of a power of attorney for health care for an adult with an intellectual disability may be substantially in the following form, and must be witnessed or executed in the same manner as the following form: DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS My name is.................... (insert your name) and my address is.................... (insert your address). I would like to designate.................... (insert the name of the person you wish to designate as your agent for health care decisions for you) as my agent for health care decisions for me if I am sick or hurt and need to see a doctor or an advanced practice registered nurse or go to the hospital. I understand what this means. If I am sick or hurt, my agent should take me to the doctor or an advanced practice registered nurse. If my agent is not with me when I become sick or hurt, please contact my agent and ask him or her to come to the doctor’s or advanced practice registered nurse’s office. I would like the doctor or advanced practice registered nurse to speak with my agent and me about my sickness or injury and whether I need any medicine or other treatment. After we speak with the doctor or advanced practice registered nurse, I would like my agent to speak with me about the care or treatment. When we have made decisions about the care or treatment, my agent will tell the doctor or advanced practice registered nurse about our decisions and sign any necessary papers. If I am very sick or hurt, I may need to go to the hospital. I would like my agent to help me decide if I need to go to the hospital. If I go to the hospital, I would like the people who work at the hospital to try very hard to care for me. If I am able to communicate, I would like the doctor or advanced practice registered nurse at the hospital to speak with me and my agent about what care or treatment I should receive, even if I am unable to understand what is being said about me. After we speak with the doctor or advanced practice registered nurse, I would like my agent to help me decide what care or treatment I should receive. Once we decide, my agent will sign any necessary paperwork. If I am unable to communicate because of my illness or injury, I would like my agent to make decisions about my care or treatment based on what he or she thinks I would do and what is best for me. I would like my agent to help me decide if I need to see a dentist and help me make decisions about what care or treatment I should receive from the dentist. Once we decide, my agent will sign any necessary paperwork. I would also like my agent to be able to see and have copies of all my medical records. If my agent requests to see or have copies of my medical records, please allow him or her to see or have copies of the records. I understand that my agent cannot make me receive any care or treatment that I do not want. I also understand that I can take away this power from my agent at any time, either by telling my agent that he or she is no longer my agent or by putting it in writing. If my agent is unable to make health care decisions for me, then I designate.................... (insert the name of another person you wish to designate as your alternative agent to make health care decisions for you) as my agent to make health care decisions for me as authorized in this document. (YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY) I sign my name to this Durable Power of Attorney for Health Care on .............. (date) at .............................. (city), ......................... (state) ....................................................... (Signature) AGENT SIGNATURE As agent for.......... (insert name of principal), I agree that a physician, advanced practice registered nurse, health care facility or other provider of health care, acting in good faith, may rely on this power of attorney for health care and the signatures herein, and I understand that pursuant to NRS 162A.815 , a physician, advanced practice registered nurse, health care facility or other provider of health care that in good faith accepts an acknowledged power of attorney for health care is not subject to civil or criminal liability or discipline for unprofessional conduct for giving effect to a declaration contained within the power of attorney for health care or for following the direction of an agent named in the power of attorney for health care. I also agree that: 1. I have a duty to act in a manner consistent with the desires of.......... (insert name of principal) as stated in this document or otherwise made known by.......... (insert name of principal), or if his or her desires are unknown, to act in his or her best interest. 2. If.......... (insert name of principal) revokes this power of attorney at any time, either verbally or in writing, I have a duty to inform any persons who may rely on this document, including, without limitation, treating physicians, advanced practice registered nurses, hospital staff or other providers of health care, that I no longer have the authorities described in this document. 3. The provisions of NRS 162A.840 prohibit me from being named as an agent to make health care decisions in this document if I am a provider of health care, an employee of the principal’s provider of health care or an operator or employee of a health care facility caring for the principal, unless I am the spouse, legal guardian or next of kin of the principal. 4. The provisions of NRS 162A.850 prohibit me from consenting to the following types of care or treatments on behalf of the principal, including, without limitation: (a) Commitment or placement of the principal in a facility for treatment of mental illness; (b) Convulsive treatment; (c) Psychosurgery; (d) Sterilization; (e) Abortion; (f) Aversive intervention, as it is defined in NRS 449A.203 ; (g) Experimental medical, biomedical or behavioral treatment, or participation in any medical, biomedical or behavioral research program; or (h) Any other care or treatment to which the principal prohibits the agent from consenting in this document. 5. End-of-life decisions must be made according to the wishes of.......... (insert name of principal), as designated in the attached addendum. If his or her wishes are not known, such decisions must be made in consultation with the principal’s treating physicians or advanced practice registered nurses. Signature: .............................................. Residence Address: .................................. Print Name: .................................................................................................................. Date: .............................................................................................................................. Relationship to principal: ........................................................................................... Length of relationship to principal: .......................................................................... (THIS POWER OF ATTORNEY WILL NOT BE VALID FOR MAKING HEALTH CARE DECISIONS UNLESS IT IS EITHER (1) SIGNED BY AT LEAST TWO QUALIFIED WITNESSES WHO YOU KNOW AND WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE OR (2) ACKNOWLEDGED BEFORE A NOTARY PUBLIC.) CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC (You may use acknowledgment before a notary public instead of the statement of witnesses.) State of Nevada } }ss. County of................................................ } On this.......... day of.........., in the year...., before me,.......... (here insert name of notary public) personally appeared.......... (here insert name of principal) personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to this instrument, and acknowledged that he or she executed it. NOTARY SEAL ....................................................... (Signature) STATEMENT OF WITNESSES (If you choose to use witnesses instead of having this document notarized, you must use two qualified adult witnesses. The following people cannot be used as a witness: (1) a person you designate as the agent; (2) a provider of health care; (3) an employee of a provider of health care; (4) the operator of a health care facility; or (5) an employee of an operator of a health care facility. At least one of the witnesses must make the additional declaration set out following the place where the witnesses sign.) I declare under penalty of perjury that the principal is personally known to me, that the principal signed or acknowledged this durable power of attorney in my presence, that the principal appears to be of sound mind and under no duress, fraud or undue influence, that I am not the person appointed as agent by this document and that I am not a provider of health care, an employee of a provider of health care, the operator of a health care facility or an employee of an operator of a health care facility. Signature: .............................................. Residence Address: .................................. Print Name: .................................................................................................................. Date: ............................................ ................................................................................. Signature: .............................................. Residence Address: .................................. Print Name: .................................................................................................................. Date: .............................................................................................................................. (AT LEAST ONE OF THE ABOVE WITNESSES MUST ALSO SIGN THE FOLLOWING DECLARATION.) I declare under penalty of perjury that I am not related to the principal by blood, marriage or adoption and that to the best of my knowledge, I am not entitled to any part of the estate of the principal upon the death of the principal under a will now existing or by operation of law. Signature: .................................... Signature: .................................... Names: ................................................... Address: ..................................................... Print Name: .................................................................................................................. Date: .............................................................................................................................. COPIES: You should retain an executed copy of this document and give one to your agent. The power of attorney should be available so a copy may be given to your providers of health care. 2. The form for end-of-life decisions of a power of attorney for health care for an adult with an intellectual disability may be substantially in the following form, and must be witnessed or executed in the same manner as the following form: END-OF-LIFE DECISIONS ADDENDUM STATEMENT OF DESIRES (You can, but are not required to, state what you want to happen if you get very sick and are not likely to get well. You do not have to complete this form, but if you do, your agent must do as you ask if you cannot speak for yourself.) .................... (Insert name of agent) might have to decide, if you get very sick, whether to continue with your medicine or to stop your medicine, even if it means you might not live..................... (Insert name of agent) will talk to you to find out what you want to do, and will follow your wishes. If you are not able to talk to.................... (insert name of agent), you can help him or her make these decisions for you by letting your agent know what you want. Here are your choices. Please circle yes or no to each of the following statements and sign your name below: 1. I want to take all the medicine and receive any treatment I can to keep me alive regardless of how the medicine or treatment makes me feel. YES NO 2. I do not want to take medicine or receive treatment if my doctors or advanced practice registered nurses think that the medicine or treatment will not help me. YES NO 3. I do not want to take medicine or receive treatment if I am very sick and suffering and the medicine or treatment will not help me get better. YES NO 4. I want to get food and water even if I do not want to take medicine or receive treatment. YES NO (YOU MUST DATE AND SIGN THIS END-OF-LIFE DECISIONS ADDENDUM) I sign my name to this End-of-Life Decisions Addendum on .............. (date) at .............................. (city), ......................... (state) ....................................................... (Signature) (THIS END-OF-LIFE DECISIONS ADDENDUM WILL NOT BE VALID UNLESS IT IS EITHER (1) SIGNED BY AT LEAST TWO QUALIFIED WITNESSES WHO YOU KNOW AND WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE OR (2) ACKNOWLEDGED BEFORE A NOTARY PUBLIC.) CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC (You may use acknowledgment before a notary public instead of the statement of witnesses.) State of Nevada } }ss. County of................................................ } On this.......... day of.........., in the year...., before me,.......... (here insert name of notary public) personally appeared.......... (here insert name of principal) personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to this instrument, and acknowledged that he or she executed it. NOTARY SEAL ....................................................... (Signature) STATEMENT OF WITNESSES (If you choose to use witnesses instead of having this document notarized, you must use two qualified adult witnesses. The following people cannot be used as a witness: (1) a person you designate as the agent; (2) a provider of health care; (3) an employee of a provider of health care; (4) the operator of a health care facility; or (5) an employee of an operator of a health care facility. At least one of the witnesses must make the additional declaration set out following the place where the witnesses sign.) I declare under penalty of perjury that the principal is personally known to me, that the principal signed or acknowledged this End-of-Life Decisions Addendum in my presence, that the principal appears to be of sound mind and under no duress, fraud or undue influence, that I am not the person appointed as agent by the power of attorney for health care and that I am not a provider of health care, an employee of a provider of health care, the operator of a health care facility or an employee of an operator of a health care facility. Signature: .............................................. Residence Address: .................................. Print Name: .................................................................................................................. Date: .............................................................................................................................. Signature: .................................... ......... Residence Address: .................................. Print Name: .................................................................................................................. Date: .............................................................................................................................. (AT LEAST ONE OF THE ABOVE WITNESSES MUST ALSO SIGN THE FOLLOWING DECLARATION.) I declare under penalty of perjury that I am not related to the principal by blood, marriage or adoption and that to the best of my knowledge, I am not entitled to any part of the estate of the principal upon the death of the principal under a will now existing or by operation of law. Signature: .................................... Signature: .................................... Names: ................................................... Address: ..................................................... Print Name: .................................................................................................................. Date: .............................................................................................................................. COPIES: You should retain an executed copy of this document and give one to your agent. The End-of-Life Decisions Addendum should be available so a copy may be given to your providers of health care.

Nev. Rev. Stat. § 162A.870 Power of attorney for adult with dementia: Form.

1. The form of a power of attorney for health care for an adult with any form of dementia may be substantially in the following form, and must be witnessed or executed in the same manner as the following form: DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS My name is.................... (insert your name) and my address is.................... (insert your address). I would like to designate.................... (insert the name of the person you wish to designate as your agent for health care decisions for you) as my agent for health care decisions for me if I am sick or hurt and need to see a doctor or go to the hospital. I understand what this means. If I am sick or hurt, my agent should take me to the doctor. If my agent is not with me when I become sick or hurt, please contact my agent and ask him or her to come to the doctor’s office. I would like the doctor to speak with my agent and, if I have the capacity to understand, me about my sickness or injury and whether I need any medicine or other treatment. After we speak with the doctor, if I have the capacity to understand, I would like my agent to speak with me about the care or treatment. When we have made decisions about the care or treatment, my agent will tell the doctor about our decisions and sign any necessary papers. If I am very sick or hurt, I may need to go to the hospital. I would like my agent to help me decide if I need to go to the hospital. If I go to the hospital, I would like the people who work at the hospital to try very hard to care for me. If I am able to communicate, I would like the doctor at the hospital to speak with me and my agent about what care or treatment I should receive, even if I am unable to understand what is being said about me. After we speak with the doctor, I would like my agent to help me decide what care or treatment I should receive. Once we decide, my agent will sign any necessary paperwork. If I am unable to communicate because of my illness or injury, I would like my agent to make decisions about my care or treatment based on what he or she thinks I would do and what is best for me. I would like my agent to help me decide if I need to see a dentist and help me make decisions about what care or treatment I should receive from the dentist. Once we decide, my agent will sign any necessary paperwork. I would also like my agent to be able to see and have copies of all my medical records. If my agent requests to see or have copies of my medical records, please allow him or her to see or have copies of the records. I understand that my agent cannot make me receive any care or treatment that I do not want. I also understand that I can take away this power from my agent at any time, either by telling my agent that he or she is no longer my agent or by putting it in writing. If my agent is unable to make health care decisions for me, then I designate.................... (insert the name of another person you wish to designate as your alternative agent to make health care decisions for you) as my agent to make health care decisions for me as authorized in this document. (YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY) I sign my name to this Durable Power of Attorney for Health Care on .............. (date) at .............................. (city), ......................... (state) ....................................................... (Signature) AGENT SIGNATURE As agent for.......... (insert name of principal), I agree that a physician, health care facility or other provider of health care, acting in good faith, may rely on this power of attorney for health care and the signatures herein, and I understand that pursuant to NRS 162A.815 , a physician, health care facility or other provider of health care that in good faith accepts an acknowledged power of attorney for health care is not subject to civil or criminal liability or discipline for unprofessional conduct for giving effect to a declaration contained within the power of attorney for health care or for following the direction of an agent named in the power of attorney for health care. I also agree that: 1. I have a duty to act in a manner consistent with the desires of.......... (insert name of principal) as stated in this document or otherwise made known by.......... (insert name of principal), or if his or her desires are unknown, to act in his or her best interest. 2. If.......... (insert name of principal) revokes this power of attorney at any time, either verbally or in writing, I have a duty to inform any persons who may rely on this document, including, without limitation, treating physicians, hospital staff or other providers of health care, that I no longer have the authorities described in this document. 3. The provisions of NRS 162A.840 prohibit me from being named as an agent to make health care decisions in this document if I am a provider of health care, an employee of the principal’s provider of health care or an operator or employee of a health care facility caring for the principal, unless I am the spouse, legal guardian or next of kin of the principal. 4. The provisions of NRS 162A.850 prohibit me from consenting to the following types of care or treatments on behalf of the principal, including, without limitation: (a) Commitment or placement of the principal in a facility for treatment of mental illness; (b) Convulsive treatment; (c) Psychosurgery; (d) Sterilization; (e) Abortion; (f) Aversive intervention, as it is defined in NRS 449A.203 ; (g) Experimental medical, biomedical or behavioral treatment, or participation in any medical, biomedical or behavioral research program; or (h) Any other care or treatment to which the principal prohibits the agent from consenting in this document. 5. End-of-life decisions must be made according to the wishes of.......... (insert name of principal), as designated in the attached addendum. If his or her wishes are not known, such decisions must be made in consultation with the principal’s treating physicians. Signature: .............................................. Residence Address: .................................. Print Name: .................................................................................................................. Date: .............................................................................................................................. Relationship to principal: ........................................................................................... Length of relationship to principal: .......................................................................... (THIS POWER OF ATTORNEY WILL NOT BE VALID FOR MAKING HEALTH CARE DECISIONS UNLESS IT IS EITHER (1) SIGNED BY AT LEAST TWO QUALIFIED WITNESSES WHO YOU KNOW AND WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE OR (2) ACKNOWLEDGED BEFORE A NOTARY PUBLIC.) CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC (You may use acknowledgment before a notary public instead of the statement of witnesses.) State of Nevada } }ss. County of ............................................... } On this.......... day of.........., in the year...., before me,.......... (here insert name of notary public) personally appeared.......... (here insert name of principal) personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to this instrument, and acknowledged that he or she executed it. NOTARY SEAL ....................................................... (Signature) STATEMENT OF WITNESSES (If you choose to use witnesses instead of having this document notarized, you must use two qualified adult witnesses. The following people cannot be used as a witness: (1) a person you designate as the agent; (2) a provider of health care; (3) an employee of a provider of health care; (4) the operator of a health care facility; or (5) an employee of an operator of a health care facility. At least one of the witnesses must make the additional declaration set out following the place where the witnesses sign.) I declare under penalty of perjury that the principal is personally known to me, that the principal signed or acknowledged this durable power of attorney in my presence, that the principal appears to be of sound mind and under no duress, fraud or undue influence, that I am not the person appointed as agent by this document and that I am not a provider of health care, an employee of a provider of health care, the operator of a health care facility or an employee of an operator of a health care facility. Signature: .............................................. Residence Address: .................................. Print Name: .................................................................................................................. Date: .............................................................................................................................. Signature: .............................................. Residence Address: .................................. Print Name: .................................................................................................................. Date: .............................................................................................................................. (AT LEAST ONE OF THE ABOVE WITNESSES MUST ALSO SIGN THE FOLLOWING DECLARATION.) I declare under penalty of perjury that I am not related to the principal by blood, marriage or adoption and that to the best of my knowledge, I am not entitled to any part of the estate of the principal upon the death of the principal under a will now existing or by operation of law. Signature: .................................... Signature: .................................... -------------------------------------------------------------------------------------------------------- Names: ................................................... Address: ..................................................... Print Name: .................................................................................................................. Date: .............................................................................................................................. COPIES: You should retain an executed copy of this document and give one to your agent. The power of attorney should be available so a copy may be given to your providers of health care. 2. The form for end-of-life decisions of a power of attorney for health care for an adult with any form of dementia may be substantially in the following form, and must be witnessed or executed in the same manner as the following form: END-OF-LIFE DECISIONS ADDENDUM STATEMENT OF DESIRES (You can, but are not required to, state what you want to happen if you get very sick and are not likely to get well. You do not have to complete this form, but if you do, your agent must do as you ask if you cannot speak for yourself.) .................... (Insert name of agent) might have to decide, if you get very sick, whether to continue with your medicine or to stop your medicine, even if it means you might not live, ..................... (Insert name of agent) will talk to you to find out what you want to do, and will follow your wishes. If you are not able to talk to.................... (insert name of agent), you can help him or her make these decisions for you by letting your agent know what you want. Here are your choices. Please circle yes or no to each of the following statements and sign your name below: 1. I want to take all the medicine and receive any treatment I can to keep me alive regardless of how the medicine or treatment makes me feel. YES NO 2. I do not want to take medicine or receive treatment if my doctors think that the medicine or treatment will not help me. YES NO 3. I do not want to take medicine or receive treatment if I am very sick and suffering and the medicine or treatment will not help me get better. YES NO 4. I want to get food and water even if I do not want to take medicine or receive treatment. YES NO (YOU MUST DATE AND SIGN THIS END-OF-LIFE DECISIONS ADDENDUM) I sign my name to this End-of-Life Decisions Addendum on .............. (date) at ...................... (city), .................... (state) ....................................................... (Signature) (THIS END-OF-LIFE DECISIONS ADDENDUM WILL NOT BE VALID UNLESS IT IS EITHER (1) SIGNED BY AT LEAST TWO QUALIFIED WITNESSES WHO YOU KNOW AND WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE; OR (2) ACKNOWLEDGED BEFORE A NOTARY PUBLIC.) CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC (You may use acknowledgment before a notary public instead of the statement of witnesses.) State of Nevada } }ss. County of ............................................... } On this.......... day of.........., in the year...., before me,.......... (here insert name of notary public) personally appeared.......... (here insert name of principal) personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to this instrument, and acknowledged that he or she executed it. NOTARY SEAL ....................................................... (Signature) STATEMENT OF WITNESSES (If you choose to use witnesses instead of having this document notarized, you must use two qualified adult witnesses. The following people cannot be used as a witness: (1) a person you designate as the agent; (2) a provider of health care; (3) an employee of a provider of health care; (4) the operator of a health care facility; or (5) an employee of an operator of a health care facility. At least one of the witnesses must make the additional declaration set out following the place where the witnesses sign.) I declare under penalty of perjury that the principal is personally known to me, that the principal signed or acknowledged this End-of-Life Decisions Addendum in my presence, that the principal appears to be of sound mind and under no duress, fraud or undue influence, that I am not the person appointed as agent by the power of attorney for health care and that I am not a provider of health care, an employee of a provider of health care, the operator of a health care facility or an employee of an operator of a health care facility. Signature: .............................................. Residence Address: .................................. Print Name: .................................................................................................................. Date: .............................................................................................................................. Signature: .............................................. Residence Address: .................................. Print Name: .................................................................................................................. Date: .............................................................................................................................. (AT LEAST ONE OF THE ABOVE WITNESSES MUST ALSO SIGN THE FOLLOWING DECLARATION.) I declare under penalty of perjury that I am not related to the principal by blood, marriage or adoption and that to the best of my knowledge, I am not entitled to any part of the estate of the principal upon the death of the principal under a will now existing or by operation of law. Signature: .................................... Signature: .................................... -------------------------------------------------------------------------------------------------------- Names: ................................................... Address: ..................................................... Print Name: .................................................................................................................. Date: .............................................................................................................................. COPIES: You should retain an executed copy of this document and give one to your agent. The End-of-Life Decisions Addendum should be available so a copy may be given to your providers of health care.
Source: NV Statutes (Official Site)URL: https://www.leg.state.nv.us/nrs/NRS-162A.htmlFetched: 10/4/2026

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