WPCL 2 ZB;0_HP LaserJet IIIXN\  PXP#XxP7XP#Lrhd/G/D/ioI&G Letterhead/ GMK/Date/io0#XxP7XP# XX  XX  X # *0 x7#t Ikard & Golden, p.c.   #X*0 x7X#!attorneys & counselors  L 8"X#f*0 x7#4Frank N. Ikard, Jr. *l%823 Congress AvenueH $DCorrespondence: ʘAlvin J. Golden *(Suite 910& $DP. O. Box 684367 ZGlenn M. Karisch *z%Austin, Texas 78701$BAustin, Texas 787684367 Jerry Frank Jones (Of Counsel) *T'512/4726695 $DFax 512/4723669 #^T*0 x7^#* Board Certified ʨEstate Planning & Probate Law%email: karisch@io.com#f*0 x 7#$DWriters Direct Line 8#^T P 7^P#Texas Board of Legal Specialization http://www.io.com/user/karisch/ikard&golden.html#f P 7P#ʠ $E512/4724542    XX ` hp x (#%#XxP 7XP# ,$ 3 1, 4 XN\  PXPx9 Z6Times New Roman RegularXXxP7XPH` AZ0Univers (WN) RegularX D\  P Px9 Z6Times New Roman Regular XxP7XPH` AZ0Univers (WN) RegularXXxP7XPH` AZ0Univers (WN) RegularX *0 x7* `(CG TimesScalableX*0 x7X* `(CG TimesScalableXf*0 x7* `(CG TimesScalable^T*0 x7^* `(CG TimesScalable^f*0 x 7* `(CG TimesScalable^T P 7^PG  Z 2CG Times (WN) Regular^f P 7PG  Z 2CG Times (WN) RegularXxP 7XPH` AZ0Univers (WN) RegularX2BJ3|x# D\  P P# GUARDIAN-ADULT DECLARATION OF GUARDIAN IN THE EVENT OF H LATER INCAPACITY OR NEED OF GUARDIAN ă I, ______________________, make this Declaration of Guardian, to operate if the need for a guardian for me later arises. 1. I designate ___________________ to serve as guardian of my person, _______________________ as first alternate guardian of my person, _______________________ as second alternate guardian of my person, and ______________________ as third alternate guardian of my person. 2. I designate ___________________ to serve as guardian of my estate, ________________________ as first alternate guardian of my estate, _____________________ as second alternate guardian of my estate, and ___________________ __ as third alternate guardian of my estate. 3. If any guardian or alternate guardian dies, does not qualify, or resigns, the next named alternate guardian becomes my guardian. 4. I expressly disqualify the following persons from serving as guardian of my person: _____________________, ________________________, and _________________________. 5. I expressly disqualify the following persons from serving as guardian of my estate: _____________________, ________________________, and _________________________. Signed this ___ day of __________, 19___. ______________________________________ Declarant _______________________________________________________________________________ Witness` ` ` hhhWitness !SELF-PROVING AFFIDAVIT Before me, the undersigned authority, on this date personally appeared the declarant, and ______________________________ and ___________________________ as witnesses, and all being duly sworn, the declarant said that the above instrument was his or her Declaration of Guardian and that the declarant had made and executed it for the purposes expressed in the declaration. The witnesses declared to me that they are each 14 years of age or older, that they saw the declarant sign the declaration, that they signed the declaration as witnesses, and that the declarant appeared to them to be of sound mind. _____________________________________ Declarant ______________________________________________________________________________ Affiant` ` ` hhhAffiant Subscribed and sworn to before me by the above named declarant and affiants on this ____ day of __________, 19__. ` ` ` hhh_________________________________________ ` ` ` hhhNotary Public in and for the State of Texas ` ` ` hhhMy Commission expires: _____________________ #XxP7XP#