AMERICAN CRYONICS SOCIETY

E- Mail: cryonics@AmericanCryonics.org, Web Page: http://AmericanCryonics.org

MAILING ADDRESS: P.O. Box 1509, Cupertino, CA 95015

FAX: (801)720-9001 PHONE: 1-800-523-2001

Cryonic Suspension Forms

People who wish to participate in the suspension program of the American Cryonics Society, Inc. ("ACS") must do three things:

One: Become a member of the American Cryonics Society and pay regular membership dues (see "Membership Application").

Two: Give ACS the legal authority to perform a suspension.

Three: Provide funding for the cryonic suspension experiment which consists of: the initial freezing; indefinite long-term maintenance; research; and future revival attempts (if any).

While ACS makes no guarantees of future success or the adequacy of funds, we provide funding guidelines (see "Minimum Recommended Funding") based upon projecting present costs to future situations.

Candidates fill out a set of forms, and provide funding (often through a life insurance policy). The following is a list of the forms needed with several choices of "forms packs" given below. The forms are indexed so you may go directly to the on-line form, fill it out, and US mail it back to us. Your suspension arrangements are *not* in place, and ACS has no responsibility for you, until you send us evidence of insurance coverage, and pay membership dues.

Our "on-line" net page forms consist only of items one through five of "A. The Suspension Forms Pack." These may be downloaded free of charge from our website: HTTP://americancryonics.org; or by first-class mail. We request a $15.00 donation for the mailed forms to help defray the costs of printing and mailing. To obtain other forms you must first become a Full or Associate member of ACS. Please note that all forms are copyright ACS and may be used only by people seeking to become ACS members.

Applicants may also wish to participate in the ACS-CI, co-op membership plan. Under this plan the member is entitled to all benefits of both CI and ACS membership, with long-term cryogenic storage at the Cryonics Institute's facility near Detroit. The full particulars of this Co-0p plan are presented elsewhere. In addition to the ACS documents, plan participants should complete a CI Suspension Contract, available for free download at: HTTP://www.cryonics.org. Alternatively, ACS will mail you this document along with your sign-up forms pack.

A. The Suspension Forms Package

The most common way members fund their suspension and give ACS the legal authority to freeze them is by use of our Suspension Forms Package, formerly called "California Short Forms".

As it is now packaged, the only form in this pack that is unique to California is the Will Form. People outside California would either not use a Will at all (relying on authority of the Uniform Anatomical Gift Act alone) or take the example Will Form to their own lawyer and have him/her draft a version for that state. The "Agreement for Suspension Membership in the American Cryonics Society, Inc." may act as a simple Will on suspension instructions. Note, however, that this form alone should not be relied upon as a Will since requirements for executing a Will vary from state to state. Be sure and check to see that any Wills you have previously executed do not direct that you be cremated or buried so you may immediately countermand any such instructions in a new Will form.

In the "Agreement" the member instructs ACS to establish a trust or dedicated fund for him, which ACS need not do until after his death. The advantage to this approach is it does not require a lawyer's assistance (although we recommend review by your attorney). Another advantage to use of the "agreement" is that periodic reviews and trust update (as trust law evolves) are not required.

Filling out PDF forms.

Viewing forms requires the Adobe Acrobat free viewer or Acrobat editor. You can, if you like, fill in many of the form blanks on your computer, then print the form, filled out with neat printing. But with the free viewer, you CANNOT save the form field contents on your PC. You can if you happen to have the full Acrobat editor. You can also just print the form and fill it out by hand later, or some combination of the two.

The Suspension Forms Package consists of:

1. American Cryonics Society Application for Membership (with this form people become "full" members of ACS)

2. Agreement for Suspension Membership (PDF) in the American Cryonics Society, Inc.

(appended: "Recommended Minimum Funding for participants in the ACS Cryonic Suspension Program")

3. Authorization of Anatomical Donation (PDF)

4. Consent for Cryopreservation (PDF)

5. Certificate of Religious Belief (PDF)

6. Agreement by Family Member (PDF) (optional, but recommended)

7. Last Will and Testiment Regarding the Disposition of My Human Remains (California only, optional but recommended)

B. The Trust Forms Package

The Trust Forms Pack is for people who wish to establish a testamentary trust themselves. The model trust, and will and trust, are model documents attorney Jim Bianchi prepared for us after his review of 1992. They are for reference by your attorney in drafting an individual trust.

The Trust Forms Pack consists of:

1. American Cryonics Society Application for Membership

(with this form people become "full" members of ACS)

2. Charitable Trust for Cryonic Research (sample and explanation)

3. Charitable Trust for Cryonic Research ("fill in the blanks" form)

4. Will and Charitable Trust (sample, and explanation)

5. Will and Charitable Trust ("fill in the blanks" form)

People using the Trust Forms Pack should also fill out:

6. Authorization of Anatomical Donation

7. Consent for Cryopreservation

8. Certificate of Religious Belief

9. Agreement by Family Member (optional, but recommended)

C. The Durable Power of Attorney Package

The Durable Power of Attorney forms pack consists of supplemental forms that could be especially useful for a member who expects opposition from a relative, or even local authorities. It provides forms to designate a trusted friend or family member who is empowered to make interment and health care decisions. This includes the authority to direct that the member be suspended, but disallows the third party to make decisions contrary to the member's wish to be suspended. Either the Suspension Forms Pack (A. above) or the Trust Forms Pack (B. above) should be completed as well. Please note that the Durable Power of Attorney for Health Care form is a California form. Similar forms for other states are available from health care providers in those states.

a. Durable Power of Attorney for Health Care.

b. Living Will Statement of Desires, Special Provisions, and Limitations.

(This document is an attachment to the Durable Power of Attorney for Health Care form {above} but is also is intended to be able to stand alone as a Living Will.)

c. Designation of Person to Control Interment Arrangements Upon Death.

D. The Authorization of Anatomical Donation by a Relative Forms Package.

This forms pack is for a relative of someone who has just died (the "patient"), or is otherwise unable to complete these forms for him or her self.

1. American Cryonics Society Application for Membership

(with this form a member of the patient's family becomes a "full" member of ACS)

2. Authorization of Anatomical Donation by a Relative form

3. Agreement for Suspension Membership in the American Cryonics Society, Inc. (filled out on behalf of the person to be suspended).

4. Contract or Agreement with the Relative (optional). Written on a case-by-case basis. No standard form covers this Agreement

Document name and path: 99 Suspension Forms Explanation

Reviewed and updated: March, 2007