I,
Jan Dieckmann,
born on 26 June 1980 in Herford (NRW, Germany),
currently with no registered address,
hereby declare that, in the event that my death has been medically certified and my organs and tissues are suitable for transplantation they may be taken. I have set out details and information regarding my medical care should I be unconscious and unresponsive in my advance healthcare directive. The following document is in my luggage:
