Attesting Affidavit

Affidavit Of Attesting Witnesses

State Of )
County Of )

Each of the undersigned, individually and severally being duly sworn, deposes and says:

The Will to which this affidavit is attached was subscribed by the testator therein named, in
the presence and sight of each of us, who were the attesting witnesses thereto, on , at the
City of , .

Said testator was at the time of so executing said Will, over the age of 18 years, and in the opinion
of each of the undersigned, of sound mind, memory and understanding and not under any
restraint, or in any respect incompetent to make a will. Said testator could read, write and
converse in the English language and, in the opinion of each of the undersigned, was suffering
from no defect of sight, hearing or speech or from any other physical, verbal or mental impairment
that would affect her capacity to make a valid will.

Said testator at the time of making such subscription declared the instrument so subscribed to be
his Last Will. The attached Will was executed as a single, original instrument and was not
executed in counterparts. The undersigned thereupon signed their names as attesting witnesses at
the end of said Will at the request of said testator and in his presence and sight and in the presence
and sight of each other.

Each of the undersigned was acquainted with said testator at the time of such execution of the
Will and makes this affidavit at his request. The original Will to which this affidavit is attached
was shown to each of the undersigned at the time this affidavit was made and examined by each of
the undersigned as to the signature of said testator and the undersigned.

The attached Will was executed by said testator and witnessed by each of the undersigned as the
attesting witnesses under the supervision of , an attorney-at-law admitted to practice in the
State of , in accordance with those applicable provisions of the Estates, Powers and Trusts
Law of the State of governing the execution and attestation of wills.
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SEVERALLY SWORN to before me this )

_____ day of , . )
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Notary Public )
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