This Self-Proving Affidavit (the “Affidavit”) is made on [Date] and relates to the Last Will and Testament of:
Testator: [Full Legal Name]
Address (Optional): [Address]
Date of Will: [Date Will Was Signed] (the “Will”)
1. Statement of Testator
1.1 I, [Testator Full Name], declare that I signed (or acknowledged my signature on) the Will on the date stated above.
1.2 I signed the Will willingly, for the purposes stated in the Will, and not under duress or undue influence.
1.3 At the time of signing, I was of legal age to make a will and of sound mind (as required by applicable law).
1.4 I requested the witnesses listed below to witness the signing of my Will.
2. Statement of Witnesses
2.1 We, the undersigned witnesses, declare that:
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The Testator signed the Will (or acknowledged the signature) in our presence.
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We signed the Will as witnesses in the Testator’s presence and in the presence of each other (if required).
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The Testator appeared to be of sound mind and acting voluntarily.
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To the best of our knowledge, we are not disqualified as witnesses under applicable law.
3.1 Witness 1:
3.2 Witness 2:
4. Optional Additional Statements
4.1 ☐ The Will was signed using a self-proving affidavit procedure permitted under the laws of [State].
4.2 ☐ Additional statement(s) required by local law: [Insert].
Signatures
Testator: [Full Name]
Date: [Date]
Signature: ___________________________
Witness 1: [Full Name]
Date: [Date]
Signature: ___________________________
Witness 2: [Full Name]
Date: [Date]
Signature: ___________________________
Notary / Notarization (Required)
State of [State]
County of [County]
On [Date], before me, [Notary Name], personally appeared [Testator Full Name], [Witness 1 Full Name], and [Witness 2 Full Name], known to me (or satisfactorily proven) to be the persons whose names are subscribed to this Affidavit, and acknowledged that they executed it for the purposes stated.
Notary Public Signature: _______________________
My Commission Expires: _______________________
Notary Seal (if applicable): ___________________