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who after being having duly sworn or affirmed to tell the truth, stated:
1.
That NAME OF THE TESTATOR declared this instrument to be his last will
and testament to the witnesses.
2.
That NAME OF THE TESTATOR signed this instrument in their presence.
3.
That the witnesses signed as witnesses in the presence of NAME OF THE
TESTATOR and each other.
4.
That NAME OF THE TESTATOR is well known to the witnesses, and the
witnesses believe NAME OF THE TESTATOR to be of lawful age, of sound mind and
under no undue influence or constraint.
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Officer
Title of Officer:__________________________________________
My Commission Expires: _________________________