Last Will And Testament Page 10
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11SELF-PROVING AFFIDAVIT
State of Florida
County of Brevard
I, Mary G. Smith, the undersigned testator, being first duly sworn, do declare to the
undersigned authority that I signed and executed the attached or annexed instrument as my last
will and testament and that I signed it willingly, that I executed it as my free and voluntary act
for the purposes expressed in that document, and that at the time I signed the document I was
eighteen years of age or older, of sound mind and memory, and under no constraint or undue
influence.
Date: ___________________
________________________________________
(Signature of Mary G. Smith)
We, the undersigned witnesses, being first duly sworn, do each declare to the
undersigned authority the following: (1) the testator declared to each of us that the attached or
annexed instrument is his or her last will and testament; (2) the testator executed the last will
and testament in our presence; (3) each of us, in the presence of the testator and in the presence
of each other, signed the last will and testament as witness; and (4) to the best of our knowledge
the testator is eighteen years of age or older, of sound mind and memory, and under no
constraint of undue influence.
1.
________________________________
_________________________________
(Signature of witness)
(Print Name)
2.
________________________________
_________________________________
(Signature of witness)
(Print Name)
Acknowledgement of Notary Public:
Subscribed, sworn and acknowledged to me on this _____ day of __________, 20__, by Mary
G. Smith, as testator, and ____________________________ and _______________________
as witnesses.
Witness my hand and seal.
Signature of Notary Public: ____________________________
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