First Codicil To Last Will And Testament Page 2

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ATTESTATION AND DECLARATION OF WITNESSES
Each of us whose signature appears below, says and declares that, on this _____ day
of __________, 200_, in the presence of each of us, ____________________ declared this
instrument to be the First Codicil to his (er) Last Will and Testament, that (s)he executed it for
such purpose, and requested that each of us sign said Codicil as attesting witnesses; that we
have signed as attesting witnesses in his (er) presence and in the presence of each other; that
we know his (er) and that (s)he appears to be of full age and of sound and disposing mind and
memory and competent in every respect to make this Codicil to his Last Will and Testament
and not under any restraint, duress or undue influence; each of us is over eighteen years of age
and otherwise competent to be an attesting witness; and this certification is made at the
request of ____________________ for the purposes of being presented to a court of
competent jurisdiction to prove the foregoing First Codicil to the Last Will and Testament of
____________________.
Each of us further declares under penalty of perjury under the laws of the State of
Washington that the foregoing declaration is true and correct.
Signed at _______________, Washington, this _____ day of _______________,
200_.
________________________
_________________________
Witness (Signature)
Witness (Signature)
________________________
_________________________
Witness (Printed Name)
Witness (Printed Name)
Address:
Address:
________________________
_________________________
________________________
_________________________
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