Self-Proving Affidavit

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SELF-PROVING AFFIDAVIT
State of FLORIDA
County of ___________________
I, ___________________________, declare to the officer taking my acknowledgment of this
instrument, and to the subscribing witnesses, that I signed this instrument as my will.
________________________________
Signature of Testator/Testatrix
We, ________________________, ________________________ and ________________________
(print testator/testatrix)
(print witness1)
(print witness2)
the testator/testatrix and the witnesses, respectively, whose names are signed to the attached or
foregoing instrument, having been sworn, declared to the undersigned officer that the testator/testatrix,
in the presence of witnesses, signed the instrument as the testator’s/testatrix’s last will (codicil), that
the testator/testatrix signed, or directed another to sign for him or her, and that each of the witnesses, in
the presence of the testator/testatrix and in the presence of each other, signed the will as a witness.
______________________________________________________
______________________________________________________
Witness1 Signature
Witness2 Signature
______________________________________________________
______________________________________________________
Street Address
Street Address
______________________________________________________
______________________________________________________
City, State, Zip
City, State, Zip
Subscribed and sworn to before me by _________________________, the testator/testatrix, q who
q has produced a __________________ as identification, and by
is personally known or
________________________, a witness q who is personally known or q has produced a
___________________ as identification, and by __________________________, a witness q who is
personally known or q has produced a _________________ as identification on this, the _____ day of
________________, 20______.
(SEAL)
_________________________
FL Notary Public – Signature
_________________________
FL Notary Public – Printed Name
FL-2211-AFF
provides this form pursuant to Florida Statute §732.503

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