Attesting Affidavit to Codicil

Attesting Affidavit Affidavit Of Attesting Witnesses State Of County Of ) ) Each of the undersigned, individually and severally being duly sworn, deposes and says: The Codicil to which this affidavit is attached was subscribed by the testator therein named, in the presence and sight of each of us, who were the attesting witnesses thereto, on , at the City of , . Said testator was at the time of so executing said Codicil, over the age of 18 years, and in the opinion of each of the undersigned, of sound mind, memory and understanding and not under any restraint, or in any respect incompetent to make a will. Said testator could read, write and converse in the English language and, in the opinion of each of the undersigned, was suffering from no defect of sight, hearing or speech or from any other physical, verbal or mental impairment that would affect her capacity to make a valid will or codicil thereto. Said testator at the time of making such subscription declared the instrument so subscribed to be a Codicil to his Last Will. The attached Codicil was executed as a single, original instrument and was not executed in counterparts. The undersigned thereupon signed their names as attesting witnesses at the end of said Codicil at the request of said testator and in his presence and sight and in the presence and sight of each other. Each of the undersigned was acquainted with said testator at the time of such execution of the Codicil and makes this affidavit at his request. The original Codicil to which this affidavit is attached was shown to each of the undersigned at the time this affidavit was made and examined by each of the undersigned as to the signature of said testator and the undersigned. The attached Codicil was executed by said testator and witnessed by each of the undersigned as the attesting witnesses under the supervision of , an attorney-at-law admitted to practice in the State of , in accordance with those applicable provisions of the Estates, Powers and Trusts Law of the State of governing the execution and attestation of wills. -2- SEVERALLY SWORN to before me this _____ day of , . Notary Public ) ) ) ) ) ) ) )