PENNSYLVANIA WILL INSTRUCTIONS 1.This will is designed to be completed on your computer. To do so, use your
mouse and click on each field, which will be highlighted in gray. This will replace the
gray with the words you type. Example: ___________[1]__________________ will become JOHN DOE. 2. Article / Field Completion InstructionsField [1] -Your name. Field [2] - Your nameField [3] -Your County of Residence.Article OneField [4] - Type the name of person you reside with.Field [5] & [6] - Type the name and birth date of your 1st
adult child.Field [7] & [8]- Type the name and birth date of your 2nd
adult child.Field [9] & {10}- Type the name and birth date of your 3rd
adult child.You may delete the fields not used. So, if you only have one adult child,
delete the other fields. Article Three This article is for you to specify specific property to go to a specific person.
If you do not leave any, type none and delete the fields.Field [11] -Type name.Field [12] -Type street address.Field [13] -Additional Address line.Field [14] -City, State, Zip. Field [15] -Relationship. Field [16] -Describe the property to go to this person.Field [17] -Type name.Field [18] -Type street address.Field [19] -Additional Address line.Field [20] -City, State, Zip. Field [21] -Relationship. Field [22] -Describe the propertyField [23] -Type name.Field [24] -Type street address.Field [25] -Additional Address line.
Field [26] -City, State, Zip. Field [27] -Relationship. Field [28] -Describe the property Article Four This article is for you to leave your homestead, if you have one on the
date of death, to persons designated. If you leave it to anyone other than your children,
check the box in front of field 29, and then type the name of the person to receive in
field 29. To make the checkbox work, double click on top of it and select checked. Field [29] -Type name of person to receive homestead, if other
than children.Field [30] -Type name(s) of children if you select this option.Note: If your home is jointly owned with another and held as joint tenants
with rights of survivorship, the home will pass to the survivor and will not be controlled
by your will. If this is the case, name the joint tenant in field 29. Article FiveThis article is for you to leave all the rest and remainder of your property,
except your homestead and any special items you listed in Article Three. If you leave it
to anyone other than your children, check the box in front of field 31 and then type the
name of the person to receive in field 31. To make the checkbox work, double-click on
top of it and select checked. Field [31] -Type name of person to receive all other property, if
other than your children.Field [32] -Type name(s) of children if children are to receive the
rest and remainder of your property. Article Six This article is necessary if you named someone other than your children in
Article 4 or 5, and should be completed regardless in order to avoid confusion. If you
named a person other than your children in Articles 4 or 5, this article says that if that
person predeceases you, your property will instead go to your children.Field [33] -Type name(s) of children. Article Seven This article is for you to name your personal representative. This must be
an adult, and can be the person with whom you live.Field [34] -Type name of Personal Representative.
Field [35] -Type name of successor Personal Representative. Article Eleven All parts of Article 11 are optional. Complete as desired. Be sure to write
your initials for any of these items you desire to apply.Field [36] -Type name of Cemetery.Field [37] -Type County.Field [38] -Type State. Ending and Signature Field [39] -Your name, followed by witness names, date, and
address of the act of signing. Field [40] -Your name.Field [41] -Your name.Field [42] -Your name.Field [43] -Your name.Field [44] -Your name. All other blanks in the Will are typically completed by hand, such as the names of
the witnesses, day, month and year executed, etc.Once you have completed the Will double check all entries and then print. The
Will should be signed by you in front of two witnesses, not related to you. The self-proving affidavit is optional but recommended. It is used to prove the
Will and make the Will subject to probate. If the affidavit is not completed now,
someone will have to locate the witnesses after your death and obtain an affidavit.
Therefore, it is best to sign the Will in the present of two witnesses AND a notary public
so that the affidavit can be completed by the Notary.You should keep your Will in a safe place once executed. It is also
recommended that you give a copy to your executor or other person as additional proof
of execution. For additional information, see the Law Summary and Information and Preview
links in the search results for this form. A Definitions section is linked on the Information
and Preview page.
Signed by Testator/Testatrix: __________________________________- 1 - LAST WILL AND TESTAMENT OF _________________[1]__________________ BE IT KNOWN THIS DAY THAT,I, ____________[2]_________________, of _______[3]___________ County, Pennsylvania,
being of legal age and of sound and disposing mind and memory, and not acting under duress,
menace, fraud, or undue influence of any person, do make, declare and publish this to be my
Will and hereby revoke any Will or Codicil I may have made. ARTICLE ONE Marriage and Children I am not married. I reside with _____________[4]________________. I am a parent of the
following adult children:NameDate of Birth______________[5]______________________[6]_________________________[7]______________________[8]_________________________[9]______________________[10]___________ ARTICLE TWO Debts and Expenses I direct my Personal Representative to pay all costs and expenses of my last illness and funeral
expenses. I further direct my Personal Representative to pay all of my just debts that may be
probated, registered, and allowed against my estate. However, this provision shall not extend
the statute of limitations for the payment of debts, or enlarge upon my legal obligation or any
statutory duty of my Personal Representative to pay debts. ARTICLE THREE Specific Bequests of Real and/or Personal Property I will, give and bequeath unto the persons named below, if he or she survives me, theProperty described below:NameAddressRelationship[11][12][13][14][15]Property: [16]
Signed by Testator/Testatrix: __________________________________- 2 -NameAddressRelationship[17][18][19][20][21]Property: [22] NameAddressRelationship[23][24][25][26][27]Property: [28] [LIST OR STATE NO PROPERTY LEFT UNDER THIS ARTICLE]In the event I name a person in this Article and said person predeceases me, the bequest to
such person shall lapse and the property shall pass under the other provisions of this Will. In
the event that I do not possess or own any property listed above on the date of my death, the
bequest of that property shall lapse. ARTICLE FOUR Homestead or Primary Residence I will, devise and bequeath all my interest in my homestead or primary residence, if I own a
homestead or primary residence on the date of my death that passes through this Will, to:(select and complete only one) _____________[29]________________ OR _____________[30]________________, my children, equally, per stirpes. If the person or persons, does not survive me, then my homestead or primary residence shall
pass under the residuary clause of this Will. ARTICLE FIVE All Remaining Property – Residuary Clause I will, devise, bequeath and give all the rest and remainder of my property and estate of every
kind and character, including, but not limited to, real and personal property in which I may have
an interest at the date of my death, and which is not otherwise effectively disposed of, to:(select and complete only one) _____________[31]________________ OR _____________[32]________________, my children, equally, per stirpes. ARTICLE SIX Contingent - All Remaining Property – Residuary Clause
Signed by Testator/Testatrix: __________________________________- 3 -In the event that I name a person other than my children in Article Five and that person shall
predecease me, I will, devise, bequeath and give all the rest and remainder of my property and
estate of every kind and character, including, but not limited to, real and personal property in
which I may have an interest at the date of my death, and which is not otherwise effectively
disposed of, to my children:_____________[33]________________.If I have more than one child, I leave my property to them, equally, per stirpes. ARTICLE SEVEN Appointment of Personal Representative, Executor or Executrix I hereby appoint _____________[34]________________, as Personal Representative of my
estate and this Will. In the event my Personal Representative shall predecease me, or, for any
reason, shall fail to qualify or cease to act as my Personal Representative, then I hereby appoint
______________[35]_______________ to serve as successor Personal Representative of my
estate and Will. The term “Personal Representative”, as used in this Will, shall be deemed to mean and include
“Personal Representative”, “Executor” or “Executrix”. ARTICLE EIGHT Waiver of Bond, Inventory, Accounting, Reporting and Approval My Personal Representative and successor Personal Representative shall serve without any
bond, and I hereby waive the necessity of preparing or filing any inventory, accounting,
appraisal, reporting, approvals or final appraisement of my estate. ARTICLE NINE Powers of Personal Representative, Executor and Executrix I direct that my Personal Representative shall have broad discretion in the administration of my
Estate, without the necessity of court approval. I grant unto my Personal Representative, all
powers that are allowed to be exercised by Personal Representatives by the laws of the State of
Pennsylvania and to the extent not prohibited by the laws of Pennsylvania, the following
additional powers:1. To exercise all of the powers, rights and discretions granted by virtue of any
"Uniform Trustees' Powers Law," and/or “Probate Code” adopted by the State of Pennsylvania.2. To compromise claims and to abandon property which, in my Executor’s opinion, is
of little or no value.3. To purchase or otherwise acquire and to retain any and all stocks, bonds, notes or
other securities, or shares or interests in investment trusts and common trust funds, or in any
other property, real, personal or mixed, as my Personal Representative may deem advisable,
whether or not such investments or property be of the character permissible by fiduciaries,
without being liable to any person for such retention or investment.
Signed by Testator/Testatrix: __________________________________- 4 -4. To settle, adjust, dissolve, windup, or continue any partnership or other entity in
which I may own a partnership or equity interest at the time of my death, subject, however, to
the terms of any partnership or other agreement to which I am a party at the time of my death. I
authorize my Personal Representative to continue in any partnership or other entity for such
periods and upon such terms as they shall determine. My Personal Representative shall not be
disqualified by reason of being a partner, equity owner or title holder in such firm from
participating on behalf of my estate in any dealings herein authorized to be carried on between
my Personal Representative and the partners or equity owners of any such partnership or other
entity.5. To lease, sale, or offer on a lease purchase, any real or personal property for such
time and upon such terms and conditions in such manner as may be deemed advisable by my
Personal Representative, all without court approval. 6.To sell, exchange, assign, transfer and convey any security or property, real or
personal, held in my estate, or in any trust, at public or private sale, at such time and price and
upon such terms and conditions (including credit) as my Personal Representative may deem
advisable and for the best interest of my estate, or any trust. I hereby waive any requirement of
issuing summons, giving notice of any hearing, conducting or holding any such hearing, filing
bond or other security, or in any way obtaining court authority or approval for any such sale,
exchange, assignment, transfer, or conveyance of any real or personal property.7. To pay all necessary expenses of administering the estate and any trust, including
taxes, trustees' fees, fees for the services of accountants, agents and attorneys, and to
reimburse said parties for expenses incurred on behalf of the estate or any trust hereunder.8.Unless otherwise specifically provided, to make distributions (including the
satisfaction of any pecuniary bequest) in cash or in specific property, real or personal, or in an
undivided interest therein, or partly in cash and partly in other property, and to do so with or
without regard to the income tax basis of specific property allocated to any beneficiary, and
without making pro rata distributions of specific assets.9.To determine what is principal and what is income with respect to all receipts and
disbursements; to establish and maintain reserves for depreciation, depletion, obsolescence,
taxes, insurance premiums, and any other purpose deemed necessary and proper by them and
to partite and to distribute property of the estate or trust in kind or in undivided interests, and to
determine the value of such property.10. To participate in any plan of reorganization, consolidation, dissolution, redemption,
or similar proceedings involving assets comprising my estate or any trust created hereunder,
and to deposit or withdraw securities under any such proceedings.11.To perform such acts, to participate in such proceedings and to exercise such other
rights and privileges in respect to any property, as if she or he were the absolute owner thereof,
and in connection therewith to enter into and execute any and all agreements binding my estate
and any trust created hereunder.12. To compromise, settle or adjust any claim or demand by or against my estate, or
any trust, to litigate any such claims, including, without limitation, any claims relating to estate or
income taxes, or agree to rescind or modify any contract or agreement.
Signed by Testator/Testatrix: __________________________________- 5 -13. To borrow money from such source or sources and upon such terms and conditions
as my Personal Representative shall determine, and to give such security therefore as my
Personal Representative may determine. All authorities and powers hereinabove granted unto my Personal Representative shall
be exercised from time to time in her or his sole and absolute discretion and without prior
authority or approval of any court, and I intend that such powers be construed in the broadest
possible extent. ARTICLE TEN Construction Intentions It is my intent that this Will be interpreted according to the following provisions:1.The masculine gender shall be deemed to include the feminine as well as the
neuter, and vice versa, as to each of them; the singular shall be deemed to include the plural,
and vice versa. 2. The term “testator” as used herein is deemed to include me as Testator or
Testatrix. 3.This Will is not a result of a contract between myself and any beneficiary,
fiduciary or third party, and I may revoke this Will at any time. 4. If any part of this Will shall be declared invalid, illegal, or inoperative for any
reason, it is my expressed intent that the remaining parts shall be effective and fully operative
and it is my intent that any Court so interpreting same construct this Will and any provision in
favor of survival. ARTICLE ELEVENMisc. Provisions I direct that this Will and the construction thereof shall be governed by the Laws of the State of
Pennsylvania.(I have placed my initials next to the provisions below that I desire to adopt. Unmarked
provisions are not adopted by me and are not a part of this Will)________ If any person named herein is indebted to me at the time of my death and such
indebtedness be evidenced by a valid Promissory Note payable to me, then such person’s
portion of my estate shall be diminished by the amount of such debt.________ Any and all debts of my estate shall first be paid from my residuary estate. Any debts
on any real property left herein shall be assumed by the person to receive such real property
and not paid by my Personal Representative._________ I desire to be buried in the _______[36]___________ cemetery in
_______[37]___________ County, ____________[38]_________________._________ I direct that my remains be cremated and that the ashes be disposed of according to
Signed by Testator/Testatrix: __________________________________- 6 -the wishes of my Executor.I, ____________[39]_________________, having signed this Will in the presence of
_____________________________ and ________________________________ who attested
it at my request on this the _____ day of _____________, 20_____ at
____________________________________________________________(address), declare
this to be my Last Will and Testament. ________________________________Testator/TestatrixThe above and foregoing Will of ___________[40]__________________ (name of
testator/testatrix) was declared by ___________[41]__________________ (name of
testator/testatrix) in our view and presence to be his/her Will and was signed and subscribed by
the said ____________[42]_________________ (name of testator/testatrix) in our view and
presence and at his/her request and in the view and presence of
_____________[43]_____________ (name of testator/testatrix) and in the view and presence of
each other, we, the undersigned, witnessed and attested the due execution of the Will of
____________[44]_________________ (name of testator/testatrix)on this the _____day of
___________________, 20__._____________________________________ __________________________________________Witness Signature Witness SignaturePrint Name: ______________________________ Print Name: _________________________________Address: ________________________________ Address:
____________________________________________________________________________ ___________________________________________Telephone No. ___________________________ Telephone No.
_______________________________
Pennsylvania Self-Proving Affidavit PENNSYLVANIA SELF AUTHENTICATING AFFIDAVIT Commonwealth of PennsylvaniaCounty of _________________ I, ______________________________________, the testator whose name is signed to
the attached or foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will; and that I signed it
willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by
_________________________________, the testator, this ________ day of
___________________, 20____.Testator
______________________________ Typed Name
______________________________ Signature of officer or attorney
______________________________Seal and official capacity of officer or state of admission of attorney
___________________________Commonwealth of PennsylvaniaCounty of _________________ We, _______________________________ and
________________________________, the witnesses whose names are signed to the
attached or foregoing instrument, being duly qualified according to law, do depose and say that
we were present and saw the testator sign and execute the instrument as his Last Will; that the
testator signed willingly and executed it as his free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of the testator signed the will
as a witness; and that to the best of our knowledge the testator was at that time 18 or more
years of age, of sound mind, and under no constraint or undue influence.Sworn to or affirmed and subscribed before me by
_______________________________ and ___________________________________,
witnesses, this ________ day of ________________, 20____. Witness
____________________________________Witness
____________________________________Signature of officer or attorney
______________________________
Pennsylvania Self-Proving AffidavitSeal and official capacity of officeror state of admission of attorney ___________________________
Signed by Testator/Testatrix: __________________________________- 1 - LAST WILL AND TESTAMENT OF _________________[1]__________________ BE IT KNOWN THIS DAY THAT,I, ____________[2]_________________, of _______[3]___________ County, Pennsylvania,
being of legal age and of sound and disposing mind and memory, and not acting under duress,
menace, fraud, or undue influence of any person, do make, declare and publish this to be my
Will and hereby revoke any Will or Codicil I may have made. ARTICLE ONE Marriage and Children I am not married. I reside with _____________[4]________________. I am a parent of the
following adult children:NameDate of Birth______________[5]______________________[6]_________________________[7]______________________[8]_________________________[9]______________________[10]___________ ARTICLE TWO Debts and Expenses I direct my Personal Representative to pay all costs and expenses of my last illness and funeral
expenses. I further direct my Personal Representative to pay all of my just debts that may be
probated, registered, and allowed against my estate. However, this provision shall not extend
the statute of limitations for the payment of debts, or enlarge upon my legal obligation or any
statutory duty of my Personal Representative to pay debts. ARTICLE THREE Specific Bequests of Real and/or Personal Property I will, give and bequeath unto the persons named below, if he or she survives me, theProperty described below:NameAddressRelationship[11][12][13][14][15]Property: [16]
Signed by Testator/Testatrix: __________________________________- 2 -NameAddressRelationship[17][18][19][20][21]Property: [22] NameAddressRelationship[23][24][25][26][27]Property: [28] [LIST OR STATE NO PROPERTY LEFT UNDER THIS ARTICLE]In the event I name a person in this Article and said person predeceases me, the bequest to
such person shall lapse and the property shall pass under the other provisions of this Will. In
the event that I do not possess or own any property listed above on the date of my death, the
bequest of that property shall lapse. ARTICLE FOUR Homestead or Primary Residence I will, devise and bequeath all my interest in my homestead or primary residence, if I own a
homestead or primary residence on the date of my death that passes through this Will, to:(select and complete only one) _____________[29]________________ OR _____________[30]________________, my children, equally, per stirpes. If the person or persons, does not survive me, then my homestead or primary residence shall
pass under the residuary clause of this Will. ARTICLE FIVE All Remaining Property – Residuary Clause I will, devise, bequeath and give all the rest and remainder of my property and estate of every
kind and character, including, but not limited to, real and personal property in which I may have
an interest at the date of my death, and which is not otherwise effectively disposed of, to:(select and complete only one) _____________[31]________________ OR _____________[32]________________, my children, equally, per stirpes. ARTICLE SIX Contingent - All Remaining Property – Residuary Clause
Signed by Testator/Testatrix: __________________________________- 3 -In the event that I name a person other than my children in Article Five and that person shall
predecease me, I will, devise, bequeath and give all the rest and remainder of my property and
estate of every kind and character, including, but not limited to, real and personal property in
which I may have an interest at the date of my death, and which is not otherwise effectively
disposed of, to my children:_____________[33]________________.If I have more than one child, I leave my property to them, equally, per stirpes. ARTICLE SEVEN Appointment of Personal Representative, Executor or Executrix I hereby appoint _____________[34]________________, as Personal Representative of my
estate and this Will. In the event my Personal Representative shall predecease me, or, for any
reason, shall fail to qualify or cease to act as my Personal Representative, then I hereby appoint
______________[35]_______________ to serve as successor Personal Representative of my
estate and Will. The term “Personal Representative”, as used in this Will, shall be deemed to mean and include
“Personal Representative”, “Executor” or “Executrix”. ARTICLE EIGHT Waiver of Bond, Inventory, Accounting, Reporting and Approval My Personal Representative and successor Personal Representative shall serve without any
bond, and I hereby waive the necessity of preparing or filing any inventory, accounting,
appraisal, reporting, approvals or final appraisement of my estate. ARTICLE NINE Powers of Personal Representative, Executor and Executrix I direct that my Personal Representative shall have broad discretion in the administration of my
Estate, without the necessity of court approval. I grant unto my Personal Representative, all
powers that are allowed to be exercised by Personal Representatives by the laws of the State of
Pennsylvania and to the extent not prohibited by the laws of Pennsylvania, the following
additional powers:1. To exercise all of the powers, rights and discretions granted by virtue of any
"Uniform Trustees' Powers Law," and/or “Probate Code” adopted by the State of Pennsylvania.2. To compromise claims and to abandon property which, in my Executor’s opinion, is
of little or no value.3. To purchase or otherwise acquire and to retain any and all stocks, bonds, notes or
other securities, or shares or interests in investment trusts and common trust funds, or in any
other property, real, personal or mixed, as my Personal Representative may deem advisable,
whether or not such investments or property be of the character permissible by fiduciaries,
without being liable to any person for such retention or investment.
Signed by Testator/Testatrix: __________________________________- 4 -4. To settle, adjust, dissolve, windup, or continue any partnership or other entity in
which I may own a partnership or equity interest at the time of my death, subject, however, to
the terms of any partnership or other agreement to which I am a party at the time of my death. I
authorize my Personal Representative to continue in any partnership or other entity for such
periods and upon such terms as they shall determine. My Personal Representative shall not be
disqualified by reason of being a partner, equity owner or title holder in such firm from
participating on behalf of my estate in any dealings herein authorized to be carried on between
my Personal Representative and the partners or equity owners of any such partnership or other
entity.6. To lease, sale, or offer on a lease purchase, any real or personal property for such
time and upon such terms and conditions in such manner as may be deemed advisable by my
Personal Representative, all without court approval. 6.To sell, exchange, assign, transfer and convey any security or property, real or
personal, held in my estate, or in any trust, at public or private sale, at such time and price and
upon such terms and conditions (including credit) as my Personal Representative may deem
advisable and for the best interest of my estate, or any trust. I hereby waive any requirement of
issuing summons, giving notice of any hearing, conducting or holding any such hearing, filing
bond or other security, or in any way obtaining court authority or approval for any such sale,
exchange, assignment, transfer, or conveyance of any real or personal property.7. To pay all necessary expenses of administering the estate and any trust, including
taxes, trustees' fees, fees for the services of accountants, agents and attorneys, and to
reimburse said parties for expenses incurred on behalf of the estate or any trust hereunder.8.Unless otherwise specifically provided, to make distributions (including the
satisfaction of any pecuniary bequest) in cash or in specific property, real or personal, or in an
undivided interest therein, or partly in cash and partly in other property, and to do so with or
without regard to the income tax basis of specific property allocated to any beneficiary, and
without making pro rata distributions of specific assets.9.To determine what is principal and what is income with respect to all receipts and
disbursements; to establish and maintain reserves for depreciation, depletion, obsolescence,
taxes, insurance premiums, and any other purpose deemed necessary and proper by them and
to partite and to distribute property of the estate or trust in kind or in undivided interests, and to
determine the value of such property.10. To participate in any plan of reorganization, consolidation, dissolution, redemption,
or similar proceedings involving assets comprising my estate or any trust created hereunder,
and to deposit or withdraw securities under any such proceedings.11.To perform such acts, to participate in such proceedings and to exercise such other
rights and privileges in respect to any property, as if she or he were the absolute owner thereof,
and in connection therewith to enter into and execute any and all agreements binding my estate
and any trust created hereunder.12. To compromise, settle or adjust any claim or demand by or against my estate, or
any trust, to litigate any such claims, including, without limitation, any claims relating to estate or
income taxes, or agree to rescind or modify any contract or agreement.
Signed by Testator/Testatrix: __________________________________- 5 -13. To borrow money from such source or sources and upon such terms and conditions
as my Personal Representative shall determine, and to give such security therefore as my
Personal Representative may determine. All authorities and powers hereinabove granted unto my Personal Representative shall
be exercised from time to time in her or his sole and absolute discretion and without prior
authority or approval of any court, and I intend that such powers be construed in the broadest
possible extent. ARTICLE TEN Construction Intentions It is my intent that this Will be interpreted according to the following provisions:5.The masculine gender shall be deemed to include the feminine as well as the
neuter, and vice versa, as to each of them; the singular shall be deemed to include the plural,
and vice versa. 6. The term “testator” as used herein is deemed to include me as Testator or
Testatrix. 7.This Will is not a result of a contract between myself and any beneficiary,
fiduciary or third party, and I may revoke this Will at any time. 8. If any part of this Will shall be declared invalid, illegal, or inoperative for any
reason, it is my expressed intent that the remaining parts shall be effective and fully operative
and it is my intent that any Court so interpreting same construct this Will and any provision in
favor of survival. ARTICLE ELEVENMisc. Provisions I direct that this Will and the construction thereof shall be governed by the Laws of the State of
Pennsylvania.(I have placed my initials next to the provisions below that I desire to adopt. Unmarked
provisions are not adopted by me and are not a part of this Will)________ If any person named herein is indebted to me at the time of my death and such
indebtedness be evidenced by a valid Promissory Note payable to me, then such person’s
portion of my estate shall be diminished by the amount of such debt.________ Any and all debts of my estate shall first be paid from my residuary estate. Any debts
on any real property left herein shall be assumed by the person to receive such real property
and not paid by my Personal Representative._________ I desire to be buried in the _______[36]___________ cemetery in
_______[37]___________ County, ____________[38]_________________._________ I direct that my remains be cremated and that the ashes be disposed of according to
Signed by Testator/Testatrix: __________________________________- 6 -the wishes of my Executor.I, ____________[39]_________________, having signed this Will in the presence of
_____________________________ and ________________________________ who attested
it at my request on this the _____ day of _____________, 20_____ at
____________________________________________________________(address), declare
this to be my Last Will and Testament. ________________________________Testator/TestatrixThe above and foregoing Will of ___________[40]__________________ (name of
testator/testatrix) was declared by ___________[41]__________________ (name of
testator/testatrix) in our view and presence to be his/her Will and was signed and subscribed by
the said ____________[42]_________________ (name of testator/testatrix) in our view and
presence and at his/her request and in the view and presence of
_____________[43]_____________ (name of testator/testatrix) and in the view and presence of
each other, we, the undersigned, witnessed and attested the due execution of the Will of
____________[44]_________________ (name of testator/testatrix)on this the _____day of
___________________, 20__._____________________________________ __________________________________________Witness Signature Witness SignaturePrint Name: ______________________________ Print Name: _________________________________Address: ________________________________ Address:
____________________________________________________________________________ ___________________________________________Telephone No. ___________________________ Telephone No.
_______________________________
Pennsylvania Self Proving Affidavit PENNSYLVANIA SELF AUTHENTICATING AFFIDAVIT Commonwealth of PennsylvaniaCounty of _________________ I, ______________________________________, the testator whose name is signed to
the attached or foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will; and that I signed it
willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by
_________________________________, the testator, this ________ day of
___________________, 20____.Testator
______________________________ Typed Name
______________________________ Signature of officer or attorney
______________________________Seal and official capacity of officer or state of admission of attorney
___________________________Commonwealth of PennsylvaniaCounty of _________________ We, _______________________________ and
________________________________, the witnesses whose names are signed to the
attached or foregoing instrument, being duly qualified according to law, do depose and say that
we were present and saw the testator sign and execute the instrument as his Last Will; that the
testator signed willingly and executed it as his free and voluntary act for the purposes therein
expressed; that each subscribing witness in the hearing and sight of the testator signed the will
as a witness; and that to the best of our knowledge the testator was at that time 18 or more
years of age, of sound mind, and under no constraint or undue influence.Sworn to or affirmed and subscribed before me by
_______________________________ and ___________________________________,
witnesses, this ________ day of ________________, 20____. Witness
____________________________________Witness
____________________________________Signature of officer or attorney
______________________________
Pennsylvania Self Proving AffidavitSeal and official capacity of officeror state of admission of attorney ___________________________
