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REVOCATION OF
LAST WILL AND TESTAMENT OF
_______________________________________
BE IT KNOWN THIS DAY THAT,
I, __________________________________, of ______________________ County, North
Carolina, 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 Revocation of Will.
ARTICLE ONE
Revocation of all Prior Wills
I hereby revoke any and all wills and codicils made by me prior to the date of this written
revocation, including, but not limited to the following:
1. Will dated _________________.
ARTICLE TWO
New Will
I may make a new will and this revocation is not intended to revoke any will I may make in the
future, including any will I may make on the date of this revocation. In other words, if I elect to
make a new will on the date of this revocation, my new will is not revoked by this instrument
and shall remain in full force.
ARTICLE THREE
Testamentary Intent
It is further my intent by execution of this revocation that no prior will of mine shall be probated,
in whole or in part, nor shall any provisions thereof be revived by any subsequent will's express
or implied revocation. Nor shall any court ruling as to the validity of any will I may make in the
future act to revive any revoked will of mine.
I, ________________________________, having signed this Revocation of 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 revocation of Last Will and Testament.
________________________________
Testator/Testatrix
The above and foregoing revocation of Will of _________________________________ (name
of testator/testatrix) was declared by _____________________________________ (name of
Signed by Testator/Testatrix: __________________________________ - 1 -
testator/testatrix) in our view and presence to be his/her revocation of Will and was signed and
subscribed by the said ______________________________________ (name of
testator/testatrix) in our view and presence and at his/her request and in the view and
presence of _____________________________ (name of testator/testatrix) and in the view
and presence of each other, we, the undersigned, witnessed and attested the due execution of
the revocation of Will of ___________________________________ (name of
testator/testatrix)on this the _____day of ___________________, 20__.
_____________________________________ __________________________________________
Witness Signature Witness Signature
Print Name: _____________________________ Print Name: _________________________________
Address: _______________________________ Address: ____________________________________
______________________________________ ___________________________________________
Telephone No. __________________________ Telephone No. _______________________________
Signed by Testator/Testatrix: __________________________________ - 2 -
North Carolina Self Proving Affidavit
I, ___________________________, the testator/testatrix, sign my name to this
instrument this _______day of ____________________, 20___, and being first duly sworn, do
hereby declare to the undersigned authority that I sign and execute this instrument as my
revocation of last will and that I sign it willingly, that I execute it as my free and voluntary act for
the purposes therein expressed, and that I am eighteen years of age or older, of sound mind,
and under no constraint or undue influence.
___________________________
Testator
We ________________________, ___________________________, the witnesses,
sign our names to this instrument, being first duly sworn, and do hereby declare to the
undersigned authority that the testator/testatrix signs and executes this instrument as his/her
revocation of last will and that he/she signs it willingly, and that each of us, in the presence and
hearing of the testator/testatrix, hereby signs this revocation of will as witness to the
testator's/testatrix’s signing, and to the best of our knowledge the testator/testatrix is eighteen
years of age or older, of sound mind, and under no constraint or undue influence.
__________________________
Witness
__________________________
Witness
THE STATE OF ____________________
COUNTY OF ____________________
Subscribed, sworn to and acknowledged before me by __________________ the
testator/testatrix and subscribed and sworn to before me by _________________ and
_________________, witnesses, this _________day of __________, ______.
(SEAL)
____________________________
NOTARY PUBLIC
Signed by Testator/Testatrix: __________________________________ - 3 -
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