Free PC-210 - Connecticut

AFFIDAVIT IN PROOF OF WILL AND/OR CODICIL PC-210 REV. 12/01

STATE OF CONNECTICUT COURT OF PROBATE [Type or print in black ink.]

RECORDED:

TO: COURT OF PROBATE, DISTRICT OF ESTATE OF ,deceased Hereinafter referred to as the testator.

DISTRICT NO. TOWN AND STATE WHERE INSTRUMENT WAS EXECUTED

IN THE MATTER OF PROVING THE FOLLOWING INSTRUMENT(S) OF SAID TESTATOR: Last Will and Testament dated First Codicil to the Last Will and Testament, dated Second Codicil to the Last Will and Testament, dated and/or and/or

HAVING BEEN DULY SWORN, THE UNDERSIGNED SUBSCRIBING WITNESS MAKES AFFIDAVIT AND SAYS THAT: The testator named above executed the instruments hereunto annexed, or the original of the certified copy of the same hereunto annexed, on the date(s) and at the place written above and declared the same to be the last will and testament and/or codicil(s) as indicated above, in the presence of the undersigned and/or each other subscribing witness to said instrument(s). The undersigned thereupon subscribed said instrument(s) as a witness at the request of the testator as did each other subscribing witness in the presence of the testator and in the presence of each other. At the time of execution of said instrument(s) the testator was at least eighteen years of age and of sound mind and memory and competent in every respect to make a will and was not under any restraint. The undersigned makes this affidavit after the death of said testator and at the request of the executor or a person interested under the will and/or codicil.

SUBSCRIBING WITNESS

Signature .................................................................................................................................................

Name [Type or print]

Mailing address:

. Dated at: ,Connecticut, on [Month, Day, Year]

SUBSCRIBED AND SWORN TO BEFORE ME this

day of

,20

.

............................................................................................ Judge, Ass't Clerk, Notary Public, Comm. Sup. Ct.

AFFIDAVIT IN PROOF OF WILL AND/OR CODICIL PC-210

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