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HIV AIDS Resource Guide
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1580.BLD
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1993-08-01
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#1580
@001 Please state the name of the testator:
@002 Please state the city, state of residence of the testator:
@003 Please state brief burial instructions:
@004 Please state name of charity:
@005 Please state type of charity for alternate beneficiaries:
@006 Please state the state where executed:
@007 Please state the name of the executor:
@008 Please state the name of alternate executor:
@010 Please state the county where executed:
#end control section
#1580
/* Short will -- all to charity Para. 1580*/
LAST WILL AND TESTAMENT OF
@001
I.
I, @001, residing at @002, being of sound mind and in the
contemplation of the certainty of death, do hereby declare this
instrument to be my last will and testament.
II.
I hereby revoke all previous wills and codicils.
III.
I direct that the disposition of my remains be as follows:
@003
IV.
I give all the rest and residue of my estate to
@004, or its successors in interest. If there is no successor to
@004, then I direct that my personal representative select a
charitable organization which has as its primary purpose:
@005
V.
I appoint @007, to act as the executor of this will, to
serve without bond. Should @007 be unable or unwilling to serve,
then I appoint @008 to act as the executor of this will.
I herewith affix my signature to this will on this
the ____________ day of ________________________________, 19___
at ________________________________________, in the presence of
the following witnesses, who witnessed and subscribed this will
at my request, and in my presence.
ATTESTATION CLAUSE
On the date above written, @001, well known to us declared
to us, and in our presence, that this instrument,
consisting of _____ pages, is their last will and testament, and
@001, then signed this instrument in our presence, and at @001's
request we now sign this will as witnesses in each other's
presence. Further that @001, appeared to us to be of sound mind
and lawful age, and under no undue influence.
Witness:
_______________________________________________________________
Address: ______________________________________________________
Witness:
_______________________________________________________________
Address: ______________________________________________________
Witness:
_______________________________________________________________
Address: ______________________________________________________
STATE OF @006
COUNTY OF @010
Before me, the undersigned authority authorized to
take acknowledgments and administer oaths, personally appeared:
@001
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
who after being having duly sworn or affirmed to tell the truth,
stated:
1. That @001 declared this instrument
to be their last will and testament to the witnesses.
2. That @001 signed this instrument in their presence.
3. That the witnesses signed as witnesses in the
presence of @001 and each other.
4. That @001 is well known to the witnesses, and the
witnesses believe @001 to be of lawful age, of sound mind and
under no undue influence or constraint.
______________________________________________________________
Officer
Title of Officer:__________________________________________
My Commission Expires: _________________________