Fillable Essex County Surrogates Court (Essex County Surrogate's Court)

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Essex County Surrogates Court (Essex County Surrogate's Court)

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11 PROOF OF WITNESS OF CODOCIL Page 1 of 1
Docket No.: _____________
State of New Jersey
Essex County Surrogate’s Court
Hall of Records, Room 206
DEVERO D. MCDOUGAL
ALTURRICK KENNEY
SURROGATE
Newark, New Jersey 07102
DEPUTY SURROGATE
Phone: 973-621-4900
Fax: 973-621-2654
In the matter of the Estate of:
}
PROOF OF WITNESS
OF CODICIL
______________________________________________, Deceased
AKA: ________________________________________
STATE OF NEW JERSEY
}
SS.
COUNTY OF ESSEX
I, ________________________________, being of full age and duly sworn upon my oath depose and say:
I am one of the subscribing witnesses to the purported Codicil to the Last Will and Testament of the above
named decedent. Said decedent willingly signed said writing in my presence, after which I subscribed my name
as witness. Said testator/rix was at said time over eighteen (18) years of age, of sound mind and under no
constraint or undue influence so far as I know and believe.
Signature
I, _________________________________________________________, the undersigned authority, do hereby
certify in the manner in which such acts are usually authenticated by me that ________________________, the
person named in the within Commission, personally appeared before me at _________________________ this
________________________ and was duly sworn by me to the truth of the above deposition signed by same.
Sworn and subscribed before me on:
______/______/______
A Notary Public of the State of ____________________________
My Commission Expires: _____________________
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Essex County Surrogates Court (Essex County Surrogate's Court)

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Completed 9 August 2021

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