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GEORGIA SELF-PROVING AFFIDAVIT
County of __________________
State of __________________
Before me, the undersigned authority, on this day personally appeared
__________________, __________________, and __________________, known to
me to be the testator and the witnesses, respectively, whose names are subscribed to
the annexed or foregoing instrument in their respective capacities, and all of said
individuals being by me duly sworn, __________________, testator, declared to me
and to the witnesses in my presence that said instrument is the last will and testament
or a codicil to the last will and testament of the testator and that the testator had willingly
made and executed it as a free act and deed for the purposes expressed therein. The
witnesses, each on oath, stated to me in the presence and hearing of the testator that
the testator had declared to them that the instrument is the testator's last will and
testament or a codicil to the testator's last will and testament and that the testator
executed the instrument as such and wished each of them to sign it as a witness; and
under oath each witness stated further that the witness had signed the same as witness
in the presence of the testator and at the testator's request; that the testator was 14
years of age or over and of sound mind; and that each of the witnesses was then at
least 14 years of age
Testator’s Signature __________________
Witness’s Signature __________________
Witness’s Signature __________________
NOTARY ACKNOWLEDGMENT
Sworn to and subscribed before me by __________________, testator, and sworn to
and subscribed before me by __________________ and __________________,
witnesses, this ____ day of __________________, ____.
Notary Signature __________________
Official Capacity of Officer __________________
(Seal)
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