IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my LAST
WILL AND TESTAMENT, this ____ day of _________, 20____.
(SEAL)
(Testator/Testatrix)
SIGNED,
SEALED,
PUBLISHED
and
DECLARED
by
the
said
________________________ to be his/her LAST WILL AND TESTAMENT in the presence of
us, who, at his/her request and in his/her presence, and in the presence of each other, so subscribe
our names as witnesses hereto, this ______ day of ______________, 20____.
_____________________________________
__________________________, Witness
Address
City State Zip
_____________________________________
__________________________, Witness
Address
City State Zip
STATE OF NORTH CAROLINA
COUNTY OF BUNCOMBE
Before
me,
the
undersigned
______________________________,
authority,
on
this
day
personally
______________________________
appeared
and
______________________________, known to me to be the Testator/Testatrix and the
witnesses, respectively, whose names are signed to the attached or foregoing instrument, and all
of these persons being by me first duly sworn. The Testator/Testatrix declared to me and to the
witnesses in my presence that said instrument is his/her Last Will and Testament and that he/she
had willingly signed the same and executed it in the presence of the witnesses as his/her free and
voluntary act for the purposes therein expressed.
____________
___________
___________
Last Will and Testament
Caryl T. Scovil
Page 1
The witnesses stated before me that the foregoing Will was executed and acknowledged
by the Testator/Testatrix as his/her Last Will and Testament in the presence of the witnesses
who, in his/her presence and at his/her request, subscribed their names thereto as attesting
witnesses and that the Testator/Testatrix at the time of the execution of the Will, was over the
age of eighteen (18) years and of sound and disposing mind and memory.
__________________________________________
__________________________(Testator/Testatrix)
__________________________________________
___________________________, Witness
__________________________________________
____________________________, Witness
Subscribed, sworn and acknowledged before me by __________________________,
the Testator/Testatrix, and by ____________________ and _____________________, the
witnesses, this _____ day of _________________, 20____.
_________________________________________
_________________________, Notary Public
Address
City State Zip
My Commission expires: ____________________
____________
___________
___________
Last Will and Testament
Caryl T. Scovil
Page 2