IN THE CIRCUIT COURT FOR FLORIDA IN RE: ESTATE OF COUNTY, PROBATE DIVISION File No. Deceased. Division OATH OF WITNESS TO CODICIL (Copy) STATE OF FLORIDA COUNTY OF The undersigned being duly sworn says that the writing exhibited to the undersigned as the last will of deceased, is the same writing that the decedent executed and that the undersigned and subscribed attesting witnesses on , as codicil to the , ; that the decedent signed the writing at the end in the presence of the attesting witnesses or acknowledged in the presence of the attesting witnesses that the decedent had previously signed the writing at the end; and that the witnesses, in the presence of the decedent and in the presence of each other, subscribed their names to the writing as attesting witnesses. Sworn to and subscribed before me on , . Affiant [choose one] [Print or Type Names Under All Signature Lines] Bar Form No. P-3.0311 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com