IN THE PROBATE COURT OF _______________________ COUNTY STATE OF GEORGIA IN RE: ESTATE OF ___________________________________, DECEASED ) ) ) ) ESTATE NO. ____________ INTERROGATORIES TO WITNESS TO WILL Re: Petition of _________________________________________________, to probate in (Common) (Solemn) Form the purported Last Will and Testament dated __________________________, of _____________________________________________________________________, deceased. ______________________________________________________________________________ Name Address To: The following interrogatories are submitted to you under the provisions of O.C.G.A. § 53-5-23 as amended, in connection with the Petition referred to above. [Initial A or B below] _____ A. The Original of said purported Will is exhibited to me herewith. _____ B. Attached hereto as Exhibit "____" is a true photographic copy of said purported Will. [NOTE: Said Attachment must be filed with the Court.] You are hereby requested to answer the following questions in the space provided with respect to said purported Will: 1. Did you sign the purported Will as a witness? 1. Answer: __________ 2. Did you witness this Document at the request of the Decedent? 2. Answer: __________ 3. Did you witness this Document in the presence of the Decedent? 3. Answer: __________ 4. At the time you witnessed the Document being signed, were you 4. Answer: __________ at least 14 years of age? 5. Did the above-named Decedent sign the Document? 5. Answer: __________ 6. Did the Decedent acknowledge that the purported Will was 6. Answer: __________ his/her Last Will and Testament at the time of signing? 7. Did the Decedent know that he/she was executing his/her 7. Answer: __________ Last Will and Testament when he/she executed this Document? 8. Did the Decedent execute this Document willingly, as a free 8. Answer: __________ act and deed? 9. Did the Decedent appear to be of sound and disposing mind 9. Answer: __________ and memory at the time of execution of the Document? 10. Was the Decedent at least 14 years of age at the time he/she 10. Answer: _________ signed the Document? Before me, the undersigned Notary Public or Clerk of the Probate Court, appeared________________________________________, who, under oath, stated that the answers (s)he has given to the foregoing interrogatories are true and correct. This _____ day of _____________________________, 20 _____. ____________________________________________ _____________________________________________________ Notary Public/Clerk of Probate Court Telephone Number: ____________________________ [NOTES: (1) General instructions applicable to all Georgia Probate Court Standard Forms are available in each Probate Court or at www.gaprobate.gov, labeled GPCSF 1. (2) If the Interrogatories are submitted to a witness to a purported Codicil(s), appropriate changes must be made in this form.] GPCSF Supplement 6 1 Eff. July 2016 American LegalNet, Inc. www.FormsWorkFlow.com ____________________________________________ Signature of Witness to Will Mailing Address: ______________________________