200.16 Verdict Form--Partial Invalidity Found Verdict Form [___] [We, the Jury, find that [designation of provision, quote, paraphrase or describe challenged provision], is not valid.] [We, the Jury, find the following contested provision or provisions invalid: (Instructions to Jury: On the blank lines below, describe the provision or provisions that you have found invalid.) __________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _______________________________________________________________________] [We further find that the remaining provisions carry out the decedent's overall testamentary intent and scheme and represent the valid last will of [name of decedent].] ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ 1 ____________________________________ 2