IN THE ORPHANS' COURT FOR (OR) BEFORE THE REGISTER OF WILLS FOR IN THE ESTATE OF: ESTATE NO. , MARYLAND PROOF OF EXECUTION OF WILL I solemnly affirm under the penalties of perjury that I have personal knowledge that the will of dated was signed or acknowledged by the testator in the presence of the following witness(es): who signed at the testator's request and in the testator's presence. Attorney Declarant Date Address Address Telephone Number Facsimile Number Email Address (FOR REGISTER'S USE) Date of Death Date Will was admitted to probate RW1102 Rev. 01/01/2016 ROWNET 11/2015 American LegalNet, Inc. www.FormsWorkFlow.com