IN THE PROBATE DIVISION, CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI In the matter of No. Decedent APPLICATION FOR PROBATE OF WILL The undersigned states that , who resided at , died on Street Address City State Zip Code and was domiciled in St. Louis County at the time of death. That decedent left an instrument purporting to be his her Last Will and Testament dated , and Codicil to said Last Will and Testament dated . The decedent222s will is is not self proving per 474.337 RSMo. If self proving, undersigned asks that it be admitted as self proving. At death decedent was single married widowed 226 spouse date of death divorced. The surviving spouse is who resides at . If instrument(s) is not self proving, the subscribing witnesses to said instrument(s) are: . WHEREFORE, your applicant prays the court consider said instrument(s) in writing to be duly proved, admitted to probate, certified and recorded as the last will and testament of the decedent. The foregoing is made on this day of , , under oath or affirmation and its representations are true and correct to the best of applicant222s knowledge and belief subject to the penalties of making a false affidavit or declaration. Attorney222s Signature Applicant222s Signature Attorney222s Name (Typed) Applicant222s Name (Typed) Street Address Street Address City State Zip Code City State Zip Code Telephone No. Bar No. Telephone No. E-Mail Address American LegalNet, Inc. www.FormsWorkFlow.com