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10PROOFOFWITNESS Page 1 of 1 Docket No.: State of New Jersey Essex County Surrogate325s Court Hall of Records, Room 206 SURROGATE Newark, New Jersey 07102 DEPUTY SURROGATE Phone: 973-621-4900 Fax: 973-621-2654 In the matter of the Estate of: } PROOF OF WITNESS , Deceased AKA: STATE OF NEW JERSEY }SS. COUNTY OF ESSEX I, , one of the witnesses to the annexed writing, purporting to be the Last Will of the testator/rix therein named, deceased, being duly sworn on their oath, says that they saw the testator/rix sign and seal the said annexed writing and heard them publish, pronounce and declare the same as and for their Last Will and Testament. That at the time of the doing thereof, the said testator/rix was of sound and disposing mind, memory and understanding, as far as this deponent knows and verily believes; that the other subscribing witness/es thereto, was /were present at the same time with this deponent when the said Will was signed by the said testator/rix and by them published and declared as and for their Last Will and Testament as aforesaid; and that the said other witness/es and deponent subscribed their names to said Will as witnesses in the presence of said testato/rix and each other, at the request of said testator/rix Signature Sworn and subscribed before me on: // A Notary Public of the State of My Commission Expires: Affix Seal American LegalNet, Inc. www.FormsWorkFlow.com