OATH OF NON-SUBSCRIBING WITNESS(ES) REGISTER OF WILLS COUNTY, PENNSYLVANIA Estate of , Deceased and (each) being duly qualified according to law, depose(s) and say(s) that acquainted with with the handwriting and signature of the decedent, and that the signature of to the foregoing instrument purporting to be the Last Will and Testament/Codicil of _______________________________ is in his/her own proper handwriting. she / he / they was / were , well- and am/are familiar (Signature) (Signature) (Street Address) (Street Address) (City, State, Zip) (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subscribed before me this of , day . Deputy for Register of Wills Form RW-04 rev. 10.13.06 American LegalNet, Inc. www.FormsWorkflow.com