OATH OF SUBSCRIBING WITNESS(ES) REGISTER OF WILLS COUNTY, PENNSYLVANIA Estate of , Deceased , (each) a subscribing witness to (Print Name/s) the " Will " Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that and that the she / he / they she / he / they was / were present and saw the above she / he / they Testator / Testatrix sign the same signed the same and that in her / his signed as a witness at the request of Testator / Testatrix presence and in the presence of each other. (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 . Executed out of Register's Office Sworn to or affirmed and subscribed before me this of , day . Deputy for Register of Wills Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Form RW-03 rev. 10.13.06 American LegalNet, Inc. www.FormsWorkflow.com