DEPOSITION OF WITNESS TO PROVE HOLOGRAPHIC WILL VA. CODE §§ 64.2-403, 64.2-447; Rule 4:2, Rule 4:3, Rule 4:5, Rule 4:6 ........................................................................................................................................................................................................ Name of Testator/Decedent Deponent ............................................................................................................................................................................................................................................ TO THE DEPONENT: You are providing the Court testimony, under oath, which will assist the Court in proving the attached handwritten document dated .......................................... , hereafter referred to as the "writing," to be the last Will and Testament of the above-named decedent. After being duly sworn, the deponent says as follows: 1. State your name, age, and residence address: ............................................................................................................................................................ ........................................................................................................................................................................................................................................................ 2. 3. Are you a beneficiary under the writing presented for probate? Ans. ............................................................................................................ Do you have any interest in the writing being offered for probate which will ultimately benefit you in any way? Ans. ............................................................................................................................................................................................................................................. 3a. If the answer to Question 3 is "Yes," describe what benefits you expect to receive as a result of your testimony. Ans. ............................................................................................................................................................................................................................................ 4. 5. Were you personally acquainted with the decedent? Ans. Describe how you personally knew the decedent. Ans. ................................................................................................................................. ........................................................................................................................................................................................................................................................ 6. Are you personally familiar with the handwriting of the decedent? Ans. ........................................................................................................................................................................................................................................................ 7. Describe how you are personally familiar with the handwriting of the decedent. (Examples: correspondence with decedent, business records, handwritten notes of decedent, etc. Ans. ........................................................................................................................................................................................................................................................ 8. If you have any such examples of the decedent's handwriting in your possession, please provide copies of examples of the handwriting of the decedent. Ans. Copies attached .........................................., OR No copies available ............................................... 9. Attached is a copy of the writing purporting to be the Last Will and Testament of the decedent, and purporting to be written wholly in the handwriting of the decedent. Do you believe this writing together with the signature to be inscribed wholly in the handwriting of the decedent? Ans. ...................................... 10. If the answer to question 9 is "No,": What portion of the writing is not inscribed in the handwriting of the decedent? Ans. .............................................................................................................................................................................................................................................. FORM CC-1602 (MASTER, PAGE ONE) 10/12 American LegalNet, Inc. www.FormsWorkFlow.com 11. Is your testimony in this matter freely and voluntarily given? Ans. ............................................ ______________________________________________________ SIGNATURE OF DEPONENT State/Commonwealth of ............................................................... [ ] State [ ] County of ...................... ....................................................................................... The foregoing instrument was acknowledged before me this by day of ........................................................................ , 20 ............. .......................................................................................................................................................................................................................................................... NAME for the purpose of filing or reading as evidence in the matter of the probate of the will of the testator named above. I am: [ ] authorized to administer oaths (depositions taken in Virginia). [ ] authorized to take depositions in the jurisdiction where the deponent is (depositions in U.S., outside Virginia). [ ] otherwise authorized under Rule 4:3 of the Supreme Court of Virginia to take this deposition. Given under my hand and seal. ........................................................................ DATE _________________________________________________________ SIGNATURE OF DEPONENT _________________________________________________________ [ ] CLERK [ ] DEPUTY CLERK [ ] NOTARY PUBLIC My commission expires .................................................................... Registration No. ................................................................................... ........................................................................ DATE ..........................................................................................