Nuncupative (verbal) Will
STATE OF __________________
COUNTY OF _________________

_______________, being first duly sworn to tell the truth, states:

That affiant resides at: ________________________________________
That on ______________________, _______________ died, and at that time was ____ years of age.

That on ___________________, TESTATOR, being in contemplation of imminent death due to terminal diagnosis, and in the opinion of the WITNESS possessing testamentary capacity, at approximately ____________, made the following dispositions of assets before ________________________ and ___________________________:
__________________________________________________________________

That the substance of the disposition was reduced to writing on _________________________ by _____________________________.



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