In the Court of Queen S Bench for Saskatchewan

Form 16-19 A

(Rule 16-19(1))

COURT FILE NUMBER __________________________(to be completed by court)

COURT OF QUEEN’S BENCH FOR SASKATCHEWAN

JUDICIAL CENTRE OF ______REGINA_____________

IN THE ESTATE OF ___________ JANE DOE ______DECEASED

AFFIDAVIT OF EXECUTION OF WILL

I, (Name), of Regina, Saskatchewan, make oath and say/affirm that:

1. I know/knew JANE DOE, late of Regina, Saskatchewan.

2. On or about the 27th day of November, 1992, I was present and saw the document annexed to this affidavit and marked as Exhibit “A” signed by JANE DOE, (if testator executed the will by making his or her mard, add: by making her mark), as the same now appears, as and for her Last Will and Testament.

3. The document was signed by JANE DOE in the presence of me and of (name of other attesting witness), who were both present at the same time, at which time we, in the presence of JANE DOE, and in the presence of each other, attested and subscribed the document as witnesses. (If the testator was blind, or executed the will by mking his or her mark, add:

4. Before the execution of the will by the testator, the will was read over to the testator by me (or by in my presence, as the case may be) and the testator had knowledge of its contents and appeared perfectly to understand the same.)

SWORN(OR AFFIRMED BEFORE ME )

at Regina, Saskatchewan )

this _____ day of ___________ 20__ )

)

)

)

) _____________________________

____________________________ ) (Signature of Subscribing Witness)

Commissioner for Oaths for Saskatchewan.