Before me, the undersigned authority authorized to take acknowledgments and administer oaths, personally appeared: who after being having duly sworn or affirmed to tell the truth, stated:
1. That the instrument on file in this court dated [Date], is the last will and testament of which witnessed.
2. That signed this instrument in their presence.
3. That is well known to , and that at the time of execution believes to be of lawful age, of sound mind and under no undue influence or constraint.