2006 Minnesota Statutes

524.2-1005 INTERNATIONAL WILL; CERTIFICATE.
The authorized person shall sign and attach to the will a certificate establishing that the
requirements of sections 524.2-1002 to 524.2-1005 for valid execution of an international will
have been fulfilled. The authorized person shall keep a copy of the certificate and deliver another
to the testator. The certificate must be substantially in the following form:

CERTIFICATE

(Convention of October 26, 1973)
1. I, .............. (name, address, and capacity),
a person authorized to act in connection with
international wills,
2. certify that on ....... (date)
at..................(place)
3. (testator) .............................(name,
address, date and place of birth) in my
presence and that of the witnesses
4. (a) ...............(name, address, date and
place of birth)
(b) ...............(name, address, date and
place of birth)
has declared that the attached document is his/her will
and that ..he knows the contents thereof.
5. I furthermore certify that:
6. (a) in my presence and in that of the witnesses
(1) the testator has signed the will or has
acknowledged his/her signature previously affixed.
*(2) following a declaration of the testator stating
that the testator was unable to sign the will
for the following
reason.................................,
I have mentioned this declaration on the will,
*and the signature has been affixed
by.....................
(name and address)
7. (b) the witnesses and I have signed the will;
8. *(c) each page of the will has been signed
by ................ and numbered;
9. (d) I have satisfied myself as to the identity
of the testator and of the witnesses as
designated above;
10. (e) the witnesses met the conditions requisite
to act as such according to the law under which
I am acting;
11. *(f) the testator has requested me to include
the following
statement concerning the safekeeping of the will:
....................................................
12. ..............................PLACE OF EXECUTION
13. ..............................DATE
14. ..............................SIGNATURE
and, if necessary, SEAL........
*to be completed if appropriate
History: 1978 c 525 s 6; 1986 c 444