Sec. 13.12.915. - International will; certificate.
The authorized person shall attach to the international will a certificate to be signed by the authorized person establishing that the requirements of AS 13.12.912 - 13.12.921 for valid execution of an international will have been complied with. The authorized person shall keep a copy of the certificate and deliver another to the testator. The certificate shall 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 the testator's will and that the testator
knows the contents of the will;
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 the
testator's signature previously affixed.
* (2) following a declaration of the testator stating that the
testator was unable to sign the testator's 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
witnesses 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 testator's will:
________________________________________________________________
________________________________________________________________
12. PLACE OF EXECUTION
13. DATE
14. SIGNATURE and, if necessary, SEAL
* to be completed if appropriate.