Affidavit (Of Executor)

IN THE CHANCERY COURT FOR WILLIAMSON COUNTY, TENNESSEE ESTATE OF:_____________________________________ ) NO._________________ ) AFFIDAVIT Before me, the undersigned authority, personally appeared ____________________, with whom I am personally acquainted and who being first duly sworn, deposes and says: 1. That (s)he is the Executor(rix) for the estate of _________________________. 2. That (s)he mailed or hand-delivered a copy of the Last Will and Testament to the following beneficiaries at their respective addresses: (a) _________________________ (d) _________________________ _________________________ _________________________ _________________________ _________________________ (b) _________________________ (e) _________________________ _________________________ _________________________ _________________________ _________________________ (c) _________________________ (f) _________________________ _________________________ _________________________ _________________________ _________________________ Further Affiant saith not. _______________________________ Affiant STATE OF TENNESSEE COUNTY OF _________________ Subscribed and sworn to before me, this the ________ day of __________________, 20___. _______________________________ Notary Public/Clerk & Master My Commission Expires: _________ (Form #6 11/01/02)