I

ntheNameofAl
l
ah,
theMostGr
aci
ous,
theMostMer
cif
ul

I
slami
cLastWi
llandTest
ament

OF_
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RESI
DINGAT_
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COUNTY_
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___DATEOFBI
RTH_
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__TELEPHONE_
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___TODAY’
SDATE_
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ARTI
CLEI
:PREAMBLE

ThePr
ophetMuhammad( maypeacebeuponhim)order
edallMusli
mst oprepareaLastWil
l&Testament
.Abdull
ahbin
‘
Umarnar
r at
edthatthePr
ophet(
pbuh)sai
d,"I
tisnotper
missi
bleforanyMuslim whohassomethingt
owil
ltostayfort
wo
ni
ght
swithouthavi
nghisWil
landTestamentwri
tt
enandkeptreadywithhi
m. "(
SahihAl-
Bukhar
i)
.

Whil
ebeinginful
lmental
capaci
tyandgoodhealt
h,I
,_
_ _
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_, a
Musli
m,doherebydecl
areandcert
ifyt
hisasmyLastWi llandTest ament .Ialsodoher ebydecl ar
et hatthisdocumentr ev okes
anyandall
formerwil
l
sandcodicil
sthatImayhaveprev i
ouslywr it
ten.

Ibearwitnessthatther
eisnonewor thyofworshi
pexceptAllah(God),andIbearwitnessthatProphetMuhammad( pbuh),
is
HisservantandMessenger .Iaskmyr el
ati
ves,
fri
endsandany onereadingt
hiswill
,whetherornottheybeli
eveasIdo,to
respectmybeli
ef sandwishes.Pleasedonotobstructoral
terthi
sdocument .Rat
her,ensurethatIam bur
iedasIask,andthat
mypr opert
yisdividedasIask.

Ial
sosayt
omyr
elat
ivesandf
ri
endswhatt
hepr
ophet
sIbr
ahi
m andYa’
cob(
Peacebeupont
hem)sai
dtot
hei "
rsons:Omy
sons,
indeedGodhaschosenf
oryout
hisr
eli
gion,
sodonotdi
eexceptwhi
leyouar
eMusl
ims.
"(Sur
at-
ul-
Baqar
ah,
2:132)
.

Di
str
ibut
ionofI
nher
it
anceAccor
dingt
otheQur
an

Al
l
ah(
SWT)saysi
ntheQur
ani
nSur
a(ver
se)An-
Nisaa:7-
14

7.Formenisashar
eofwhatparent
sandcl
oser
elat
ivesl
eav
e,andf
orwomeni
sashar
eofwhatt
hepar
ent
sandcl
oser
elat
ivesl
eav
e,bei
t
l
it
tleormuch–anobli
gat
oryshare.

8.Andwhen[ ot
her]r
elat
ivesandorphansandtheneedyarepresentatt
he[
ti
meof
]di
vi
sion,
thenpr
ovi
def
ort
hem [
somet
hing]outofi
t[i
.e.
,
theest
ate]andspeaktothem wordsofappropr
iat
ekindness.

9.Andlett
hose[execut
orsandguar
dians]f
ear[i
njust
ice]asi
fthey[
themsel
ves]hadl
eftweakof
fspr
ingbehi
ndandf
ear
edf
ort
hem.Sol
et
them f
earAll
ahandspeakwordsofappropri
ateki
ndness.

10.I
ndeed,
thosewhodev
ourt
hepr
oper
tyofor
phansunj
ust
lyar
eonl
yconsumi
ngi
ntot
hei
rbel
l
iesf
ir
e.Andt
heywi
l
lbebur
nedi
naBl
aze[
i.
e.
Hell
fi
re]
.

11.All
ahi nst
ructsyouconcer ni
ngy ourchi
ldr
en[ i.
e.thei
rport
ionsofinher
it
ance] :f
ort hemal e,whatisequal t
otheshareoft wofemales.
Butifthereare[onl
y]daughters,twoormor e,forthem istwothir
dsofone’sest at
e.(Literal
ly,“
thatwhichi sleft
.”
).Andifthereisonlyone,
forherishalf
.Andf orone’sparent s,toeachoneoft hem i
sasixthofhisestateifhelef tchi
ldren.Butifhehadnochi ldren,andtheparents
[
alone]inheri
tforhim,thenforhismot herisonet hi
rd.Andifhehadbr ot
hers[and/orsi ster
s],f
orhi smot herisasixt
h,(Althoughthesibl
ings
themselvesdonoti nheri
tinthiscase. )aft
eranybequesthe[ mayhav e]madeordebt .Yourpar entsory ourchil
dren–y ouknownotwhi chof
them,arenear estt
oy ouinbenefit.[Theseshar esare]anobli
gati
on[i
mposed]byAl lah.Indeed, Al
lahisev erKnowingandWi se.

12.Andf oryouishal
fofwhaty ourwiv
esleaveiftheyhavenochild.Butiftheyhav eachil
d,foryouisonef ourt
hofwhattheyleave,af
ter
anybequesty ou[mayhave]madeordebt.Andi famanorwomanl eavesneitherascendantsnordescendantsbuthasabr ot
herorasi ster
,
thenforeachonei sasixt
h.Butift
heyaremoret hantwo,theyshareat hi
rd,(thesesharesaredi
v i
dedequallybetweenmalesandf emales),
afteranybequestwhichwasmadeordebt ,aslongast her
eisnodet ri
ment[ caused].(
Thisisacondi t
ionforanybequest
.Ifi
thasbeen
violat
edbythedeceased,hisbequesti
snottobehonor ed,oritmaybeadj ustedbyt heexecutor
).[Thisi
s]anordinancef
rom All
ah,and
AllahisknowingandForebeari
ng.

13.Thesearethel
imit
sofAll
ah,andwhosoev
erobeysAll
ahandHi sMessengerwi
l
lbeadmi
tt
edbyHi
mtogar
dens[
inPar
adi
se]under
whichri
ver
sf l
ow,abi
dinget
ernal
l
yther
ein;
andthati
sthegreatat
tainment
.

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___I
nit
ial
s:_
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__Dat
e
Page1of1
14.Andwhosoev
erdi
sobeysAl
l
ahandHisMessenger
,andt
ransgr
essesHi
sli
mit
s-Hewi
l
lputhi
mint
otheFi
ret
oabi
deet
ernal
l
yther
ein,
andhewil
lhaveahumil
i
ati
ngpuni
shment
.

ARTI
CLEI
I:MYI
MMEDI
ATEFAMI
LY

A.Iam mar
ri
edt
o _
___
___
___
___
___
___
___
___
___
__andal
_ lref
erencesi
nthi
sWi
l
ltomyhusband/
wif
e(s)ar
eref
erencest
othi
sper
son.

B.Iam t
hef
ather
/mot
heroft
hef
oll
owi
ngchi
l
drenwhosenamesanddat
esofbi
rt
har
e:

1._
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_

3._
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5._
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_

ARTI
CLEI
II
:EXECUTOR

A.Iherebyappoi
ntthepersonnamedbel owtoser
veastheexecutorofmywi ll
.Ither
ebyent
rustcont
rolofmyent
ireest
ate
(cash,
bankaccounts,r
ealproper
ty,shar
esinanybusi
ness,
andanyot herpropert
ynotmenti
onedi nt
hisWil
l)
,tot
heperson
namedbel ow,whoshall
distr
ibut
eitaccordi
ngtomywishesandIslamiclaw.

1.____________________________________,
or,i
fhe/shefail
stosur v
ivemeby45day s,
2.______________________________________,
or,i
fhe/shef
ail
sto
surv i
v emeby45day s, 3. _ _____
____
______
______
_ __
______
___
___
_____
____
_____ _, or ,ifhe/ shef ai lst osur viv
emeby45day s,
4.
_____ __ ___ __ __ ___ __ __ ___ __ _____
____
___,or
,ifhe/shefail
stosur
viv
emeby45day s, t heI mam oft hel ocal Sunni
Musli
m
communi ty.

B.Idir
ectthatmyexecutort
akeal
lact
ionsl
egal
l
yper
missi
blet
oexecut
ethedi
str
ibut
ionofmyest
ateassi
mpl
yandas
expedi
tiousl
yaspossi
ble.

C.Igi
vemyexecut
orpowert
osel
lmypr
oper
ty,
real
,per
sonal
ormi
xed,
wit
houtacour
tor
derandwi
thoutbond.

D.Igi
vemyexecut
orpowert
oset
tl
eanycl
aimf
ororagai
nstmyest
ate.

ARTI
CLEI
V:ARBI
TRATI
ON

Anydisputesr egardi
ngthisWi l
lshal
lbeadj udi
catedvi
apr i
vate,bi
ndingArbi t
rati
onbyaneut ral
Arbit
rator.Iherebyappoint
___
_ _
______________
_____
____toserveastheAr bit
rator
.Ifhe/ she/i
tisunableorunwi ll
ingtoserveasArbitrator
,Idir
ectthat
___
_ _
______________
_____
_____
_ __beappointed.TheArbitrat
orshallusehis/ her/i
tsj
udgmentandknowl edget oresolveanyand
al
ldisputesr egardi
ngthisWil
l whil
eadheringstri
ctl
ytot hedi r
ecti
onscont ainedthereinaswellasI
slamicl aw.Thej udgment
oftheAr bi
tratorshall
bef i
nalandlegal
lyenf or
ceabl
e,nomat terwhetherthedi sput
ingparti
esconsiderhis/her/i
tsjudgment
i
mper fect.

ARTI
CLEV:BURI
ALARRANGEMENTS

Iordai
nt hatmybodybepr epar
edf orburiali
nkeepingwi ththeSunni Musli
m Law( Shari
ah).Iaskthatundernocircumstances
shallmybodybev olunt
ari
lytur
nedov erforanaut opsy,orembalming, ororgandonati
on.Mybodymustbepr epar
edf orburi
al,
andbur i
ed,accor
dingtotheShariah.Absolutel
ynonon- Isl
amicreli
giousser v
iceorobservanceshallbeconducteduponmy
death,oronmybody ,oratthegravesite.Nopictures,
sy mbols,ormusi cshouldbeinvol
vedatanyst ageofmybur i
al.

Mybodymaynotbet r
ansportedoveranyunr easonabl
edistancefrom t
helocal
ityofmydeathunl
essnecessitatedbythe
ci
rcumstancesorconsensusofmyMusl imf ami l
ymember s.Mygr aveshouldf
aceinthedir
ect
ionoftheKa’abai nMakkah,
SaudiArabi
a.Mybodymustbebur i
edwithoutcasketoranyot herencasementthatsepar
atest
heshroudfrom the
surr
oundingsoi
l.Mygravemustbecov eredwi thdir
tonl
y.Mybur ialmusttakepl
aceassoonaspossible,
preferablybef
ore
sunsetonthedayofmydeat horthefoll
owingday .

ARTI
CLEVI
:CUSTODYOFMI
NORCHI
LDRENANDGUARDI
AN

If,
atmydeat h,
anyofmychi l
drenaremi nors,Irecommendt hatmyhusband/ wife___
_ _
_ __
_____
_____ _
_________beappoint
ed
guardianofmymi norchi
ldren,pr
ovidedhe/ sheisaMusl i
m.I fhe/sheisunableorunwil
lingtoserveasper sonalguar
dian,
I
recommendt hat_____
___
_ ____
_____
________________
___
____
_ _
_ _
____beappointedguardianofmymi norchi l
dren.I
fhe/sheis
unableorunwil
li
ngt oser
v easpersonal guardi
an, Ir
ecommendt hat__
______
______
__________
_____
_ _
_ ___
__________
___
_____
_be
appointedguar
dianofmymi norchi
ldren.Ifhe/sheisunableorunwi l
li
ngtoserveasper sonalguardian,Irecommendt hat

_
___
___
___
___I
nit
ial
s:_
___
___
___
__Dat
e
Page2of2
_
___
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___
___
___
___
___
___
___
___
___
__beappoi
ntedguar
dianofmymi
norchi
l
dren.

Inal
lcases,Iur
get hatallmymi norchi
l
drenber aisedaspract
icingSunni
Muslimsandnotinanywaybei ndoctr
inat
edint
o
anyotherfai
th,
reli
gion,orsectofIsl
am.Idir
ectt hatnobondber equi
redofanyper
sonalguardian.Anyproper
tyorother
i
nheri
tancethatthi
sWi l
l gi
vestoanyofmymi norchildr
enshal
l beadmini
ster
edbythei
rguardianinthei
rbestinter
est.

ARTI
CLEVI
I:DEBTSANDEXPENSES

Idi
rectmyexecut
or:

A.Ret
urnt
other
ight
ful
owner
sal
ltr
ustandpr
oper
tyt
hatar
einmycar
eatt
het
imeofmydeat
h.

B.Tofi
rstappl
ytheassetsofmyestatetot
hepaymentofal
lmylegal
debt
s,i
ncl
udi
ngsuchexpensesi
ncur
redbymyl
ast
i
ll
nessandburi
alaswellastheexpensesoft
headmini
str
ati
onofmyestat
e.

C.Topayanyout
standi
ng"
obl
i
gat
ionduet
oGod"bi
ndi
ngonme,
incl
udi
ngunpai
dzakat
,kaf
far
aatofunper
for
medpi
l
gri
mage
(Haj
j
),et
c.

ARTI
CLEVI
II
:BEQUESTS

Idir
ectmyexecut
orpaythefol
lowi
ngamountf
rom anyr
emai
nderofmyest
atetothepeopl
eorgroupsl
i
stedbelow.The
fol
lowi
ngenti
ti
esarenotalr
eadyguar
ant
eedapor
ti
onofmyestate,
andt
hetotal
mustnotexceed33percent(
onethir
d)of
theremai
nderofmyestate.

1._
___
___
___
___
___
___
___
___
___
___
___
___
___
___
_….
..
..
.%oft
het
otal
remai
nder 2._
___
___
___
___
___
___
___
___
___
___
___
___
___
___
_….
..
..
.%oft
het
otal
remai
nder

3._
___
___
___
___
___
___
___
___
___
___
___
___
___
___
_….
..
…%oft
het
otal
remai
nder TOTALBEQUESTS(
mustnotbemor
ethan33%)….
..
..
..
..
..
..
..
.%oft
het
otal
remai
nder

ARTI
CLEI
X:DI
STRI
BUTI
ONOFTHEREMAI
NDEROFMYESTATE

1.Di
str
ibut
ether
esi
dueandr
emai
nderofmyest
atest
ri
ctl
yinaccor
dancewi
tht
het
enet
sofSunni
Musl
i
mlawofi
nher
it
ance.

2.Incaseofanydif
fi
cul
tyordi
sput
esi
ndi
str
ibut
ingmyest
ateaccor
dingt
othi
sWi
l
l,t
hemat
tershoul
dber
efer
redt
othe
previ
ousl
ydeclar
edArbi
trat
or.

3.Theresidueandremai
nderofmyest
ateaf
tertheexecuti
onofArti
clesIt
oVIIandArt
icl
eVII
Isecti
ons1to6abov
ebe
donat
edt othefol
lowi
ngperson/
soror
gani
zati
on/sfortheadvancementofIsl
am.__
_____
___
_____
_____
___
___
__

4.Anyport
ionofmyestatedi
sclai
medorrefusedtobereceiv
edbyanyofthel
egateesnamesorref
erredtoint
hisdocument
bedonatedtothef
oll
owingperson/soror
ganizat
ion/
sfortheadv
ancementofI
slam.____
___
___
______
_ _
____
___
_____
_

ARTI
CLEX:SEPARABI
LITY

I
fanypar
toft
hiswi
l
lisdet
ermi
nedi
nval
i
dbyacour
t,t
heot
herpar
tsshal
lremai
nval
i
dandenf
orceabl
e.

ARTI
CLEXI
:CONCLUSI
ON

Thi
sconcl
udesmyLastWi
l
landTest .“
ament Then,
whoeveral
ter
sit[
i.
e.t
hebequest
]af
terhehashear
dit-t
hesi
nisonl
y
upont
hosewhohaveal
ter
edi
t.
"(Sur
ahal
-Baqar
ah2:
181)
.

Isubscri
bemynamet othi
sWillthi
sday___
_ _
_of_______
_____
,2014at_ __
____
_am/pm anddoherebydeclar
et hatIsignand
executethi
sinstr
umentasmyl astWil
landthatIsi
gnitwill
i
ngly,
thatIexecut
eitasmyfreeandvol
untar
yactf orthepurposes
ther
einexpressed,andt
hatIam ofageorotherwi
selegal
lyempower edtomakeaWi l
l
,undernoconstr
aintorunduei nfl
uence.

__
______
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___
___
_Si
gnat
ure,
DateandTime

WI
TNESSES

Onthisday,
____
___
___
___
__ _
_ _
___
______
_dateof___
___
___
____
___
_____
____
____
____
______
____
,theundersi
gneddecl
aredt
ous
t
hatthisi
nstr
umentwashis/herWil
landrequest
edustoactaswit
nessestoi
t.He/Shether
euponsignedthi
sWill
inour

_
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___I
nit
ial
s:_
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__Dat
e
Page3of3
presence, al
l ofusbeingpr esentatt
hesametime.Wenow, athi
s/herr
equest,
inhi
s/herpresence,
andinthepresenceof
eachot her,subscri
beournamesaswi t
nessanddeclaret
hatweunderst
andthist
obehi s/
herLastWil
l,andthat
,tothebest
ofourknowl edgethet estatori
softheageofmajor
it
y ,
orisot
herwisel
egal
lyempoweredtomakeaWi l
l
, andunderno
constraintorunduei nfluence.

Winess1._
t _____
___
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____
_____
___
____
___
__
NameandSignat
ure DateandTime

Winess2._
t _____
___
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___
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___
___
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___
___
___
___
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___
___
___
___
___
___
___
___
___
____
_____
___
____
___
_
NameandSignat
ure DateandTime

*
OPTI
ONAL*

HEALTHCAREPROXY,
LIVI
NGWI
LL&NOTARI
ZATI
ON
IfthetimecomeswhenIam i ncapaci
tat
edandcannolonger NameandSi
gnat
ure
activel
ytakeparti
ndeci
sionsformyownl i
feandam unabl
e
todi r
ectmyphysici
anastomyownmedi calcare,
Iwi
shthi
s
statementtostandasatestamentofmywi shes.

I,
_____
____
___
___
___
____
___
___
___
________
___
___
___
___
__
*
**OPTI
ONAL*
**
herebyappoi
ntt
hefol
l
owingi
ndi
vidualasmyheal
thcar
e
agent.
Subscr
ibedandswor
ntobef
oremet
his_
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__dayof_
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,

Name:____
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__ Not
aryPubl
i
c__
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__Si
gnat
ure&Seal
Phone#_
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_____
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__

Addr
ess:
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__

Thisheal thcar epr oxyshal ltakeef f

ecti fandwhenIbecome
unabl et omakemyownheal thcar edeci sions.I nrespectof
eachdeci sionmadef ormebymyagent , iti
smywi shand
directiont hatmyagentbegui dedsol elybyI slami cShar i
ah
ast owhatmyowndeci sionwoul dhavebeeni nthesame
cir
cumst ances.Wi thoutl imi tingt heunr est r
ictedscopeofmy I
ncaseofemer
gency
,cont
act(
incl
udephonenumber
s):
agent ’saut hor i
tyher eunder ,Iexpr esslyaut horizemyagent
todi rectt hatnot reat mentbeconduct edorwi thheldf rom _
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mei ftodosoi sagai nstt het eachingsofI slam, t

ot hebest _
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ofunder st andi ngofmyagent .Idirectt hatmedi cationbe
j
udi ciousl yadmi nist eredt omet oalleviat epai n.Idonot _
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i
ntendanydi recttaki ngofmyl i
fe.Ialsodi rectt hat"li
fe
suppor tsyst ems"maybeusedi naj udici ousmannerandi ts Wehopet hiswillbenefi
tyouandyourf amily.Forawilltobelegali
n
usedi scont inued, justl ikeanyot hermedi cine, i
fitbecomes mostst ates,youhavet obeatleast18year soldandofsoundmi nd.
reasonabl yappar entt hati thasnocur ativeval ue.The" li
fe Thewi llmustbesi gnedbyyouandwi tnessedbyt wopeopl ewho
suppor tsyst ems"i ncl udebutar enotl imi tedt oar t
ifi
cial willnotreceiveanythi
ngfrom yourestate.However,pleaseconsult
respi r
at i
on, cardiopul monar yr esuscitation, artifi
cialmeans withanI sl
ami cscholarand/oranattorneyf orl
egaladvice.Pl
ease
ofpr ovidingnut ri
ti
onandhydr ati
on, andanyphar maceut i
cal al
sof eelfreetopassorshar ethi
sinformat i
onwi t
hyourf ri
endsand
otherMusl ims.
drugs.Idi rectt hatmyf ami ly,allphysi cians, hospi talsand
otherheal thcar epr ovi dersandanycour torj udgehonort he
deci sionofmyagent /alternat eagent .Thi sr equesti smade, Prayforthepeopl
eatTheI slami
cBullet
inwhopr eparedtheor
igi
nal
form ofthi
ssamplewi l
l
,whichwassubsequent l
yeditedbythe
aftercar ef ulr efl
ection, whi l
eIam ofsoundmi nd. I
slami cCommunityCenterofAtl
anta.Jazakum All
ahKhairan(May
GodRewar dYou).Ifyouhavefur
therquestions,
contact:
Name:
_
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__Si
gnat
ure:
_
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_

Al
-Far
ooqMasj
i
d
Wit
ness1._
_____
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NameandSignat
ure 44214t
hStNW,
Atl
ant
a,GA30318

Wi
tness2._
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__ 404-
874-
7521

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nit
ial
s:_
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__Dat
e
Page4of4
 *
OPTI
ONAL*

DETAI
LEDDI
STRI
BUTI
ONOFMYESTATE
Iagaindi r
ectexecutorofmyWi llt
ost ri
ctl
yadher etotheIsl
amiclawgov erningt hedi st
ributi
onofestate.I
fur
therdi r
ectthatprevi
ouslynamedAr bi
trator
______
____
_ _
____
_ _
_______
__ _
__ _beconsul tedforinter
pretat
ionof
theIslamicLawgov er
ningestatedistr
ibuti
on,pri
ortothedistr
ibuti
onofest ateappl icableinthi
ssection.
Shouldanyofmyhei r
swhoar enotMusl i
msatt hetimeofexecut i
onoft hi
sWi l
l
, acceptIslam pri
ortomy
deatht heyshallbecomeeligi
bleheirsandr ecei
veinheri
tanceaccordingtot heIslami claw.Adoptedchi l
dren
andt heirhei
rsarenott obeconsideredasmyhei rsinal
lofthedistri
buti
onsbel ow.

I
tispr
efer
redt
ocont
actt
heI
slami
caut
hor
it
yli
stedabov
e,especi
all
yift
hef
oll
owi
ngcondi
ti
onex
ist
:
 IfIam notsur
viv
edbysons,
daught
ers,
grandsons,
fat
herandbr
otherwi
thsamebi
ologi
cal
mot
her
orf
atherasmine
 I
fal
ltheappl
i
cabl
eshar
esbel
owamountt
oat
otal
ofmor
ethanone(
100%)

Thefol
lowi
ngisasummaryoftheI
slamiclawgover
ningt
hedi
stri
buti
onofest
ate;t
hisi
sneit
hertobe
const
ruedasbei
ngcompl
etenordoesitexcl
udeall
theot
herI
slamicLawgover
ningthedi
str
ibut
ionofest
ate.
SPOUSE
 I
fthesur vi
vi
ngspousei shusband,hei stobegivenfrom myestate:
Onefour t
h(1/4),i
fIam surviv
edbysons, daught
ers,grandsonsorfather
Onehalf(1/2),i
fnoneoft heabovesurv i
vesme,butsurvivedbybrot
hersorsist
erswit
hsame
bi
ologicalmotherorfatherasmi ne
Thefullamountoft heestate,
ifI
’m notsurvi
vedbyson, gr
andson,daughter
,fat
her,
mother
,br
other
orsister
.

 I
fthesurviv
ingspousei swif
e, shei
stobegi venfrom myest at
e:
Oneeighth(1/8)
,ifIam sur
vivedbysons,daughters,grandsonsorfat
her
Onefourth(1/4)
,ifnoneoftheabov esur
vivesmebutsur vi
vedbymymot herorbrot
hers/si
sters
wit
hsamebi ologicalmotherorfat
herasmi ne.(Thi
samounti stobesharedequall
yifmor ethan
onewife).
Thefull
amount ,i
fI’
m notsurvivedbyson,grandson,daughter,
fat
her,mot
her,br
otherorsist
er.

Attheti
meofwri
ti
ngthi
sWi l
l
,myspouseis___
_____
_____
____whosedat
eofbi
rt
his_
_/_
_/_
_andsoci
al
secur
it
ynumberi
s___
_ -
___
-__
___
_.cont
acti
nfo:__
_____
_____
FATHER
 Myf at
her,i
fhesur vi
vesme, i
stobegivenfr
om myest at
easf oll
ow:
Onesixth(1/6),
ifIam survi
vedbysonsorgrandsons
Onesixth(1/6)oftheestatepl
usresi
dualest
ateafterdistr
ibut
ingsharesaspergui
del
i
nest
o
survi
vi
ngdaught ers,
granddaught
ers,
spouse,mot herorgrandmother
Myfatheris_ _
__ _
___
___
__ _
___whosedateofbi
rt
his_
_/_
_/_
_andt
hesoci
alsecur
it
ynumberi
s__
__-
___
-
__
____
, contactinfoi
fal
ive:__
___
____
____
__
MOTHER
 Mymot her,i
fshesurvi
vesme, ist
obegi venfrom myestateasfollow:
Onesixth(1/6)oft
heestate,
ifIam surv
ivedbysons,daughters,grandsons,gr
anddaughter
s’,
husband,fat
herorbrot
herswithsamebi ol
ogical
mot herorfatherasmi ne.
Onethir
d( 1/
3)oftheestat
e,ifmywi f
eorf at
hersurv
ivesmebutnoneoft heabovesurviv
esme.
Onethir
d( 1/
3)oftheestat
e,ifnoneoftheabov esur
vivesme.
Thefullamount,i
fnoneoftheabov esurv
ivesme.

Mymotheris__
____
___
_____
___whosedat
eofbi
rt
his_
_/_
_/_
_andt
hesoci
alsecur
it
ynumberi
s__
__-
___
-
__
___
_contacti
nfoi
fal
ive:
_____
___
____
___
CHI
LDREN
 Ifatl
eastoneofmysonssur v
ivesme, all
r emai
ningestat
eafterexecut
ingSecti
onAofAr ti
cleV
andSectionBIt
em 1,2and3ofAr t
icleV,istobedistri
but
edamongmychi ldr
en,wi
thsons
i
nherit
ingdoubl
etheshareofdaughters.
 Ifnoneofmysonssur v
ivemeandonedaught ersurv
ivesme,sheinheri
tsonehalf(
1/2)ofthe
estat
e.
 Ifnoneofmysonssur v
iveme,andmor ethanonedaughtersurv
ivesme, t
wothir
ds(2/3)ofmy
estat
eisdist
ri
butedequal
lyamongthem.

Att
heti
meofwr it
ingthisWil
l,Ihavethef
oll
owingbiologicalchil
dren:
1. __
_____
_ _
______
_______,
whoismy_ _
_ _
____(son/ daughter)
,whosedateofbir
this
__/
__/_
_andthesocialsecurit
ynumberis____
-___-_
_ _
___.contactinf
o:__
_____
____
____
2. __
_____
_ _
______
_______,
whoismy_ _
_ _
____(son/ daughter)
,whosedateofbir
this
__/
__/_
_andthesocialsecurit
ynumberis____
-___-_
_ _
___.contactinf
o:__
_____
____
____
3. __
_____
_ _
______
_______,
whoismy_ _
_ _
____(son/ daughter)
,whosedateofbir
this
__/
__/_
_andthesocialsecurit
ynumberis____
-___-_
_ _
___.contactinf
o:__
_____
____
____
4. __
_____
_ _
______
_______,
whoismy_ _
_ _
____(son/ daughter)
,whosedateofbir
this
__/
__/_
_andthesocialsecurit
ynumberis____
-___-_
_ _
___.contactinf
o:__
_____
____
____
I
faddi
ti
onalchi
ldr
en, at
tachasepar at
esheetwithalltheinformationandrefert
otheabov esect
ion.

Asusedinwri
ti
ngthi
sWil
l,t
hewor ds“mychi
l
dren”shal
lmeant
hebi
ologi
cal
sonsanddaught
ersl
i
sted
abov
e,andanyother
sher
eafterbornt
ome.
BROTHERSANDSI STERS( shar
ingmybiologicalmot herorfat
her )
Inpresenceoffatheroroneormor eofmysonsorgr andsons,thesurvivi
ngbrot
hersorsist
ersar
enot
givenanyshare.
Inthepresenceofmot herordaughter
(s)
,onlybrother(s)fr
om thesamef at
herwil
lgetshare,
whichis
remainderofmyest ateaft
erexecuti
ngSecti
onAofAr t
icl
eVandSect i
onBI t
em 1,2,3and4ofAr t
icl
e
V,tobedi st
ri
butedequall
yamongal lmybrothersfrom samef ather.

IfI
’m NOTsur vivedbysons, daughter s,grandsons, fatherormother ,
remai nderofmyest at
eaf ter
executi
ngSect ionAofAr ticleVandSect ionBI tem 1ofAr ti
cleV,isdistri
but edi nthefollowingmanner :
 Mat ernal Brot hersandSi sters(f
rom mymot herbutdi f
fer
entfathert hanmi ne)willeachr eceiveone
sixt
h( 1/6)oft hemyest ate,will
t otalofallthistonotexceedonet hi
r d( 1/ 3)ofthet otal
est ate.
 Pat ernalBr othersandSi sters(from myf atherwi thsamemot herordi ffer entmot her)willshar ethe
remainderoft heestatewi thbrot herinherit
ingdoubl etheshar eofsi ster s.
 I fnobr othersur vi
vesmeandi fonesi stersur vivessheget shalf(1/2)andi fmor ethanonesi ster
survi
vet hent her emainderi stobeequal lydivided.

Atthetimeofwr i
ti
ngthisWi ll
,Ihavethefoll
owingsibl
ingsf r
om mybi ologicalf
atherand/ormother
(Pater
nal:f
rom samef ather,
Mat ernal
:i
ffrom samemot herbutdif
fer
entf ather
):
1. _____
_____
__ _
_ _
_______,whoismy_ _____
___(paternal
/maternal)______
__(br
other/
sist
er)
,
whosedat eofbir
this_ _/
__/__andthesocialsecur
itynumberi s____-_
__ -
___
___contacti
nfo:
_____
_____
_____
2. _____
_____
__ _
_ _
_______,whoismy_ _____
___(paternal
/maternal)______
__(br
other/
sist
er)
,
 whosedateofbi r
this__/_
_/__andthesoci
alsecuri
tynumberis___
_ -
___
-__
____.contacti
nfo:
___
____
________
3. __
__ _
_____
_ _
____
_____
_, whoismy______
___(pater
nal/
maternal
)_____
___(br
other/
sist
er)
,
whosedateofbi r
this__/_
_/__andthesoci
alsecuri
tynumberis___
_ -
___
-__
____.contacti
nfo:
___
____
________
I
faddi
ti
onalsibli
ngs,att
achasepar at
esheetwithallt
heinformati
onandr ef
ertotheabov esecti
on.

Remainderf
rom t
healloft
heabovepercent
agebasedcal
cul
ati
on,i
fany,shal
lbeappl
iedtothecl
osestmal
e
hei
r(
s)ordi
str
ibut
edbetweenhei
r(s)i
npropor
ti
ontothei
rshar
esli
stedinthesect
ionsabove.

Inthecase,t
hatanyofmyhei rs,predeceasemeori sineligibl
ef ori
nheritance,Idirectthatt
hei
rsharebe
dist
ri
butedamongt heel
igibl
ehei r
sinpr oport
iontotheirshar esli
stedint heinstructi
onsinthi
ssecti
onsabov e.
Inthecasethatal
lofmyhei r
spr edeceasemeori nel
igible,Idirectt
hatt her emainderofmyest at
e,aft
er
execut
ingArti
cleI
IIandSecti
onAofAr ticl
eV, bedi
stri
but edtot hefoll
owi ngindi
v i
dualsand/oror
ganizati
ons:
1. ____
___
_ _
____
_ _
_____,whoseaddr essis_______ _
_ _
______
_ _
____ __
_ _
____,aamountequal t
o_ __
_____
percent(
__%)ofmyr emainingestate.
2. ____
___
_ _
____
_ _
_____,whoseaddr essis_______ _
_ _
______
_ _
____ __
_ _
____,aamountequal t
o_ __
_____
percent(
__%)ofmyr emainingestate.