Indiana

State of Indiana County of _______________ We, {testatorName}, the Testator, and the Witnesses whose names are signed to the attached or foregoing instrument, declare under penalties for perjury under the laws of the State of Indiana, pursuant to Ind. Code §29-1-5-3.1(c): (1) that the Testator executed the instrument as the Testator's will; (2) that, in the presence of both Witnesses, the Testator signed the will (or directed another to sign for the Testator in the Testator's presence and at the Testator's express direction); (3) that the Testator executed the will as a free and voluntary act for the purposes expressed in it; (4) that each of the Witnesses, in the presence of the Testator and of each other, signed the will as an attesting witness; (5) that, to the best knowledge of each Witness, the Testator was, at the time the will was executed, of sound mind; and (6) that, to the best knowledge of each Witness, the Testator was, at the time the will was executed, at least eighteen (18) years of age, or was a member of the armed forces or of the merchant marine of the United States or its allies. This self-proving clause may be signed and dated under penalties for perjury under §29-1-5-3.1(c) without a notarial acknowledgment, in which case the perjury declaration on the signatures of the Testator and each Witness is the proof of authenticity. The Testator and Witnesses may instead, or in addition, acknowledge their signatures before a notary public; the notary block below applies only if the notary path is used. Subscribed and acknowledged before me by the Testator, {testatorName}, and subscribed and sworn to before me by the Witnesses, this _____ day of ______________, 20____.

I direct that my estate be administered as an unsupervised administration under Ind. Code §29-1-7.5-2(b)(1). I expressly authorize my Personal Representative to administer my estate without continuous supervision by the probate court, except as Ind. Code §29-1-7.5 et seq. otherwise requires for the admission of this Will to probate, the issuance of letters testamentary, and any matter that the Personal Representative or an interested person elects to bring before the court. Nothing in this direction is intended to waive any heir's, devisee's, or other interested person's statutory right under Ind. Code §29-1-7.5-2 to petition the court at any time for the entry of an order requiring supervised administration, and any such right remains exercisable notwithstanding this clause.

I am competent to be a witness in the State of Indiana and have no interest in this power of attorney, in the principal's estate, or in any property subject to this power of attorney that would disqualify me from acting as an attesting witness under Ind. Code §30-5-4-1.3 (as added by P.L.185-2021, SEC.19, effective July 1, 2021).

I am at least 18 years of age. I am signing this advance directive in the declarant's presence as one of two (2) adult witnesses under Ind. Code §16-36-7-28(c)(1). At least one (1) of the two witnesses is not the declarant's spouse or other relative. I am NOT the person who signed the advance directive on behalf of the declarant. I am NOT the health care representative or any successor health care representative named in this Healthcare Directive.