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)
a person authorized to act in connection with
international wills,
address, date and place of birth)
in my presence and that of the witnesses
place of birth)
place of birth)
has declared that the attached document is his/her will
and that ..he knows the contents thereof.
acknowledged his/her signature previously affixed.
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)
by ................ and numbered;
of the testator and of the witnesses as
designated above;
to act as such according to the law under which
I am acting;
the following
statement concerning the safekeeping of the will:
....................................................
and, if necessary, SEAL........
*to be completed if appropriate
Minn. Stat. § 524.2-1005
1978 c 525 s 6; 1986 c 444