(I)

F. Details of Guardian
Name: Marcus Tan (Uncle)
NRIC: 650902-12-5542
Address: 1, Jalan Ikan number and street name Seksyen 20 section 40300 Shah Alam
SELANGOR MALAYSIA

G. Details of Witness
Name: Jacquline Jainol
NRIC: 810403-12-5493

Name: Erica Monica Lee

NRIC: 790912-12-5491

H. Details of Testator death

(II)
F. Guardian
If my husband does not survive me and I leave minor children surviving me, I appoint as
guardian of the person and property of my minor children my uncle Marcus Tan. He shall
have custody of my minor children, and shall serve without bond.

G. Witness
We, the witnesses, sign our names to this document, and declare that the testator willingly
signed and executed this document as the testator's last will.
In the presence of the testator, and in the presence of each other, we sign this will as
witnesses to the testator's signing.
To the best of our knowledge, the testator is of the age of majority or otherwise legally
empowered to make a will, is of sound mind and under no constraint or undue influence. We
declare under penalty of perjury that the foregoing is true and correct, this ____ day of ____,
____, at ______

First Witness
Name:
NRIC:
Sign:

Second Witness
Name:
NRIC:
Sign: