(_______________)______字第______号
继承人：_____________，男，___________年___________月___________日出生，现住___________省___________市___________街___________号。被继承人：_____________，女，生前住___________省___________市___________街___________号。查___________于___________年___________月___________日___________在___________(地名)死亡，死亡后在___________(地名)留有遗产。死者生前立有遗嘱。根据遗嘱，死者___________的遗产应由___________继承。中华人民共和国______省______(市)公证处公证员：__________________(签名章或签名)_________________年_____________月_____________日