As many hazards to human life is subject, and knowing I sinner, I'm born to die, and I know not the hour so that I do not find the unprepared death, I have decided to arrange with the help of God, and thus prostrate at the feet of my Lord Jesus Christ crucified for my love, I declare to all the creatures of heaven and earth, that my will is explained here in as follows:
In the name of the Father and the Son and the Holy Spirit. Amen.
First, I say that as the foundation of my salvation, I protest in the presence of Almighty God, the Blessed Virgin his Mother, and all the heavenly court, that my will to live and die obedient to the Holy Catholic Apostolic Roman , firmly believing, as I believe, all articles of faith taught by the Holy Apostles, as proposed and explained our Holy Mother the Church. So if I ever should occur any thing against them, I have certainly in error and temptation of the enemy. And if, which God forbid, should say or do something that is contrary, under of this clause as revoked and annulled, and it is my will that has not said or done.
declare this my last will, that in my death I wish to receive the holy sacrament of penance, confessing all my sins, and if by some accident MIGHT I confess, is my willingness to confess and hurting all of them, weep bitterly not so much by fear of eternal punishment, as for having offended the Supreme Good, whom I serve and love above all things, which is now firmly resolve with his divine grace as long as rest of my life.
is my will also receive the Holy Viaticum, and if for any reason be unable to declare that my wish is to receive at least spiritually, loving heart to my Lord Jesus Christ, Sacrament, and begged him to deign to join me in that dangerous trip, fend off enemies from hell, and take the safe harbor of eternal bliss.
also declare that my wish is to pass from this life, having received the Sacrament of Extreme Unction, and can not receive, I pray to my God and Lord may deign to anoint with holy oil of his mercy, forgiving the sins I committed to the five senses.
It's my life will end up waiting in the infinite mercy of God to forgive all my sins and the salvation of no soul, having as I have as infallible word of my Lord Jesus Christ, who said: I came not to call the righteous, but sinners confess
even the good works I ever did with many flaws and negligence, and that the devil is confusing I do not presume to declare that my work alone merit heaven, but mainly by the infinite merits and precious Blood of my Lord Jesus Christ, shed for my salvation.
is my will suffer with patience and conformity to the last breath of my life, together with what my Divine Saviour suffered for me, any sickness and pain God sends me, and if I fall through weakness and misery in some impatience to complain immoderately, now I repent of sin and bad examples of either work in word, praying to God not to forsake me in this dangerous and last trance.
forgive all the wrongs I have done the men, begging them to forgive me also to me, and God who take them do not own, but to help and assist you with his grace, using all of indulgence and pity. 
I thank the Lord for all the blessings you have given me so spiritual and temporal, particularly the creation, redemption and calling to his holy knowledge, and also for me so far expected to repentance, having deserved punish me thousand times with eternal punishment. Be forever blessed his goodness and mercy. wish that this my last will be enforceable the Glorious Virgin Mary, a lawyer for sinners, the glorious Patriarch St. Joseph, and my main advocates and protectors, St. N. and N., whom pray favor me in that hour, asking the Lord for his infinite mercy deign to receive my soul in eternal peace of the Saints. 
constitute and appoint a defender of my soul, my guardian angel Santo, in the court of God, when you see my cause, and pronounce final sentence, pleading that as our Lord entrusted my soul, bringing it under his tutelage and protection in this life, the place for their protection and hands in the halls of eternal glory. pray for the bowels of Jesus Christ to all my relatives and friends to help me with prayers and works of satisfaction, especially the Holy Sacrifice of the Mass, as a medium between all the most effective, so that if, by the mercies of God has my soul destined to the pains of Purgatory, they will be free soon, and back to enjoy the sight of God, that I offer not to be ungrateful to such a great benefit. Finally, paying humble thanks to God for having so far kept the life, protest and declare to be my intention to accept death in any way and time to send me, humbly receive in satisfaction for my sins, and forming in this and all my will to His holy and lovable, which humbly beg you not let me ever apart. Amen. San Carlos Borromeo
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