IN THE NAME of the Most Holy Trinity, Father, Son and Holy Ghost, I, a poor, unhappy sinner, make this solemn declaration before thee, O beloved Angel, who has been given me as a protector by the Divine Majesty:
1. I desire to die in the Faith which the Holy, Roman and Apostolic Church adheres to and defends, in which all the Saints of the New Testament have died. I pray thee provide that I may not depart out of this life before the Holy Sacraments of that Church have been administered to me.
2. I pray that I may depart from this life under thy holy protection and guidance, and I beseech thee, therefore, to assist me at the hour of my death and to propitiate the Eternal judge, whose Sacred Heart was inflamed with most ardent love for sinners upon the Cross.
3. With my whole heart I long to be made a partaker of the merits of Jesus Christ and His holy Mother Mary, thine exalted Queen, and I pray thee, through the sufferings of Jesus on the Cross, to mitigate the agonies of my death and to move the Queen of Heaven to cast her loving glance upon me, a poor sinner, in that dreadful hour, for my sweetest consolation.
O my dearest Guardian Angel! Let my soul be placed in thy charge, and when it has gone forth from the prison of this body, do thou deliver it into the hands of its Creator and Redeemer, that with thee and all the Saints, it may gaze upon Him in the bliss of Heaven, love Him perfectly and find its blessedness in Him throughout eternity. Amen.