1. Lord Jesus Christ! Thou Son of God and Son of the Virgin Mary, God and Man, Thou Who in fear sweated blood for us on the Mount of Olives in order to bring peace, and to offer Thy Most Holy Death to God Thy Heavenly Father for the salvation of this dying person … If it be, however, that by his sins he merits eternal damnation, then may it be deflected from him. This, O Eternal Father through Our Lord Jesus Christ, Thy Dear Son, Who liveth and reigneth in union with the Holy Spirit now and forever. Amen

2. Lord Jesus Christ! Thou Who meekly died on the trunk of the cross for us, submitting Thy Will completely to Thy Heavenly Father in order to bring peace and to offer Thy most Holy Death to Thy Heavenly Father in order to free… (this person)… and to hide from him what he has earned with his sins; grant this O Eternal Father! Through Our Lord Jesus Thy Son, Who liveth and reigneth with Thee in union with the Holy Spirit now and forever. Amen.

3. Lord Jesus Christ! Thou Who remained silent to speak through the mouths of the Prophets: I have drawn Thee to me through Eternal Love, which Love drew Thee from Heaven into the body of the Virgin, which Love drew Thee from the body of the Virgin into the valley of this needful world, which Love kept Thee 33 years in this world, and as a sign of Great Love, Thou hast given Thy Holy Body as True Food and Thy Holy Blood as True Drink, as a sign of Great Love, Thou has consented to be a Prisoner and to be led from one judge to another and as a sign of Great Love Thou hast consented to be condemned to death, and hast consented to die and to be buried and truly risen, and appeared to Thy Holy Mother and all the Holy Apostles, and as a sign of Great Love Thou hast ascended, under Thy own Strength and Power, and sitteth at the Right Hand of God Thy Heavenly Father, and Thou has sent Thy Holy Spirit into the hearts of Thy Apostles and the hearts of all who hope and believe in Thee. Through Thy Sign of Eternal Love, open Heaven today and take this dying person … and all his sins into the Realm of Thy Heavenly Father, that he may reign with Thee now and forever. Amen