Codicil

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Codicil

WHEREAS, on _____________, I, ____________, executed my last will and testament, and; WHEREAS, I made various instructions and bequests, and, WHEREAS, I desire to add an additional provision to the will; I NOW PUBLISH THIS CODICIL to my last will and testament of ________________:

I reaffirm all parts and exhibits of said will, except that, I: _________________________

______________________________________

I direct that the executors of my estate enact these requests as if they were part of my last will and testament.

Dated: _________________

________________________________

____________, TESTATOR

I herewith affix my signature to this codicil on this the ____________ day of __________________, 20___ at ________________________________________, in the presence of the following witnesses, who witnessed and subscribed this codicil at my request, and in my presence.

ATTESTATION CLAUSE

On the date above written, ____________, well known to us declared to us, and in our presence, that this instrument, consisting of _____ pages, is a codicil to their last will and testament, and ____________, then signed this instrument in our presence, and at ____________’s request we now sign this codicil as witnesses in each other’s presence. Further that ____________ appeared to us to be of sound mind and lawful age, and under no undue influence.

Witness:

_______________________________________________________________

Address: ______________________________________________________

Witness:

_______________________________________________________________

Address: ______________________________________________________

Witness:

_______________________________________________________________

Address: ______________________________________________________

STATE OF _________________

COUNTY OF ________________

Before me, the undersigned authority authorized to take acknowledgments and administer oaths, personally appeared:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

who after being having duly sworn or affirmed to tell the truth, stated:

1. That ____________ declared this instrument to be a codicil to their last will and testament to the witnesses.

2. That ____________ signed this instrument in their presence.

3. That the witnesses signed as witnesses in the presence of ____________ and each other.

4. That ____________ is well known to the witnesses, and the witnesses believe ____________ to be of lawful age, of sound mind and under no undue influence or constraint.

______________________________________________________________

Notary

My Commission Expires: _________________________