Sample Codicil Form printable pdf download

SAMPLE CODICIL

[date]

[name],

a resident of the County of

[county],

State of

[state],

declare that this is the

codicil to my last will and testament, which is dated

[date original signed].

I add or change said last will in the following manner:

[List all specific changes or additions to the original will. Reference each section number

of the will and the specific language you will be affecting. This is where you could

include a bequest to support our mission. See our suggested

bequest language

that can

assist you.]

Otherwise, I hereby confirm and republish my will dated

[date original signed],

in all

respects other than those herein mentioned.

I subscribe my name to this codicil this

[day, e.g. 1st]

day of

[month], [year],

[full

address where signed],

in the presence of

[full name of first witness to codicil], [full name

of second witness to codicil],

and

[full name of third witness to codicil],

attesting

witnesses, who subscribe their names here in my presence.

___________________________________

Maker

ATTEST

On the date last above written,

[name],

known by us to be the person whose

signature appears at the end of this codicil, declared to us,

[full name of first witness

to codicil], [full name of second witness to codicil],

and

[full name of third witness to

codicil], the undersigned, that the foregoing instrument, consisting of

[number of

pages to codicil]

page(s) was the codicil to the will dated

[date original signed];

who

then signed the codicil in our presence, and now in the presence of each other, we

now sign our names as witnesses.

_____________________________________

Witness

Address:

_____________________________

_____________________________________

Witness

Address:

_____________________________

Sample Codicil Form

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