Codicil Form Sample printable pdf download

SAMPLE CODICIL

(for making a change or addition to an existing will)

I, [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

City of Hope. 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. 1

] day of [month], [year], at [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 the 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.

_______________________________

Address:

Witness

_____________________________________

_______________________________

Address:

Witness

_____________________________________

_______________________________

Address:

Witness

_____________________________________

________________________________________________________

Codicil Form Sample