Sample Codicil
[date]
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 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], 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 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 1:
Address: