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Codicil to Will

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Codicil to Will Page 2
III.
I hereby confirm and republish my will dated _________, _________[if previous
codicil is to be republished, add: and my codicil to that will dated _________] in all
respects other than those above-mentioned.
I subscribe my name to this codicil on _________[date], at _________[address],
_________ County, _________[state], in the presence of _________, _________, and
_________, attesting witnesses, who subscribe their names to this codicil on
_________[date] at my request and in my presence.
[Signature]
ATTESTATION CLAUSE
On the date last above written, _________[testator's name], known to us to be the
person whose signature ap-pears at the end of this codicil, declared to us, the
undersigned, that the foregoing instrument, consisting of _________pages, including the
page on which we have signed as witnesses, was the _________[number, such as:
second] codicil to _________[his or her] will dated _________. _________[He or She]
then signed the codicil in our presence and, at _________[his or her] request, in
_________[his or her] presence and in the presence of each other, we now sign our
names as witnesses.
_________, residing at _________
[Signature] [Street, city, state]
_________,
residing at
_________
[Signature] [Street, city, state]
_________,
residing at
_________
[Signature]
[Street, city, state]
Codicil to Will
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