Fill and Sign the Codicil Forms

Codicil to Last Will and Testament of _____________________ (Name of Testator) I, ___________________ (Name of Testator) , of ___________________ (Name of County) County, ____________________ (Name of State) , declare this to be a Codicil to my Last Will and Testament dated _________________ (date) . This Codicil amends or supplements my Will only as provided herein. Except as amended or supplemented, my Will shall remain in full force and effect. By this codicil I revoke that part of Article ______________ (Number) of my Last Will and Testament in which I devised and bequeathed to _____________________ (Name of Beneficiary) , of _______________________________________________________________ _______________ (street address, city, state, zip code) , certain property. I declare that all of the devises and bequests contained in my Last Will and Testament to ____________________ (Name of Beneficiary) , are null and void, and ________________________ (Name of Beneficiary) shall take nothing under my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto subscribed my name this the _ day of ____________, 20____. ____________________________ (Printed Name of Testator) ____________________________ (Signature of Testator) This instrument was, on the day and year shown above, signed, published and declared by ________________________ (Name of Testator) , to be his Last Will and Testament in our presence, and we, at his request, have subscribed our names hereto as witnesses in his presence and in the presence of each other. _______________________ (Printed Name of Witness) _______________________ (Signature of Witness) _______________________ (Printed Name of Witness) _______________________ (Signature of Witness) State of ______________ County of ______________ Affidavit of Subscribing Witnesses This day personally came and appeared before me, the under-signed authority at law in and for said jurisdiction, ____________________ (Name of Witness) and ________________ __________________ (Name of Witness) , the two subscribing witnesses to that certain instrument of writing purporting to be a Codicil to the Last Will and Testament of _______________________ (Name of Testator) , a resident of _________________________ ___________________ (Name of City, County and State) , each of whom, having been first duly sworn, makes oath that the said ____________________ (Name of Testator) , signed, published and declared the original of said instrument as his Codicil to his Last Will and Testament on the ___________________ (date) , the day and date of said instrument, in the presence of said two affiants, both of whom were the subscribing witnesses to said instrument; that said Testator was then of sound and disposing mind and memory and above the age of twenty-one (21) years; and each of the said two subscribing witnesses subscribed and attested said instrument as witnesses to the signature and publication thereof, at the special instance and request, and in the presence of the said Testator and in the presence of each other. ______________________ (Printed Name of Witness) ______________________ (Signature of Witness) ______________________ ______________________ (Address of Witness) ______________________ (Printed Name of Witness) ______________________ (Signature of Witness) ______________________ ______________________ (Address of Witness) SWORN to and subscribed before me, this the _____ day of day of ________________, 20_____. ______________________ NOTARY PUBLIC My Commission Expires: _____________________