Fill and Sign the Codicil Will Form

CODICIL TO LAST WILL AND TESTAMENT OF ___________________________________________ I, __ ___________________________ , of _____________________________ County, Indiana, declare this as a Codicil to m y Will dated _____________ . 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. [All Articles are example s only. Only type changes to be made to will or additions thereto] ARTICLE I. I devise and bequeath to _____________ my _____________ . ARTICLE II. I revoke the prior devise and bequest of _____________ to _____________ , my _____________ . ARTICLE III I have another child named, _____________ , and amend Article _____________ to add said child as an addit ional beneficiary of the trust specified therein. ARTICLE V. I amend my will to appoint _____________ , or if the appointee fails to qualify or cease to act, I appoint _____________ , as Trustee of the Trust provisions of this Will to serve in said capacity with all the powers during the administration of the Trust as are granted to Trustees under the laws of the State of Indiana including the power to sell any of the real or personal property of the Trust for cash or on credit or to mortgage it or to lease it, all to be exercised without Court order. ARTICLE VI. In the event that my _____________ , _____________ , dies without having made just provision for the care and custody of our minor children, I appoint _____________ , as Guardian(s) of said minor children. Page One Signed by Maker/Testator: ________________ ARTICLE VII. I amend my will to appoint _____________ , as executor/executrix/personal representative of my Will, or if the appointee fails to qualify or ceas es to act, I appoint _____________ both to serve without bond, inventory, appraisal or accounting to any Court and to have all the powers during the administration of my estate as are granted to Trustees under the law s of the State of Indiana or any other law including the power to sell any of my real or personal property at public auction or private sale, for cash or on credit, or to mortgage it or to lease it, all to be exercised without Court order. I, _____ ________ , having signed this Codicil in the presence of __________________________________________________ and ___________________________________________ who attested it at my request on this the _____________ day of _____________ , 20 _____________ . _____________________________ MAKER/TESTATOR The above and foregoing Codicil of _____________ was declared and attested by _____________ in our presence to be _____________ Codicil and was signed by the said _____________ in our presence and at _____________ request and in the presence of _____________ and in the presence of each other, we, the undersigned, witnessed and attested the due execution of the Codicil of _____________ on this the _____________ day of ____________ _, 20 _____________ , and Further, that to the best of our knowledge the testator is 18 years of age or older, of sound mind, and under no constraint or undue influence and t hat we, as witnesses, are not interested or an heir of the estate of _____________ . ___________________________________ WITNESS ADDRESS:__________________________ ___________________________________ WITNESS ADDRESS:__________________________ UNDER PENALTIES FOR PERJURY, we, the undersigned testator/testatrix and the undersigned witnesses, respectively, whose names are signed to the attached or foregoing instrument declare: (1) that the testator/testatrix executed the instrument as the testa tor's/testatrix’s will; (2) that, in the presence of both witnesses, the testator/testatrix signed or acknowledged the signature already made; (3) that the testator/testatrix executed the will as a free and voluntary act for the purposes expressed in it; (4) that each of the witnesses, in the presence of the testator/testatrix and of each other, signed the will as a witness; (5) that the testator/testatrix was of sound mind when the will was executed; and (6) that to the best knowledge of eac h of the witnesses the testator/testatrix was, at the time the will was executed, eighteen (18) or more years of age or was a member of the armed forces or of the merchant marine of the United States or its allies. ______________________ ________ Testator/Testatrix ______________________________ Date ______________________________ Witness ______________________________ Witness State of Indiana County of __________________ Before me, ______________________________ , personally appeared ______________________________ , testator, and ______________________________ and ______________________________ , of ________________________ , who acknowledged execution of the foregoing __________________ and who, having been duly sworn, stated that the representations therein contained are true. ___________________________________ Notary Public, State of Indiana, County of _________________ Printed Name:________________________ My Commission Expires: _________________