Fill and Sign the I of County Iowa Declare This to Be Form

CODICIL TO LAST WILL AND TESTAMENT OF____________________________ I, ________________________, of ____________________ County, Iowa, declare this to be my Codicil to my Will dated the ____ day of_______________, 20__. ARTICLE I. I amend Article __of my will as follows: __________________________________________________________________ ARTICLE II I further change or amend my Will as follows: ________________________________________________________________ ARTICLE III All other provisions of my Will dated the ____ day of _____________, ____, shall remain in full force and effect. I, _____________________, having signed this Codicil to Will in the presence of ________________________________ and __________________________whoattested it at my request on this the _____ day of _____________,20__. ________________________________TESTATOR/TESTATRIX The above and foregoing Will of ____________________ was declared by ________________ in our presence to be his/her Will and was signed by the said __________________ in our presence and at his/her request and in the presence of _______________ and in the presence of each other, we, the undersigned, witnessed and attested the due execution of the Will of _____________________on this the _____ day of ______________, 20__. _____________________________WITNESSADDRESS:_____________________ _____________________________ _____________________________WITNESS ADDRESS:_____________________ _____________________________ Iowa Self Proving Affidavit STATE OF IOWACOUNTY OF ____________We, the undersigned, ____________________________, ____________________________ and ________________________________, the testator/testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, declare to the undersigned authority that said instrument is the testator's/testatrix’s Will and that the testator/testatrix willingly signed and executed such instrument, in the presence of the witnesses, as a free and voluntary act for the purposes therein expressed; that said witnesses, and each of them, declare to the undersigned authority that such Will was executed and acknowledged by the testator/testatrix as the testator's/testatrix’s Will in their presence and that they, in the testator's/testatrix presence, at the testator's/testatrix’s request, and in the presence of each other, did subscribe their names thereto as attesting witnesses on the date of the date of such Will; and that the testator/testatrix, at the time of the execution of such instrument, was of full age and of sound mind and that the witnesses were sixteen years of age or older and otherwise competent to be witnesses. _____________________________TESTATOR/TESTATRIX Typed Name:_______________ _____________________________WITNESS_____________________________WITNESSSubscribed, sworn and acknowledged before me by ____________________________, the testator/testatrix; and subscribed and sworn before me by _________________________ and ___________________________, witnesses, this _____ day of ______________, 20___._______________________SEAL NOTARY PUBLICMy Commission Expires:______________________ Iowa Self-Proving Affidavit STATE OF IOWACOUNTY OF ____________We, the undersigned, ____________________________________________________, ___________________________________ and ________________________________ , the testator/testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, declare to the undersigned authority that at the date of the instrument, we all knew the identity of each other; the instrument was exhibited to the witnesses by the testator, who declared it to be the testator's last will and testament and was signed by the testator or by another at the direction of the testator at ___________________________ , in the County of ____________, State of ____________ on the date shown in the instrument, and in the presence of each other as subscribing witnesses; that we, as witnesses, declare to the undersigned authority that in our presence the testator executed and acknowledged such will as the testator's will and that we, in the testator's presence, at the testator's request, and in the presence of each other, did subscribe our names thereto as attesting witnesses on the date of such will; and that the witnesses were sixteen years of age or older.__________________________________TESTATOR/TESTATRIX Typed Name: __________________________________ _________________________________WITNESS_________________________________WITNESSSubscribed, sworn and acknowledged before me by ____________________________, the testator; and subscribed and sworn before me by _________________________ and ___________________________, witnesses, this _____ day of ______________, 20___._______________________SEAL NOTARY PUBLICMy Commission Expires:______________________