Fill and Sign the I of County New York Declare Form

CODICILTO LAST WILL AND TESTAMENT OF _____________________ I, _____________________ , of _____________________ County, New York, declare this as a Codicil to my Will dated _____________________. This Codicil amends or supplements my Will only as provided herein. Except as amended or supplemented, my Will referenced herein shall remain in full force and effect. [All Articles are examples 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 additional 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 New York including the power to sell any of the rea l 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. ARTICLE VII. I amend my will to appoint ____________________, as executor/executrix/personal representative of my Will, or if the appointee fails to qualify or ceases to ac t, 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 grante d to Trustees under the laws of the State of New York 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 mort gage 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_____. ________________________________ TESTATOR/TESTATRIX The above and foregoing Codicil of _____________________ was declared and attested by _____________________ in our presence to be his/her Codicil 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 Codicil of _____________________ on this the _____ day of _____________________ , 20_____. ___________________________________ WITNESS ADDRESS___________________________ ___________________________________SS#___________________________ ___________________________________ WITNESS ADDRESS___________________________ ___________________________________SS#___________________________ ATTESTING WITNESSES SHOULD READ CAREFULLY BEFORE SIGNING THIS AFFIDAVIT -- NOTARY SHOULD NOT BE A PARTY OR WITNESS STATE OF NEW YORK COUNTY OF ___________________________ Each of the undersigned, individually and severally being duly sworn, deposes and says: The within Codicil to Will was subscribed in our presence and sight at the end thereof by ___________________________, the within-named Testator/Testatrix, on the _____ day of ___________________________, 20_____, at ________________________________________ [address]. Said Testator/Testatrix at the time of making such subscription declared the instrument so subscribed to be his/her Codicil to Last Will and Testament. Each of the undersigned thereupon signed his or her name as a witness at the end of said Codicil to Will at the request of said Testator/Testatrix and in his/her presence and sight and in the presence and sight of each other. Said Testator/Testatrix was, at the time of so executing said Codicil to Will, over the age of 18 years and, in the respective opinions of the undersigned, of sound mind, memory and understanding and not under any restraint or in any respect incompetent to make a codicil. The Testator/Testatrix, in the respective opinions of the undersigned, could read, write and converse in the English language and was suffering from no defect of sight, hearing or speech or from any other physical or mental impairment which would affect his/her capacity to make a valid will. The Codicil Will was executed as a single, original instrument and was not executed in counterparts. Each of the undersigned was acquainted with said Testator/Testatrix at said time and makes this affidavit at his/her request. The within Codicil to Will was shown to the undersigned at the time affidavit was made, and was examined by each of them as to the signature of said Testator/Testatrix and of the undersigned. _____________________________ Witness _____________________________ Witness Severally sworn to before me on this _____ day of _____________________, 20_____. _____________________________ NOTARY PUBLIC My Commission Expires:_____________________________