State of xxxxxxx / Rev. xxxxxxxx
[FIRST] CODICIL TO LAST WILL AND TESTAMENT OF
[FULL NAME AND DATE OF WILL]

I, ______[Name], of ______[Address], declare this to be my ____[MY1] Codicil (this “Codicil”) to my Last Will and Testamentcreated by me on ______[date of original will] (my “Last Will and Testament”).

1. My Last Will and Testament shall be amended and modified as set forth herein below.

2. ______[MY2] shall be amended to change my intended appointed executorfrom ______[original executor] to ______[new executor], my ______[relationship]. It is my intent to appoint ______[new executor] as my executor,______[original executor] shall not be appointed. In all other respects ______shall remain the same.

3. [______[MY3][sentence number ___] shall be deleted in its entirety].

4. ______[MY4] is hereby added to my Last Will and Testament and shall read as follows: ______.

5. ______[MY5]shall be modified so that ______.

6. If any statement in this _____ Codicil contradicts orconflicts with my Last Will and Testament, this Codicil shall control.

7. In all other respects I reaffirm and republish my Last Will and Testament as referenced above.

IN WITNESS WHEREOF, I, ______[name], have signed my initials on each of the preceding ____[MY6] page(s), and have signed my name below, on this day of ______, 2016.

TestatorSignature

SIGNED AND DECLARED by ______[testator name], in our joint presence to be [his/her[MY7]] ______[number codicil] Codicil to Last Will and Testament, and remaining in [his/her] presence, and in the presence of each other, and at [his/her] request, we signed as attesting witnesses, this clause having first been read aloud.

First Witness

First Witness Signature / (date)
First Witness Name
First Witness Address
First Witness City, State and Zip Code

Second Witness

Second Witness Signature / (date)
Second Witness Name
Second Witness Address
Second Witness City, State and Zip Code

STATE OF NEW YORK

CITY OF NEW YORK

We, , , , and JOHN SMITH, the witnesses and Testator, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned officer that the Testator, in the presence of witnesses, signed the instrument as his Last Will and that he signed voluntarily and that each of the witnesses in the presence of the Testator and in the presence of each other signed the Will as a witness and that to the best of the knowledge of each witness, the Testator was, at the time, 18 or more years of age, of sound mind and under no constraint or undue influence.

JOHN SMITH, Testator

Witness

Witness

Witness

SWORN TO and SUBSCRIBED before me on this day of , 2016, by JOHN SMITH, the Testator and by , , and , who are personally known to me or produced a driver's license as identification and who did take an oath.

NOTARY PUBLIC: STATE OF NEW YORK

Signature

My Commission Expires:

[MY1]What number codicil is this?

First, Second, Third…

[MY2]Is the original will being amended by changing the executor to the will?

Yes

What section of the original will names the executor?

e.g Article I, Paragraph 3; Section I.A.; Paragraph 2

Who is the original executor?

Who is being appointed as the new executor?

[MY3]Is the original will being amended by deleing a section?

Yes, a few sentences are being deleted

Deleted Sentences – Enter section no. as it appears in the original will, e.g. Article V; Section II; Paragraph 3

Section No.

Sentence No.

Yes, an entire section is being deleted

Deleted Sections - Enter section no. as it appears in the original will, e.g. Article V; Section II; Paragraph 3

Deleted Section No.

[MY4]Is the original will being amended by adding a section?

Yes

Added sections - e.g. Article V; Section II; Paragraph 3

Added Section No.

Added Section Text

[MY5]Is the original will being amended by modifying a section?

Yes

What section is being modified?

e.g Article I, Paragraph 3; Section I.A.; Paragraph 2

How is the section being modified?

e.g. my spouse shall receive a sum of $1,000,000.00

[MY6]Is there a way to automatically put in the number of pages? We also have this in our last will – if not, I will tweak this section.

[MY7]Ask user if they are male or female.