Codicil to Will
This is my (first) (second) (third) CODICIL to the will dated ______ of __________ of the following address, ________ in the city of ________ the State of ___.
1. I revoke clause _______ of my will and substitute the following clause for it:
2. In all other respects I confirm my will.
In witness to which CODICIL, I have signed my name to it below on _______________, 20 __.
Signed by me:
in our presence and by us in (his) (her) presence and in the presence of each other:
Witness # 1:
Witness # 2: