Will Amendment

SPECIFIC DIRECTIVE CODICIL TO THE
LAST WILL AND TESTAMENT
OF ${input_62_7}

WHEREAS, on ${input_62_2} , I, ${input_62_7} ,residing and domiciled at ${input_62_8_1} in the City of ${input_62_8_3} , in the County of ${input_62_8_6} and in the State of ${input_62_8_4} ${input_62_8_5} , executed my last will and testament, and; WHEREAS, I made various instructions and bequests, and, WHEREAS , I desire to add an additional provision to the will; I NOW PUBLISH THIS CODICIL to my LAST WILL AND TESTAMENT.

My Last Will and Testament is to be amended to add the following provisions:

IN WITNESS WHEREOF , I have set my hand and seal on ${input_62_91}

_____________________________________________
(TESTATOR/TESTATRIX SIGNATURE)

TESTATION CLAUSE

Subscribed by ${input_62_7} , Testator/Testatrix, in the presence of each of us, the undersigned witnesses, being first duly sworn, and at the same time declared by the Testator/Testatrix to us that this is the ${input_62_11} Codicil to his/her LAST WILL AND TESTAMENT, and we thereupon at his/her request, in his/her presence and in the presence of each other sign our names as Witness hereto effective ${input_62_91} .

WITNESSES SIGNATURES AND INFORMATION:

_______________________________________________________________

( ${input_62_94} )

${input_62_95_1}

${input_62_95_3} , ${input_62_95_4} ${input_62_95_5}

( ${input_62_94} )

${input_62_95_1}

${input_62_95_3} , ${input_62_95_4} ${input_62_95_5}

( ${input_62_98} )

${input_62_99_1}

${input_62_99_3} , ${input_62_99_4} ${input_62_99_5}

( ${input_62_102} )

${input_62_103_1}

${input_62_103_3} , ${input_62_103_4} ${input_62_103_5}

SELF-PROVING AFFIDAVIT

IN WITNESS WHEREOF , the undersigned authority personally appearing before me on this day ${input_62_7} , the Testator/Testatrix, and the Witnesses, whose names are shown in the foregoing instrument in their respective capacities, and all of said individuals being first duly sworn by me, said Testator/Testatrix declared to me and to the aforementioned Witnesses in my presence that said instrument is the ${input_62_11} Codicil to his/her LAST WILL AND TESTAMENT and the s/he had willingly made and executed it as his/her free and voluntary act and deed for the purposes therein expressed; and the said Witnesses each on his/her oath stated to me in the presence and hearing of the said Testator/Testatrix that the said Testator/Testatrix had declared to them that said instrument is the ${input_62_11} Codicil to his/her LAST WILL AND TESTAMENT, and that s/he executed the same as such and wanted each of them to sign it as a Witness; and upon their oaths each Witness stated further that they did sign the same as a Witnesses; and upon their oaths of each Witness stated further that they did sign the same as Witnesses in the presence of the said Testator/Testatrix and at his/her request, and that said Testator/Testatrix was at the time of the age of consent of 18 years of age or over and was of sound mind.

Subscribed and acknowledged before me by the said Testator/Testatrix, and subscribed and sworn to before me by the aforementioned Witnesses, on ___________________________.

NOTARY ACKNOWLEDGMENT
${input_62_11} CODICIL TO THE
LAST WILL AND TESTAMENT
OF
${input_62_7}

I, ${input_62_7} , residing and domiciled in the City of ${input_62_8_3} , in the County of ${input_62_8_6} and in the State of ${input_62_8_4} , hereby make, publish and declare this to be a Codicil to my LAST WILL AND TESTAMENT dated ${input_62_2} .

My Last Will and Testament is to be amended to add the following provisions:

IN WITNESS WHEREOF, I ${input_62_7} , have to this ${input_62_11} Codicil of my LAST WILL AND TESTATMENT, subscribed my name as of _____________________________________.

_____________________________________________
(TESTATOR/TESTATRIX SIGNATURE)

Subscribed and acknowledged before me by the said Testator/Testatrix, and subscribed and sworn to before me by the aforementioned Witnesses.