FIRST CODICIL TO THE LAST WILL AND TESTAMENT OF I, of

FIRST CODICIL TO THE
LAST WILL AND TESTAMENT OF
I, ____________________________ of _____________________________________________,
do make, publish and declare this to be the first Codicil to my Last Will and Testament dated
________________20_____.
FIRST:
SECOND:
IN WITNESS WHEREOF, I, ____________________________, have to this first Codicil of my
Last Will and Testament, consisting of 2 pages, subscribed my name this _____ day of
______________, 20_____.
_______________________________
Testatrix

Subscribed by _________________________, Testatrix, in the presence of each of us, the
undersigned, and at the same time declared to us to be the first Codicil to the Last Will and
Testament, and we thereupon her request, in her presence and in the presence of each other sign
our names as Witnesses hereto this day of _____________________, 20____.
WITNESSES
ADDRESSES:
_________________________________
____________________________________
____________________________________
_________________________________
____________________________________
____________________________________
STATE OF
COUNTY OF
BEFORE ME, the undersigned, authority, on this day personally appeared
_______________________, known to me to be the Testratix, and the Witnesses, whose names
are subscribed to the annexed and foregoing instrument in their respective capacities, and all of
said persons being by me first duly sworn, said ___________________, Testratix, declared to me
to be the said Witnesses in my presence and said instruments is the first Codicil to her LAST
WILL AND TESTAMENT and that willingly made and executed it as a voluntary act and deed
fro the purposes therein expresses; and the said Witnesses of each on oath stated to me in the
presence and hearing of the Testratix that the said Testratix had declared to them that said
instrument is the first Codicil to her LAST WILL AND TESTAMENT, and that it was 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 the same as Witnesses in the presence of the said Testratix
and at request, and that said Testratix was a the time eighteen (18) years of age or over and was
of sound mind.
__________________________________
TESTRATIX
___________________________________
WITNESS
___________________________________
WITNESS
SEAL
____________________________________
Notary Public
My Commission Expires: _____________________
Important Note: Once this document has been completed, Holy Family Memorial, Manitowoc,
Wisconsin highly recommends reviewing this and other Will documents with your attorney or
tax consultant.