CODICIL TO LAST WILL OF________________________
I, ________________________ (the 'Testatrix') of ______________________, Connecticut, declare this to be my codicil to last will (my 'Codicil') to my last will and testament being dated the 10th day of December, 2016 (my 'Last Will').
IN WITNESS WHEREOF, I have signed my name on this the 10th day of December, 2016, at __________, Connecticut, declaring and publishing this instrument as my Codicil to Last Will, in the presence of the undersigned witnesses, who witnessed and subscribed this Codicil to Last Will at my request, and in my presence._____________________________________________________ (Testatrix)
SIGNED AND DECLARED by ________________________ on the 10th day of December, 2016 to be her Codicil to Last Will, in our presence, at __________, Connecticut, who at her request, in her presence and in the presence of each other, all being present at the same time, have signed our names as witnesses.
__________________________Witness #1 Signature__________________________Witness #1 Name (Please Print)__________________________Witness #1 Street Address__________________________Witness #1 City/State
__________________________Witness #2 Signature__________________________Witness #2 Name (Please Print)__________________________Witness #2 Street Address__________________________Witness #2 City/State
STATE OF CONNECTICUTCOUNTY OF _____________________________I, ________________________, the Testatrix, sign my name to this instrument this ________ day of ____________________, 20______, and being first duly sworn, declare to the undersigned authority all of the following:1. I execute this instrument as my Codicil to Last Will.2. I sign this Codicil to Last Will willingly, or willingly direct another to sign for me.3. I execute this Codicil to Last Will as my free and voluntary act for the purposes expressed therein.4. I am 18 years of age or older, of sound mind and under no constraint or undue influence.Testatrix: ____________________We, ____________________ and ____________________, the witnesses, being first duly sworn, sign our names to this instrument and declare to the undersigned authority all of the following:1. The Testatrix executes this instrument as her Codicil to Last Will.2. The Testatrix signs it willingly, or willingly directs another to sign for her.3. Each of us, in the conscious presence of the Testatrix, signs this Codicil to Last Will as a witness.4. To the best of our knowledge, the Testatrix is 18 years of age or older, of sound mind and under no constraint or undue influence.
Subscribed and sworn to before me by ________________________, the Testatrix, and by ____________________ and ____________________, witnesses, this _____ day of ____________________, 20_______.(Seal)(Signed) ___________________________________________________________________(Official capacity of officer)
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