CODICIL TO LAST WILL OF________________________
I, ________________________ (the 'Testatrix') of ______________________, Michigan, declare this to be my codicil to last will (my 'Codicil') to my last will and testament being dated the 2nd day of December, 2016 (my 'Last Will').
IN WITNESS WHEREOF, I have signed my name on this the 2nd day of December, 2016, at __________, Michigan, 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 2nd day of December, 2016 to be her Codicil to Last Will, in our presence, at __________, Michigan, 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
I, ________________________, the Testatrix, sign my name to this document on _____ day of ____________________, 20_______. I have taken an oath, administered by the officer whose signature and seal appear on this document, swearing that the statements in this document are true. I declare to that officer that this document is my Codicil to Last Will; that I sign it willingly or willingly direct another to sign for me; that I execute it as my voluntary act for the purposes expressed in this Codicil to Last Will; and that I am 18 years of age or older, of sound mind, and under no constraint or undue influence._____________________________(Signature) TestatrixWe, ____________________ and ____________________, the witnesses, sign our names to this document and have taken an oath, administered by the officer whose signature and seal appear on this document, to swear that all of the following statements are true: the individual signing this document as the Testatrix executes the document as his or her Codicil to Last Will, signs it willingly or willingly directs another to sign for him or her, and executes it as his or her voluntary act for the purposes expressed in this Codicil to Last Will; each of us, in the Testatrix's presence, signs this Codicil to Last Will as witness to the Testatrix's signing; and, 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.
STATE OF MICHIGANCOUNTY OF _____________________________Sworn to and signed in my presence by ________________________, the Testatrix, and sworn to and signed in my presence by ____________________ and ____________________, witnesses, on _______________ (month) _____________ (day) _______ (year).(Seal)(Signed) ___________________________________________________________________(Official capacity of officer)
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