State of Georgia s1

CODICIL OF

______(Your Name)

STATE OF GEORGIA COUNTY OF BARROW

Whereas I, ______, did on the ______day of ______, 20_____, sign, seal, declare and publish my Last Will and Testament in the presence of ______(Name of Witness) and ______(Name of Witness) who signed the said Will and Testament as witnesses; and

Whereas I am desirous of adding an additional testamentary gift under this Will to the (Mission of Nonprofit Organization, eg: elimination of poverty);

I therefore make and publish this Codicil to my Last Will and Testament, and also republish all the terms of said Will not in conflict with the Codicil.

I hereby give to (Name of Nonprofit Organization):

(Whatever you wish to give them)

Every other provision of my Last Will & Testament not in conflict with this Codicil shall remain published as executed and unchanged.

This ______day of ______, 20_____.

______Testator (Your name here)

Signed, sealed, declared, and published by ______(your name), as a Codicil to his/her last Will and Testament, in the presence of us, the undersigned, who subscribe our names hereto in the presence of said Testator, after (s)he had signed his/her name thereto, and at his/her special instance and request, and in the presence of each other.

______Witness Address

Before me, the undersigned authority, on this day personally appeared the above-named Testator and Witnesses. The Testator declared to me and to the said witnesses in my presence that this instrument is a Codicil to his/her Last Will & Testament and that (s)he had willingly made and executed it as his/her free act and deed for the purposes therein expressed. The witnesses stated to me in the presence and hearing of the Testator that the Testator had declared to them that the instrument is a Codicil to his/her Last Will & Testament and that he/she executed same as such and wanted them to sign it as a witness; and upon his/her oath each witness stated further that (s)he did sign the same as witness in the presence of the Testator and at his/her request; and that Testator and witnesses were at that time 14 years of age or over and were of sound mind.

This ______day of ______, 20______.

______Notary Public