OMISSION
OF PARTICULAR INDIVIDUAL
As codicil and amendment to my will, dated
___________________, and witnessed by
______________________________,
__________________________________, and ______________________________, I,
______________________________ declare the following:
I am fully aware that
__________________________________________ is my
__________________________________ (Relationship)
and that I have omitted _________ (him/her)
from my will. This is neither
unintentional nor an oversight.
____________________________________ _______________
Signature Date
____________________________________ _______________
Witness Date
____________________________________ _______________
Witness Date
___________________________________ _______________
Witness Date
