Codicil
I (full name) ______________________________________________
of (full address) ________________________________________________________________________________
______________________________________________________________________________________________
Postcode ______________________________________________
declare this to be the (1st/2nd/3rd/other) ___ codicil to my Will dated and made (date) ____________________
I give, free of inheritance tax, the sum of £ __________________
or
I give _____ per cent of my residuary estate
to The Pennoyer Centre, Station Road, Pulham St. Mary, Diss, IP21 4QT registered charity number 1135788 (England and Wales) absolutely for its general charitable purposes and I declare that the receipt of the treasurer or other proper officer for the time being shall be a sufficient discharge to my executors. In all other respects I confirm my said Will.
Please ensure you sign this form in the presence of two independent witnesses aged over 18 who are not representatives of The Pennoyer Centre (who must complete their details to the right.) This cannot be a direct family member / your executor / anyone who stands to benefit from your Will or their spouse.
Testator’s signature: _______________________________________________________
In witness whereof I have hereunto set my hand this ____________ (day) of ___________ (month) 20_____
Signed in the presence of:
First Witness
Signature ______________________________________________
Full name ______________________________________________
Address _______________________________________________________________________________________
______________________________________________________________________________________________
Occupation ____________________________________________
Second Witness
Signature ______________________________________________
Full name ______________________________________________
Address _______________________________________________________________________________________
______________________________________________________________________________________________
Occupation ____________________________________________
Please keep this form with your Will in a safe place