[FIRST] Codicil to Will of
[NAME OF TESTATOR]

I, [NAME OF TESTATOR], of[CITY/COUNTY], Virginia, make this [FIRST] Codicil to my Will dated [DATE WILL WAS SIGNED].

I hereby revoke [ARTICLE/SECTION/PARAGRAPH BEING REPLACED] of my Will in its entirety and substitute the following in its place:

[NEW PROVISION]

Except as amended in this codicil, I re-declare and republish my Will.

In testimony whereof, I,[NAME OF TESTATOR], sign and seal this instrument consisting of ____ pages, and on all pages of which I have placed my initials, on [DATE THIS CODICIL WILL BE SIGNED].

_______________________________

[NAME], Testator

The Testator signed, sealed, published, and declared this as [his/her] codicil in our presence on the date shown above. At the request of the Testator, we have both signed our names as witnesses in the presence of each other and the Testator. All of this occurred while we were all present at the same time.

_______________________________

[WITNESS 1 NAME]

[WITNESS 1 ADDRESS]

_______________________________

[WITNESS 2 NAME]

[WITNESS 2 ADDRESS]

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