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(for making a change or addition to an existing will)
To help you to complete the Codicil Form we have included this sample as a reference tool.
To leave a gift in your Will to the Irish Heart Foundation simply complete the blank
Codicil Form supplied and return it to us using the freepost envelope enclosed.
I [name] of [address] (hereinafter called the Testator’) make this codicil to my
Will dated [
x] day of [month] 20 [year] (hereinafter called my said Will’).
1. I make the following amendments to my said Will:
2. In all other respects I confirm my said Will.
IN WITNESS whereof I have hereunto set my hand this [
x] day of [month] 20 [year]
SIGNED by the Testator in the presence of us and then signed by us in the presence of
the Testator
Witness 1
Witness 2
(Testator’s signature)
[I give to the Irish Heart Foundation, 50 Ringsend Road, Dublin 4,
(Charity No. 5507) the sum of €
[ x ] and declare that the receipt in
writing of the treasurer or other proper ofcer of that charity shall be a
sufcient discharge to my Executors.
Sample Codicil Form
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