OMISSION OF FORMER SPOUSE
As codicil and amendment to my will, dated ___________________, and witnessed by ______________________________, __________________________________, and ______________________________, I, ______________________________ declare the following:
____________________________________ (Name), of ______________________ ________________________________, who was my _________________, until our divorce on ________________________ (Date) has been willfully omitted from my will and shall have no claim to any part of my estate.
____________________________________ Signature ____________________________________ Witness ____________________________________ Witness ___________________________________ Witness
_______________ Date _______________ Date _______________ Date _______________ Date