SETTLEMENT OF BANKRUPTCY DISCHARGED DEBTS As codicil and amendment to my will, dated ___________________, and witnessed by ______________________________, __________________________________, and ______________________________, I, ______________________________ declare the following: In addition to all outstanding debts I accrued at the time of my death, my executor shall also pay $___________________ to ________________________, for the fulfillment of a debt incurred, but discharged in __________________________ bankruptcy court on _____________________.
_____________________________________ Signature
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_____________________________________ Witnessed _____________________________________ Witnessed
_______________ Date _______________ Date
_____________________________________ Witnessed Date
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