CONDITIONAL RETIREMENT OF DEBT As codicil and amendment to my will, dated ___________________, and witnessed by ______________________________, __________________________________, and ______________________________, I, ______________________________ declare the following: My executor is directed to discharge all debts owed to me by my __________________ (Relationship), ______________________________ (Name), and furnish __________ (him/her) with any and all notes documenting these debts, marked retired, as soon after my death as possible. This codicil is, however, conditional upon the following requirements: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ____________________________________________. ______________________________________ ____________________ Signature Date ______________________________________ ____________________ Witness Date ______________________________________ ____________________ Witness Date ______________________________________ ____________________ Witness Date