SETTLEMENT OF BANKRUPTCY DISCHARGED DEBTS
As codicil and amendment to my will, dated , I, declare the following:
, and witnessed by
,
, and
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
Date
Witnessed
Date
Witnessed
Date
Witnessed
Date
electronic form 2005
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