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(Name of State), declare this to be a Codicil to my Last Will and Testament dated (date). This Codicil amends or supplements my Will only as provided herein. Except as amended or supplemented, my Will shall remain in full force and effect. I. I direct that my Last Will and Testament (identified above) be amended by deleting paragraphs (designation of paragraphs) of Article (number) appearing on pages (list of page numbers) in.

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