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Codicil Form

A codicil is an amendment, change, or addition to an existing will.

If you have already made your will but would like to add a bequest to the Glaucoma Research Foundation, please do so following the example of this Codicil Form (you should verify that the form complies with your state law).

We recommend that you contact your attorney before making any changes to your will; please remember that your codicil must be signed and witnessed in the same way as your original will.

Glaucoma Research Foundation’s federal tax-exempt 501©(3) identification number is 94-2495035.

You can also download the form as a PDF.


I, __________________________________, do hereby publish this as and for a Codicil to my last Will and Testament dated the _______ day of _____________, 20____. Anything to the contrary in my aforesaid last Will and Testament notwithstanding, I hereby devise and bequeath to the Glaucoma Research Foundation, a not-for-profit organization, incorporated in the state of California, USA, with its offices at 251 Post Street, Suite 600, San Francisco, CA 94108, or the legal successor thereto: (insert sum of money; portion of estate; description of property; or the rest, residue, and remainder of my estate)



which shall be used for the chartered purposes of the organization. In all other ways I do hereby ratify and confirm my last Will and Testament as heretofore published.
In witness whereof, I have hereunto set my hand and seal this ______ day of _______________, 20____.

(Seal) ____________________________________________________

Signed, sealed, and published by the Testator (Testatrix) in the presence of each of us, and at the same time declared and acknowledged by him (her) to be a Codicil to his (her) last Will and Testament, and thereupon we, at the request of the Said Testator (Testatrix) and in his (her) presence and in the presence of each other, have hereunto subscribed our names as witnesses thereof.

Witness:_______________________ Witness:_______________________

Note: This is a sample form. Please consult with an attorney or estate planning professional when preparing legal documents.

Last reviewed on October 29, 2017

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