I give, devise, and bequeath $ ___________ to Carleton University, a Canadian charity with Registration # 11883 8937 RR0001, for its charitable uses and purposes.
In all other respects I ratify and confirm all of the provisions of my said last Will and Testament dated on the _________ day of ______________, 20__
IN WITNESS WHEREOF, I sign, publish and declare this instrument to be a Codicil to my last Will and Testament in the presence of both persons witnessing said Codicil at my request this _____ day of ___________, 20__.
_________________________ residing at __________________________
(name)
Witnesses
_________________________ residing at ___________________________
(name)
_________________________ residing at ___________________________
(name)
[The codicil, to be valid, must be signed in the presence of both witnesses who are present at the same time, and the original placed with your other valuable papers. A copy can go to your lawyer and a copy to Carleton University.]