I give, devise, and bequeath $ ___________ to Cottey College, 1000 West Austin Blvd., Nevada MO 64772, for its charitable uses and purposes.
In all other respects I ratify and confirm all of the provision of my said last Will and Testament dated on the _________ day of ______________, 201_.
IN WITNESS WHEREOF, I sign, publish and declare this instrument to be a Codicil to my last Will and Testament in the presence of the persons witnessing said Codicil at my request this _____ day of ___________, 201_.
The codicil, to be valid, must be signed in the presence of witnesses, and the original placed with your other valuable papers. A copy can go to your lawyer and a copy to Cottey College.