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I, {Name}, of {Address}, born {date}, and being of sound mental health and full mental capacity, do instate the following provision to my will regarding the division and dispersal of my estate:
I make no provisions for {Name}. For all intents and purposes concerning my estate and all benefits of this deed, I will consider {Name} to have predeceased me.
Any reference to any other bequeathals, benefits, or monetary gains previously allotted to {Name} are hereby revoked. Any bequeathals, benefits, or monetary gains previously allotted to {Name} in prior writings should be bestowed up {Name/Organization} instead.
I, {Name}, hereby declare this provision to be an addition or change to my will. All other aspects of my will are to remain intact.
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Name, signature & date
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Witness, signature & date
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Witness, signature & date
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