1/ _________________________% of my estate
2/ The residue of my estate
3/ ______________% of the residue of my estate
4/ The sum of $__________________________
5/ Property or assets as follows:
______________________________________
______________________________________
______________________________________
______________________________________
…to the society known as the Leprosy Mission NZ, whose present office is 591 Dominion Road, Balmoral, Auckland, and I declare that the receipt of the Director or other Officer of the said Society shall be sufficient discharge for my trustees in respect of such payment.
Name: ___________________________________
Signature: ___________________________________
Date: ___________
Witness: ___________________________________
Signature: ___________________________________ |