Fill and Sign the Arkansas Renunciation and Disclaimer of Joint Tenant or Tenancy Interest Arkansas Form

RENUNCIATION AND DISCLAIMER OF JOINT TENANT INTEREST (Entire Interest of Joint Tenant) I. Pursuant to the Arkansas Code Title 28, Subtitle 1, Chap. 2, the undersigned ____________________________ , the surviving joint tenant with right of survivorship, chooses to exercise his/her right to disclaim any and all interests he/ she may have in any property or interest that is the subject of a joint tenancy devolving to him/her because of the death of the decedent. II. The undersigned, as the surviving joint tenant, has an interest in the property of ____________________________ (the decedent) who died on ____________________________ . III. The undersigned attests that the disclaimer of the property interest will be filed no later than nine months after the death of the decedent. IV. As a joint tenant with right of survivorship, the undersigned has an interest in the following property: _____________________________________________________________________________ _____________________________________________________________________________ V. Pursuant to applicable law of the State of Arkansas, and the Internal Revenue Code of 1986, if applicable, the undersigned hereby renounces and disclaims any interest or right to the property or asset of the deceased described in paragraph IV. VI. The property devolves to others pursuant to the provisions of applicable State law as though the undersigned had predeceased the decedent. VII. This renunciation and disclaimer shall for all purposes be deemed to relate back to the date of decedent's death and is an irrevocable refusal to accept that property effected hereby, and is hereby delivered to the personal representative, executor or executrix of the Estate of __________________ to be filed with the court in the above-captioned proceeding. DATED this ________ day of ____________________ , 20 _______ . _________________________ (Name) Receipt of an executed copy of the above Renunciation and Disclaimer is acknowledged this ________ day of ______________ , 20 ________ . _______________________________ (Name) ___________________ Personal Representative/Executor/Executrix STATE OF ARKANSAS COUNTY OF _________________ On this the ________ day of _______________ , 20 ______ , before me, _____________________ , the undersigned officer, personally appeared ________________________________ , known to me (or satisfactorily proven) to be the person whose name is/are subscribed to the within instrument and acknowledged that he/she/they executed the same for the purposes therein contained. In witness whereof I hereunto set my hand and official seal. _________________________________ Notary Public Printed Name: ______________________ My Commission Expires: ______________________ I certify that on ______________________ ______ , 20 ___ , I delivered a true copy of the Renunciation and Disclaimer of Property by ( ) personal delivery, ( ) registered mail, and/or ( ) certified mail, return receipt requested, to the personal representative/executor/executrix or other fiduciary of the decedent. DATED this _____ day of ________________________ , 20 _____ . _________________________________ Signature _________________________________ Print Name _________________________________ Address _________________________________ City, State, Zip Code _________________________________ Telephone