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Prepared by U.S. Legal Forms, Inc.
Copyright 2016 - U.S. Legal Forms, Inc.
STATE OF CONNECTICUT
RENUNCIATION AND DISCLAIMER OF PROPERTY
[Real Property Interest]
Control Number – CT - 04 - 03
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NOTE ABOUT COMPLETING THE FORMS
The forms in this packet contain “form fields” created using Microsoft Word. “Form fields”
facilitate completion of the forms using your computer. They do not limit you ability to print the
form “in blank” and complete with a typewriter or by hand.
If you do not see the gray shaded form fields, go the View menu, click on Toolbars, and then
select Forms. This will open the forms toolbar. Look for the button on the forms toolbar that
resembles a shaded letter “a”. Click in this button and the form fields will be visible.
The forms are locked which means that the content of the forms cannot b e changed. You can
only fill in the information in the fields.
If you need to make any changes in the body of the form, it is necessary for you “unlock” or
“unprotect” the form. IF YOU INTEND TO MAKE CHANGES TO THE CONTENT, DO
SO BEFORE YOU BEGIN TO FIL L IN THE FIELDS. IF YOU UNLOCK THE
DOCUMENT AFTER YOU HAVE BEGUN TO COMPLETE THE FIELDS, WHEN
YOU RELOCK, ALL INFORMATION YOU ENTERED WILL BE LOST. To unlock
click on “Tools” in the Menu bar and then selecting “unprotect document”. You may then be
prom pted to enter a password. If so, the password is “uslf”. That is uslf in lower case letters
without the quotation marks . After you make the changes relock the document before you
being to complete the fields.
After any required changes and re -protectin g the document, click on the first form field and enter
the required information. You will be able to navigate through the document from form field to
form field using your tab key. Tab to a form field and insert your data. If problems, please let us
kno w.
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DISCLAIMER
These materials were developed by U.S. Legal Forms, Inc. based upon statutes and forms for the
State of Connecticut. All Information and Forms are subject to th is Disclaimer: All forms in this
package are provided without any warranty, express or implied, as to their legal effect and
completeness. Please use at your own risk. If you have a serious legal problem we suggest that
you consult an attorney. U.S. Legal Forms, Inc. does not provide legal advice. The products
offered by U.S. Legal Forms (USLF) are not a substitute for the advice of an attorney.
THESE MATERIALS ARE PROVIDED "AS IS" WITHOUT ANY EXPRESS OR IMPLIED
WARRANTY OF ANY KIND INCLUDING WARRANTIES O F MERCHANTABILITY,
NONINFRINGEMENT OF INTELLECTUAL PROPERTY, OR FITNESS FOR ANY
PARTICULAR PURPOSE. IN NO EVENT SHALL U. S. LEGAL FORMS, INC. OR ITS
AGENTS OR OFFICERS BE LIABLE FOR ANY DAMAGES WHATSOEVER
(INCLUDING, WITHOUT LIMITATION DAMAGES FOR LOSS OF PROFITS, BUSINESS
INTERRUPTION, LOSS OF INFORMATION) ARISING OUT OF THE USE OF OR
INABILITY TO USE THE MATERIALS, EVEN IF U.S. LEGAL FORMS, INC. HAS BEEN
ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
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RENUNCIATION AND DISCLAIMER OF PROPERTY
(Real Property Interest)
I.
Pursuant to the General Statutes of Connecticut, Title 45, Chap. 802g, the undersigned,
______________________________ chooses to exercise his/her right to disclaim an interest in
the real property which has devolved to him/her because of the death of the decedent,
______________________________ .
II.
The decedent died on ____________ ______ , 20 ______ and the undersigned has an interest in
the described real property.
III.
A description of the real property is as follows:
________________________________________________________________________
IV.
The undersigned attests that the disclaimer of the real property interest will be filed no later than
nine months after the death of the decedent.
V.
Pursuant to applicable law of t he State of Connecticut and the Internal Revenue Code of 1986,
if applicable, the undersigned hereby renounces and disclaims any interest or right to the real of
the deceased described in paragraph III.
VI.
The real property devolves to others pursuant t o 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 decedent. A copy of
the disclaimer shall be recorded in the office of the county clerk and recorder of the county in
which the property or i nterest disclaimed is located.
DATED this the ______ day of ____________ , 20 ______ .
Signature
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Type or Print Name
State of Connecticut
County of __________________
The foregoing instrument was acknowledged before me this __________________ (date) by
______________________________ (name of person acknowledged).
In witness whereof I hereunto set my hand.
Date: ________________________
Notary Public
My commission expires:
Type or Print Name
I certify that on the ______ day of ____________ , 20 ______ , I delivered a true copy of
the Renunciation and Disclaimer of Property by personal delivery, registered mail,
and/or certified mail to ________________________________________________ (name
and address), the personal representative, executor, executrix, or other fiduciary of
the decedent.
DATED this the ______ day of ____________ , 20 ______ .
Signature of Party
Printed Name
Address
-6-
City, State, and Zip
Telephone Number
Receipt of an executed copy of the above Renunciation and Disclaimer is acknowledged this
______ day of _____ _____________ , 20 ______ .
Signature
Type or Print Name
Personal Representative/Executor/Executrix
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