Fill and Sign the Deed of Disclaimer Form

Recorded at the Request of: ____________________ When Recorded, mail to:____________________________(Name)________________________________________________________ (Mailing Address)Disclaimer Deed FOR AND IN CONSIDERATION of One Dollar ($1.00), cash in hand paid, and other good and valuable consideration, the receipt of which is hereby acknowledged, the undersigned ___________________________ (Name of Grantor), a single person, does hereby convey and quitclaim unto ____________________________ (Name of Grantee) the following described land and property (hereinafter called Property) situated in __________________ (Name of County) County, _____________________ (Name of State), to-wit: Legal Description The Property above described is the sole and separate property of the Grantee having been purchased with separate funds of the Grantee or was a gift or devise made to the Grantee as the Grantee’s sole and separate property. The undersigned Grantor has no past or present right, title, interest, claim or lien of any kind or nature whatsoever in, to or against said Property. This instrument is executed, not for the purpose of making a gift to the Grantee, but solely for the purpose of clearly showing of record that the undersigned has and claims no interest in and to said Property. NOW THEREFORE, in consideration of the premises, the undersigned Grantor does hereby disclaim, remise, and release unto the Grantee and to the heirs and assigns of said Grantee forever, all right, title, interest, claim and demand which the undersigned might appear to have in and to the Property. WITNESS my signature, this the _____ day of _______________, 20______. _________________ Name of Grantor State of ______________ County of ________________ On this, the _____ day of _______________, 20____, before me _________________, the undersigned officer, personally appeared ________________________ (Name of Grantor) known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he/she executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seals.______________________________ NOTARY PUBLIC My Commission Expires: ___________________________