Fill and Sign the Disclaimer of Right to Inherit or Inheritance All Property from Estate or Trust Form

DISCLAIMER OF INHERITANCE RIGHTS I, __________________________, the undersigned, being an heir of the estate of __________________, deceased, hereby disclaims my right to receive any property from the Estate of ___________________, whether by Will or intestate succession and further state as follows: 1. I have been fully advised of my rights to certain property of the Estate of ______________ and waive and disclaim my right to same voluntarily and without duress or undue influence. This disclaimer applies to all real and personal property I would have received. [The real estate is located in the County of _________, City of ____________, State of _________________.] 2. I direct that my right to disclaim exists notwithstanding (a) any limitation on the interest of the disclaimant in the nature of a spendthrift provision or similar restriction or (b) any restriction or limitation on the right to disclaim contained in the governing instrument. 3. To the extent permitted by law, I direct that the following provisions shall apply to this disclaimer: (a) If property or an interest therein devolves to a disclaimant under a testamentary instrument, under a power of appointment exercised by a testamentary instrument, or under the laws of intestacy, and the decedent has not provided for another disposition of that interest, should it be disclaimed, or of disclaimed or failed interests in general, the disclaimed interest devolves as if the disclaimant had predeceased the decedent, but if by law or under the testamentary instrument the descendants of the disclaimant would take the disclaimant's share by representation were the disclaimant to predecease the decedent, then the disclaimed interest passes by representation to the descendants of the disclaimant who survive the decedent. A future interest that takes effect in possession or enjoyment after the termination of the estate or interest disclaimed takes effect as if the disclaimant had predeceased the decedent. A disclaimer relates back for all purposes to the date of death of the decedent. (b) If property or an interest therein devolves to a disclaimant under a nontestamentary instrument or contract and the instrument or contract does not provide for another disposition of that interest, should it be disclaimed, or of disclaimed or failed interests in general, the disclaimed interest devolves as if the disclaimant had predeceased the effective date of the instrument or contract, but if by law or under the nontestamentary instrument or contract the descendants of the disclaimant would take the disclaimant's share by representation were the disclaimant to predecease the effective date of the instrument, then the disclaimed interest passes by representation to the descendants of the disclaimant who survive the effective date of the instrument. A disclaimer relates back for all purposes to that date. A future interest that takes effect in possession or enjoyment at or after the termination of the disclaimed interest takes effect as if the disclaimant had died before the effective date of the instrument or contract that transferred the disclaimed interest. 4. This disclaimer is binding upon the disclaimant or person waiving and all persons claiming through or under either of them. DATED this the __________ day of _____________________, 20____. _______________________________ Signature Print Name: ________________________ Witness Name and Address: _________________________ _________________________ _________________________ _________________________ Witness name and Address: __________________________ __________________________ __________________________ __________________________ State of _______________ County of _________________ This instrument acknowledged, by me on this the ________ day of _____________, 20_____ by _______________________, who signed, executed and delivered same. ______________________________ NOTARY PUBLIC My Commission Expires: _____________________