Prepared by U.S. Legal Forms, Inc.
Copyright 2016 - U.S. Legal Forms, Inc.
STATE OF GEORGIA
Renunciation And Disclaimer of Property
(Intestate Succession)
Control Number – GA -03 -03
NOTES ON COMPLETING THESE FORMS
The form(s) 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.
It is also helpful to be able to see the location of the form fields. Go to 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 .
By clicking on the appropriate form field, you will be able to enter the needed information. In
some instances the form field and the line will disappear after information is entered. In other
cases it will not. This is appropriate and the way the fo rm is designed to function.
DISCLAIMER
These materials were developed by U.S. Legal Forms, Inc. based upon statutes and forms for the
State of Georgia. All Information and Forms are subject to this Disclaimer: All forms in this
package are provided with out 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 OF MERCHANTABILITY,
NONINFRINGEMENT OF INTELLECTUAL PROPERT Y, 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.
RENUNCIATION AND DISCLAIMER OF PROPERTY
(Intestate Succession)
GEORGIA, __________________ COUNTY
To the Honorable Judge of the Probate Court of said State and County:
The undersigned ______________________________ , whose mailing address is
_______________________________________________________ , (Street City State Zip )
respectfully shows to the Court the following:
I.
Pursuant to the Georgia Code, Title 53, Chapter 1, Article 3, th e undersigned,
______________________________ , chooses to exercise his/her right to disclaim ( ) a partial
interest or ( ) the entire interest in the described property.
II.
The decedent died intestate on the ______ day of __________________ , 20 ______ and the
undersigned has an interest in the described property.
III.
Pursuant to intestate succession, t he undersigned has an interest in the following property:
___________________________________________________ _________
IV.
The undersigned attests that the disclaimer of the property interest will be filed no later than
nine months after the death of the decedent or nine months after the undersigned reaches the
age of 21.
V.
Pursuant to applicable law of the State of Georgia, and the Interna l 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 III.
VI.
The property devolves to others pursuant to the provisions of a pplicable 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 prop erty effected hereby, and is
hereby delivered to the personal representative, executor or executrix of the decedent.
DATED this ______ day of __________________ , 20 ______ .
Signature
Type or Print Name
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
IN WITNESS WHEREOF, this instrument has been duly executed and sealed by
________________________ the day and year first above written.
Signature
Signed, sealed and delivered in the presence of
Witness
Notary Public
My Commission expires:
(AFFIX SEAL and STAMP)
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
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