Fill and Sign the Hawaii Renunciation and Disclaimer of Property from Will by Testate Hawaii Form

(Name, Address of Party or attorney)                   State Bar No.       ( ______ ) ______ - ____________ Attorney for ____________ Pro Se IN THE DISTRICT COURT OF THE ____________ CIRCUIT ____________ DIVISION State of Hawaii IN RE THE ESTATE OF ) )       ) DECEASED ) CIVIL NO. ____________ ) ) ) RENUNCIATION AND DISCLAIMER ) OF PROPERTY (TESTATE) ) I. Pursuant to the Hawaii Revised Statutes, Chap. 526, the undersigned, ______________________________ , chooses to exercise his/her right to disclaim ( ) a partial interest or ( ) the entire interest in the described property. II. The undersigned has an interest in the property in the above-captioned estate of ______________________________ (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. Pursuant to the provisions of paragraph ______ of decedent's last will and testament dated __________________ (the "Will"), ______________________________ is entitled to receive the following property: ____________________________________________________________ V. The property devolves to others pursuant to the provisions of applicable State law as though the undersigned had predeceased the decedent. VI. Pursuant to applicable law of the State of Hawaii, 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. 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 ______ . Signature       Type or Print Name Personal Representative/Executor/Executrix STATE OF HAWAII COUNTY OF __________________ On this ______ day of __________________ , 20 ______ , before me personally appeared ____________________________________ , to me known to be the person (or persons) described in and who executed the foregoing instrument, and acknowledged that he/she/they executed the same as his/her/their free act and deed. 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       City, State, and Zip       Telephone Number