Fill and Sign the Mississippi Renunciation and Disclaimer of Property Ira Annuity or Bond Mississippi Form

© 2016 - U.S. Legal Forms, Inc.       MISSISSIPPI RENUNCIATION AND DISCLAIMER OF PROPERTY [ Individual Retirement Account, Annuity or Bond ] Control Number: MS -09-03 I. TIPS ON COMPLETING THE FORMS The form(s) in this packet may contain “form fields” created using Microsoft Word or Adobe Acrobat (“.pdf” format). “Form fields” facilitate completion of the forms using your computer. They do not limit your 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 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. The form was created to function in this manner. II. FILING THE FORM WITH THE CHANCERY COURT In some cases this form will need to be filed in the Chancery Court. If so, use the first page filing sheet and attached form. If it is unnecessary to file the form, you me discard the first page filing sheet. I II. DISCLAIMER These materials were developed by U.S. Legal Forms, Inc. based upon statutes and forms for the State of Mississippi . All information and Forms are subject to this 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 in your state. 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. 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Name of Person Filing:       Street Address:       City, State, Zip Code:       Telephone No.:       Representing Cells (No Attorney), Represented by Attorney If Attorney, Bar Number:       IN THE CHANCERY COURT OF ____________ COUNTY, MISSISSIPPI ____________ JUDICIAL DISTRICT IN THE MATTER OF THE ESTATE OF ) ) ) Docket No .             ) Decedent ) ) NOTICE OF FILING RENUNCIATION AND DISCLAIMER OF PROPERTY       , as       , hereby files the attached ______________________________ . Signature       Print or Type Name CERTIFICATE OF SERVICE I certify that a copy of this Notice of Filing Renunciation and Disclaimer of Property was sent by ordinary U.S. mail on ____________ (date) to:                         Signature       Print or Type Name RENUNCIATION AND DISCLAIMER OF PROPERTY (Individual Retirement Account, Annuity, or Bond) I. Pursuant to the Mississippi Code, Title 89, Chapter 021, the undersigned,       , has an interest in an Individual Retirement Account, and/or an Annuity, and/ or a Bond. The identifying account and/or bond information is as follows:             . II. The undersigned, as the surviving joint tenant, has an interest in the property of       (the decedent) who died on       . III. The undersigned attests that the disclaimer of the property interest will be filed no later than nine (9) months after the death of the decedent. IV. The undersigned is entitled to receive the following proceeds:             V. The property devolves to others pursuant to the provisions of applicable State law as though the undersigned had predeceased the decedent. VI. Renunciation and Disclaimer Page 1 of 3 Pursuant to applicable law of the State of Mississippi, 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       . DATED:       Signature       Type/Print Name State of Mississippi , County of __________________ Personally appeared before me, the undersigned authority in and for said county and state, on __________________ , 20 ______ , within my jurisdiction, the within named       , who acknowledged that he executed the above and foregoing instrument. Notary Public       Type of Print Name My commission expires:       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 to the personal representative or other fiduciary of the decedent. DATED:       Renunciation and Disclaimer Page 2 of 3 Signature of Party       Type or Print Name       Street Address       City, State, Zip Phone:       Receipt of an executed copy of the above Renunciation and Disclaimer is acknowledged this ______ day of __________________ , 20 ______ . Name       Type or Print Name Personal Representative Renunciation and Disclaimer Page 3 of 3