Fill and Sign the Renunciation and Disclaimer of Property from Life Insurance or Annuity Contract Texas Form

Prepared by U.S. Legal Forms, Inc. Copyright 2016 - U.S. Legal Forms, Inc. STATE OF TEXAS RENUNCIATION AND DISCLAIMER OF PROEPRTY ( Life Insurance Or Annuity Contract) Control Number – TX - 05 - 03 - 1 – 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 form is designed to function. DISCLAIMER These materials were developed by U.S. Legal Forms, Inc. based upon statutes and forms for the State of Texas. 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. 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 PROPERTY, 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. - 2 – NO.       IN RE THE ESTATE OF § IN THE __________________ COURT §       § § DECEASED § __________________ COUNTY, TEXAS RENUNCIATION AND DISCLAIMER OF PROPERTY (Life Insurance or Annuity Contract) I. Pursuant to the Texas Probate Code, 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 has an interest in the property in the above-captioned proceeds of ________________________ (the decedent) who died on ________________________ . III. Pursuant to the Texas Probate Code, Chapter II, the undersigned, ________________________ , chooses to exercise his/her right to disclaim a partial interest or the entire interest in the described 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. Life Insurance or Annuity Contract- 1 – V. Pursuant to applicable law of the State of Texas, 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. VI. The property devolves to others pursuant to the provisions of applicable 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 property effected hereby, and is hereby delivered to the personal representative, executor or executrix of the decedent. 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 TEXAS COUNTY OF ________________________ This instrument was acknowledged before me on ________________________ (date) by ______________________________ (name or names of person or persons acknowledging). Life Insurance or Annuity Contract- 2 – Notary Public My commission expires:       Type or Print Name 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 of Party       Printed Name       Address       City, State, and Zip       Telephone Number Life Insurance or Annuity Contract- 3 –