Fill and Sign the Renunciation and Discliamer of Form

Prepared by U.S. Legal Forms, Inc.Copyright 2016 - U.S. Legal Forms, Inc. STATE OF PENNSYLVANIA RENUNCIATION AND DISCLIAMER OF JOINT TENANT INTEREST [JOINT TENANCY] Control Number – PA - 02 - 03 NOTE ABOUT COMPLETING THE FORMS The forms 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.If you do not see the gray shaded form fields, go 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.The forms are locked which means that the content of the forms cannot be changed. You can only fill in the information in the fields. If you need to make any changes in the body of the form, it is necessary for you “unlock” or “unprotect” the form. IF YOU INTEND TO MAKE CHANGES TO THE CONTENT, DO SO BEFORE YOU BEGIN TO FILL IN THE FIELDS. IF YOU UNLOCK THE DOCUMENT AFTER YOU HAVE BEGUN TO COMPLETE THE FIELDS, WHEN YOU RELOCK, ALL INFORMATION YOU ENTERED WILL BE LOST. To unlock click on “Tools” in the Menu bar and then selecting “unprotect document”. You may then be prompted to enter a password. If so, the password is “uslf”. That is uslf in lower case letters without the quotation marks. After you make the changes relock the document before you being to complete the fields. After any required changes and re-protecting the document, click on the first form field and enter the required information. You will be able to navigate through the document from form field to form field using your tab key. Tab to a form field and insert your data. If problems, please let us know. DISCLAIMER These materials were developed by U.S. Legal Forms, Inc. based upon statutes and forms for the State of Pennsylvania. 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HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. COURT OF COMMON PLEAS OF __________________ COUNTY ORPHANS’ COURT DIVISION ESTATE OF ________________________, Deceased No. ____________ of 20 ____________ RENUNCIATION AND DISCLAIMER OF JOINT TENANT INTEREST (Entire Interest of Joint Tenant) I. Pursuant to the Pennsylvania Statutes, Title 20, Chapter 62, the undersigned, ______________________________, the surviving joint tenant with right of survivorship, chooses to exercise his/her right to disclaim any and all interests he/ she may have in any property or interest that is the subject of a joint tenancy devolving to him/her because of the death of the decedent. 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 months after the death of the decedent. IV. As a joint tenant with right of survivorship, the undersigned has an interest in the following property: ____________________________________________________________ V. Pursuant to applicable law of the State of Pennsylvania, 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 the ______ day of ____________, 20______. Signature of Party Printed Name Address City, State, and Zip Telephone NumberCommonwealth of Pennsylvania County of __________________ On this ____________ day of __________________, ____________, before me, the undersigned officer, personally appeared ____________________________________, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he/she executed the same for the purposes therein contained. In witness whereof, I hereunto set my hand and official seal.Notary PublicMy commission expires: Type or Print NameI 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 NumberReceipt 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 (Seal)Notary PublicMy commission expires: Type or Print Name