Fill and Sign the Transfer Death Designation Beneficiary Form

      TRANSFER ON DEATH DESIGNATION AFFIDAVIT [Individual to Two Individuals] STATE of OHIO ) COUNTY of       )       , owner, a married individual, currently owner of record of the following real property located at       ,       , Ohio as recorded at Volume       , Page       , of the       County deed records: See Legal Description Attached as Exhibit A incorporated by reference as though set forth in full Legal Description:       hereby designates the following as “Transfer on Death” Beneficiary to receive the owner’s title to that property, as tenants in common, upon the death of the owner:       , whose street address is       , in the City of       , State of       , and Zip Code of       and       , whose street address is       , in the City of       , State of       , and Zip Code of       . The above is intended to convey property known as: Transfer on Death Designation Affidavit Page 1 of 3       . Parcel #       Alt Id#       Prior Instrument Reference:       I,       wife husband of the Owner/Affiant, release all rights of dower in the above described premises. WITNESS Affiant’s hand this the ____ day of ________________ , 20 ____ . Signed, Sealed and Delivered in the presence of: Witness Signature             Type or Print Name Type or Print Name Witness Signature of Spouse (if required)             Type or Print Name Type or Print Name STATE OF OHIO,} ss before me a notary public, in and for said County, County       } personally appear the above named       Who acknowledged that he did sign the forgoing instrument, and that the same is his free act and deed. IN TESTIMONY WHEREOF I have hereunto set my hand and official seal, at       ,       . This       day of       , A.D. 20       . Notary Public Owner/Affiant’s Address:       Transfer on Death Designation Affidavit Page 2 of 3             First Beneficiary’s Address: Second Beneficiary’s Address:                                     This Instrument was prepared by and return to:                         Signature       Print or Type Name Transfer on Death Designation Affidavit Page 3 of 3 EXHIBIT A       Exhibit A