Fill and Sign the Transfer on Death Designation Affidavit David Smith Ohio Form

Transfer on Death Designation Affidavit Page 1 of 3 TRANSFER ON DEATH DESIGNATION AFFIDAVIT[Husband and Wife to Two Individuals] STATE of ) COUNTY of ) and , husband and wife and owners of record, with title held by Affiants as Tenants in Common,, 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” Beneficiaries to receive, as tenants in common, the owner’s title to that property upon the death of the owners: , 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 . Transfer on Death Designation Affidavit Page 2 of 3 If either or both designated Transfer on Death Beneficiary precedes Owner in death, then the interest of that beneficiary shall pass to the beneficiary's heirs at law per stirpes. The above is intended to convey property known as: . Parcel # Alt Id# Prior Instrument Reference: WITNESS Grantor’s hands this the ____ day of ________________, 20____. Signed, Sealed and Delivered in the presence of: Witness Signature Type or Print Name Type or Print Name WitnessSignature 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 they did sign the forgoing instrument, and that the same is their 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 Grantor’s Address: Grantor’s Address: Transfer on Death Designation Affidavit Page 3 of 3 Grantee’s Address: Grantee’s Address: This Instrument was prepared by and return to: Signature Print or Type Name Exhibit A EXHIBIT A Grantors: Grantee: Legal Description: