______________________________________________________________________________
TRANSFER ON DEATH DEED
NOTICE TO OWNER
You should carefully read all information on this form. You may want to consult a lawyer before using this form.
This form must be recorded before your death or it will not be effective.
TAX STATEMENT
Until a change is requested, the county clerk shall send tax statements to the following address: _______________
IDENTIFYING INFORMATION
Owner or Owners Making This Deed:
Printed name: _________
Mailing address: _________
Printed name: _________
Mailing address: _________
Legal description of the property:
PRIMARY BENEFICIARY
I designate the following beneficiary if the beneficiary survives me:
Printed name: _________
Mailing address, if available:
ALTERNATE BENEFICIARY
If my primary beneficiary does not survive me, I designate the following alternate beneficiary if that beneficiary survives me:
Printed name: _________
Mailing address, if available:
TRANSFER ON DEATH
At my death, I transfer my interest in the described property to the beneficiaries as designated above.
Before my death, I have the right to revoke this deed.
SPECIAL TERMS
RETURN OF DEED
After recording, the county clerk shall return the deed to: _______________
SIGNATURE OF OWNER OR OWNERS
MAKING THIS DEED
Signature: _________
Date: _________
Signature: _________
Date: _________
State of _________
County of _________
This instrument was acknowledged before me on ___ (date) by _________. (name(s) of person(s))
Title (and Rank)
My commission expires: _________
______________________________________________________________________________ [2011 c.212 §16]
Note: See note under 93.948.