______________________________________________________________________________
INSTRUMENT REVOKING
TRANSFER ON DEATH DEED
NOTICE TO OWNER
This instrument revoking a transfer on death deed must be recorded before you die or it will not be effective. This instrument is effective only as to the interests in the property of the owner who signs this instrument.
IDENTIFYING INFORMATION
Owner or Owners of Property Making This Instrument of Revocation:
Printed name: _________
Mailing address: _________
Printed name: _________
Mailing address: _________
Legal description of the property:
REVOCATION
I hereby revoke all my previous transfers of this property by transfer on death deed.
RETURN OF INSTRUMENT
After recording, the county clerk shall return the instrument 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 §17]
Note: See note under 93.948.