Disclaimer and Renunciation of Interest (Qualified Disclaimer) — Indiana
Disclaimer and Renunciation of Interest (Indiana)
Before you use this: For federal qualified-disclaimer treatment, deliver the signed writing to an authorized recipient within nine months after the later of the transfer creating the interest or the disclaimant's 21st birthday, subject to the federal timely-mailing and weekend/holiday rules. For a death-created interest, the transfer ordinarily occurs at death. Federal law also requires no acceptance of benefits and that the interest pass without the disclaimant's direction, to the decedent's spouse or someone else. Identify both the Indiana delivery recipient and a recipient under 26 U.S.C. § 2518 and 26 C.F.R. § 25.2518-2 before signing. Check whether a prior written waiver, acceptance, transfer, judicial sale, or child-support arrearage bars all or part of the disclaimer under Ind. Code §§ 32-17.5-8-1, 8-2, and 8-2.5.
Disclaimant and interest
| Field | Entry |
|---|---|
| Disclaimant's full legal name | [FULL LEGAL NAME] |
| Disclaimant's address | [STREET, CITY, STATE ZIP] |
| Date of birth | [__/__/____] |
| Transferor or decedent | [FULL LEGAL NAME] |
| Date of death or date of transfer creating the interest | [__/__/____] |
| Source of interest | ☐ Will or intestacy ☐ Testamentary trust ☐ Inter vivos trust ☐ Other: [DESCRIBE] |
| Instrument or estate case | [WILL/TRUST NAME AND DATE; COURT AND CASE NUMBER, IF ANY] |
| Property or power being disclaimed | [DESCRIBE PRECISELY; FOR LAND INCLUDE COMPLETE LEGAL DESCRIPTION] |
| Extent of disclaimer | ☐ Entire interest ☐ Only an undivided [FRACTION / PERCENTAGE] of the entire interest |
Disclaimer
I, [DISCLAIMANT FULL LEGAL NAME], hereby irrevocably and unqualifiedly disclaim the interest or power identified above, to the extent stated above, under Ind. Code §§ 32-17.5-3-1 and 32-17.5-3-3. This is a refusal to accept that interest or power. I do not assign it or direct who receives it. The disclaimed interest shall pass under the governing instrument and applicable law, including Ind. Code § 32-17.5-4-1.
I state that I have not accepted the disclaimed interest or its benefits and have not voluntarily assigned, conveyed, encumbered, pledged, transferred, or contracted to transfer it. I intend this writing to satisfy 26 U.S.C. § 2518 and 26 C.F.R. § 25.2518-2; this statement of intent does not replace the required timely receipt, lack of acceptance, and passage without my direction.
Disclaimant signature: [________________________________]
Printed full name: [DISCLAIMANT FULL LEGAL NAME]
Date signed: [__/__/____]
Acknowledgment for recording, if the disclaimer will be recorded
State of [STATE], County of [COUNTY].
Before me, [NOTARY PUBLIC FULL NAME], a Notary Public, on [__/__/____], [DISCLAIMANT FULL LEGAL NAME] acknowledged the execution of this Disclaimer and Renunciation of Interest.
Notary Public signature: [________________________________]
Printed full name: [NOTARY PUBLIC FULL NAME]
Commission expiration: [__/__/____]
Indiana county of commission or primary employment (Indiana notary only): [COUNTY]
Official seal: [AFFIX NOTARY'S SEAL; AN INDIANA NOTARY'S SEAL MUST SHOW THE COMMISSION NUMBER]
Delivery record
Under Ind. Code § 32-17.5-7, select and complete the applicable state route:
- ☐ Will or intestacy: Deliver to the serving personal representative; if none serves, file with a court having jurisdiction to appoint one. § 32-17.5-7-2.
- ☐ Testamentary trust: Deliver to the serving trustee; if none serves, deliver to the personal representative; if neither serves, file with a court having jurisdiction to enforce the trust. § 32-17.5-7-3.
- ☐ Inter vivos trust: Deliver to the serving trustee; if none serves, file with a court having jurisdiction to enforce the trust. If the disclaimer precedes irrevocability, delivery to the settlor of a revocable trust or the transferor is also a statutory route. § 32-17.5-7-4.
- ☐ Other interest: [IDENTIFY APPLICABLE ROUTE UNDER IND. CODE § 32-17.5-7 BEFORE DELIVERY].
For federal treatment, confirm timely delivery to the transferor, the transferor's legal representative, the holder of legal title, or the person in possession of the property; a qualifying timely mailing counts as timely delivery, and the regulation extends a deadline falling on a weekend or legal holiday to the next business day. See 26 U.S.C. § 2518(b)(2) and 26 C.F.R. § 25.2518-2(b)–(c). Indiana permits personal delivery, first class mail, or another method likely to result in receipt, subject to the particular interest's delivery rule. § 32-17.5-7-1.
| Recipient and capacity | Address | Delivery or filing method | Date sent | Date received or filed |
|---|---|---|---|---|
| [NAME; ROLE] | [ADDRESS] | [METHOD] | [__/__/____] | [__/__/____] |
| [NAME; ROLE] | [ADDRESS] | [METHOD] | [__/__/____] | [__/__/____] |
Person completing delivery record: [NAME / SIGNATURE]
If an instrument affecting the property may be recorded or filed, Ind. Code § 32-17.5-10-1 permits the disclaimer to be recorded or filed too. Record in [COUNTY / OFFICE / INSTRUMENT NUMBER], if applicable: [DETAILS]. For an instrument to be recorded, complete the acknowledgment above under Ind. Code § 32-21-2-3 and the certificate requirements of § 33-42-9-12. Complete the recorder statements below when Ind. Code § 36-2-11-15 applies; subsection (a) excludes, among other instruments, one executed or acknowledged outside Indiana.
Indiana irrevocability occurs at the later of delivery or filing under chapter 7 and the disclaimer's effectiveness under chapters 4 through 6. Ind. Code § 32-17.5-3-5.
Recorder statements, if applicable
This instrument was prepared by [PREPARER FULL NAME / GOVERNMENTAL AGENCY, IF ANY].
I affirm, under the penalties for perjury, that I have taken reasonable care to redact each Social Security number in this document, unless required by law. [PREPARER FULL NAME]
Sources and references
About this template
- Last updated
- October 21, 2026
- Citations checked
- October 21, 2026
- Jurisdiction
- Indiana
- Category
- Estate Planning & Wills
Legal authority
- Ind. Code § 32-17.5-3-1 (power to disclaim)
- Ind. Code § 32-17.5-3-3 (contents and delivery of disclaimer)
- Ind. Code § 32-17.5-3-4 (partial disclaimer)
- Ind. Code § 32-17.5-3-5 (when irrevocable)
- Ind. Code § 32-17.5-4-1 (effect of disclaimer of property interest)
- Ind. Code § 32-17.5-7-1 (delivery methods)
- Ind. Code § 32-17.5-7-2 (intestate or will interest)
- Ind. Code § 32-17.5-7-3 (testamentary trust interest)
- Ind. Code § 32-17.5-7-4 (inter vivos trust interest)
- Ind. Code § 32-17.5-8-1 (written waiver bar)
- Ind. Code § 32-17.5-8-2 (acceptance, transfer, and judicial sale bars)
- Ind. Code § 32-17.5-8-2.5 (child support arrearage bar)
- Ind. Code § 32-17.5-9-1 (federal tax qualified disclaimer)
- Ind. Code § 32-17.5-10-1 (optional recording)
- 26 U.S.C. § 2518 (federal qualified disclaimer)
- 26 C.F.R. § 25.2518-2 (federal qualified disclaimer requirements)
- Ind. Code § 32-21-2-3 (notarial act for recording)
- Ind. Code § 33-42-9-12 (notarial certificate)
- Ind. Code § 33-42-9-8 (out-of-state notarial acts)
- Ind. Code § 33-42-10-2(a) (Indiana notary seal contents)
- Ind. Code § 36-2-11-15 (recorder preparation and Social Security number statements)
Estate planning documents decide what happens to your property, your children, and your medical care when you cannot make those decisions yourself. Wills, trusts, powers of attorney, and health care directives each serve different purposes and each have to meet state law requirements for signing, witnessing, and notarization. A document that looks fine on the page but was not executed correctly can be rejected in probate, which is exactly when it is too late to fix.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on October 21, 2026.
Ind. Code § 32-17.5-3-1 (checked October 21, 2026): "A person may disclaim, in whole or part, any interest in or power over property, including a power of appointment."
Ind. Code § 32-17.5-3-3 (checked October 21, 2026): "A disclaimer must: (1) be in a writing or other record; (2) state that it is a disclaimer; (3) describe the interest or power disclaimed; (4) be signed by the person making the disclaimer; and (5) be delivered or filed in the manner provided in IC 32-17.5-7."
Ind. Code § 32-17.5-3-4 (checked October 21, 2026): "A partial disclaimer may be expressed as: (1) a fraction; (2) a percentage; (3) a monetary amount; (4) a term of years; (5) a limitation of a power; or (6) any other interest or estate in the property."
Ind. Code § 32-17.5-3-5 (checked October 21, 2026): "A disclaimer becomes irrevocable upon the occurrence of the later of the following to occur: (1) The disclaimer is delivered or filed as set forth in IC 32-17.5-7. (2) The disclaimer becomes effective as set forth in IC 32-17.5-4 through IC 32-17.5-6."
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