Disclaimer and Renunciation of Interest (Qualified Disclaimer) — Massachusetts
DISCLAIMER AND RENUNCIATION OF INTEREST
1. DISCLAIMANT AND INTEREST
Disclaimant full legal name: [________________________________]
Address: [________________________________]
Decedent or transferor: [________________________________]
Date of death or transfer creating the interest: [__/__/____]
Source of interest (will, trust, beneficiary designation, joint ownership, intestacy, or other): [________________________________]
Instrument and provision creating the interest, if any: [________________________________]
Personal representative, trustee, or other property holder: [NAME AND ADDRESS: ________________________________]
Probate court and docket, if any: [________________________________]
Property or interest disclaimed, described precisely (attach legal description for real property): [________________________________]
Extent of disclaimer:
☐ The entire interest described above.
☐ Only the following identified fractional or other separate portion: [________________________________]. Federal qualification of a partial disclaimer requires separate review of the interest.
2. DISCLAIMER
I clearly and unequivocally disclaim the interest identified in Section 1, to the extent selected there. I do not direct who receives the disclaimed interest. Its disposition is controlled by the governing instrument and applicable law. I understand that a disclaimer satisfying the applicable requirements of G.L. c. 190B, § 2-801 becomes irrevocable upon execution and applicable filing.
3. FACTS TO CONFIRM BEFORE EXECUTION
Complete these statements only if true:
☐ I have not assigned, conveyed, pledged, encumbered, transferred, or contracted to dispose of the disclaimed interest.
☐ I am not insolvent at the time of this disclaimer.
☐ I have not signed a written waiver of my right to disclaim.
☐ I have not accepted this interest or knowingly received its benefit without objection.
☐ I have not directed the passage of the disclaimed interest to a person of my choosing.
State deadline calculation: The event finally ascertaining me as beneficiary and indefeasibly vesting the interest occurred on [__/__/____]. The state execution and filing deadline calculated under G.L. c. 190B, § 2-801(c) is [__/__/____]. For a surviving joint tenant or tenant by the entirety, identify the other tenant's death date: [__/__/____]. Any court extension order: [COURT / DATE / DOCKET: ________________________________].
Federal qualification, if sought: The later of the transfer creating my interest or my 21st birthday occurred on [__/__/____]. The federal receipt deadline calculated under 26 U.S.C. § 2518(b)(2) and applicable regulations is [__/__/____]. The intended recipient of this signed writing is [TRANSFEROR / REPRESENTATIVE / TITLE HOLDER OR PERSON IN POSSESSION: ________________________________]. A qualifying timely mailing and a weekend or legal-holiday last day are governed by 26 C.F.R. § 25.2518-2(c).
☐ Federal qualified-disclaimer treatment is intended and the remaining requirements of 26 U.S.C. § 2518(b) have been reviewed.
☐ This disclaimer is made under Massachusetts law without a representation that it qualifies under federal tax law.
4. EXECUTION
I sign this writing intending to disclaim only the identified interest and extent.
Disclaimant signature: ______________________________________
Printed name: [________________________________]
Date signed: [__/__/____]
If a guardian, conservator, or estate representative signs: [NAME, CAPACITY, AND PROBATE COURT AUTHORIZATION: ________________________________]
Representative signature: ______________________________________ Date: [__/__/____]
5. FILING, RECORDING, AND DELIVERY RECORD
File the original or an attested copy with the probate court or courts identified by G.L. c. 190B, § 2-801(e), if any. If real property is involved, acknowledge this instrument as for a deed and record it in the proper registry to establish its effect against the persons specified in § 2-801(e). Deliver a copy by hand or certified mail to the person or entity with custody or possession of the property.
| Step | Recipient, court, or registry | Date | Receipt, docket, book/page, or document number |
|---|---|---|---|
| Probate filing, if applicable | [NAME] | [DATE] | [PROOF] |
| Real-property recording, if applicable | [NAME] | [DATE] | [PROOF] |
| Copy delivered to property holder | [NAME] | [DATE] | [PROOF] |
| Federal receipt recipient, if qualification sought | [NAME] | [DATE] | [PROOF] |
Real-property acknowledgment, if applicable:
Commonwealth of Massachusetts, County of [________________________________]
On [__/__/____], [DISCLAIMANT OR AUTHORIZED REPRESENTATIVE] personally appeared before me and acknowledged signing this Disclaimer.
Notary public: ______________________________________ Commission expires: [__/__/____]
SOURCES AND REFERENCES
About this template
- Last updated
- October 15, 2026
- Citations checked
- October 15, 2026
- Jurisdiction
- Massachusetts
- Category
- Estate Planning & Wills
Legal authority
- G.L. c. 190B, § 2-801(b)
- G.L. c. 190B, § 2-801(c)
- G.L. c. 190B, § 2-801(d)
- G.L. c. 190B, § 2-801(e)
- G.L. c. 190B, § 2-801(g)
- G.L. c. 190B, § 2-801(h)
- 26 U.S.C. § 2518(b)
- 26 C.F.R. § 25.2518-2(b)(2)
- 26 C.F.R. § 25.2518-2(c)
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 15, 2026.
26 U.S.C. § 2518(b)(2), receipt (checked October 15, 2026): "such writing is received by the transferor of the interest, his legal representative, or the holder of the legal title to the property to which the interest relates not later than the date which is 9 months after the later of"
G.L. c. 190B, § 2-801(b) (checked October 15, 2026): "Unless barred by the provisions of subsection (h), a beneficiary may disclaim any interest in property which, except for the execution and filing of a disclaimer in accordance with the provisions of this section, pass to the beneficiary"
G.L. c. 190B, § 2-801(c) (checked October 15, 2026): "A disclaimer shall be executed and filed pursuant to the provisions of this section at any time after the creation of the interest in property being disclaimed, but in any event not later than nine months after the event determining that the beneficiary is finally ascertained as the beneficiary of such interest and that such interest is indefeasibly vested"
G.L. c. 190B, § 2-801(d) (checked October 15, 2026): "A disclaimer shall be in writing, shall describe the interest in property being disclaimed, shall declare the disclaimer and the extent thereof, shall be clear and unequivocal, and shall be signed by the beneficiary"
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