Disclaimer and Renunciation of Interest (Qualified Disclaimer) — Minnesota

TIMING — IRC § 2518 (9-MONTH DEADLINE): To qualify as a federal "qualified disclaimer," this writing must be signed and received by the proper recipient by the nine-month date measured from the later of the transfer creating this interest or the disclaimant's 21st birthday (subject to the limited federal mailing and weekend/holiday rules in Treas. Reg. § 25.2518-2(c)(2)), with no acceptance of the interest or its benefits. Minnesota's Uniform Disclaimer of Property Interests Act permits a disclaimer at any time unless barred (Minn. Stat. §§ 524.2-1105, 524.2-1106), but the federal 9-month limit governs qualified-disclaimer treatment (Minn. Stat. § 524.2-1104). Verify the deadline with counsel before signing.

DISCLAIMER AND RENUNCIATION OF INTEREST (QUALIFIED DISCLAIMER)

STATE OF MINNESOTA

TABLE OF CONTENTS

1. Disclaimant Information
2. Identification of the Transfer and Interest Disclaimed
3. Statutory Authority
4. The Disclaimer
5. Qualified-Disclaimer Representations
6. Effect and Passing of the Disclaimed Interest
7. Irrevocability and Binding Effect
8. Delivery, Filing, and Recording
9. Signature, Acknowledgment, and Notarization
10. Verification / Declaration
11. Certificate of Delivery / Service
12. Attachments Checklist

1. DISCLAIMANT INFORMATION

The undersigned (the "Disclaimant") is a person who may disclaim an interest in or power over property under Minn. Stat. § 524.2-1107, namely a(n): ☐ heir ☐ devisee ☐ legatee ☐ grantee ☐ donee ☐ surviving joint tenant ☐ beneficiary under a governing instrument or contract ☐ appointee, object, or taker in default under a power of appointment ☐ other: [____________________].

2. IDENTIFICATION OF THE TRANSFER AND INTEREST DISCLAIMED

Source of the interest (check all that apply):
☐ Last Will and Testament of the Decedent
☐ Intestate succession
☐ Revocable or testamentary trust
☐ Beneficiary designation (life insurance, retirement plan, annuity, POD/TOD account, or security registered in beneficiary form)
☐ Joint tenancy with right of survivorship
☐ Power of appointment
☐ Other: [________________________________]

Extent of the disclaimer:
☐ Full disclaimer — the Disclaimant disclaims the entire interest described above.
☐ Partial disclaimer — the Disclaimant disclaims only the following portion, which under Minn. Stat. § 524.2-1107(d) may be expressed as a fraction, percentage, monetary amount, specific property, term of years, portion of a beneficial interest, or limitation of a power: [____________________] (e.g., an undivided ____% interest, or the sum of $[____________]).

Federal partial-disclaimer check: The listed state-law partial forms do not automatically qualify for federal tax treatment. A disclaimer of an income interest for a limited number of years does not qualify under Treas. Reg. § 25.2518-3(a)(1)(i); check the selected portion under that regulation before treating this instrument as federally qualified.

Legal description of any real property disclaimed (or see attached Exhibit A): [________________________________]

3. STATUTORY AUTHORITY

This Disclaimer is made under the Minnesota Uniform Disclaimer of Property Interests Act, Minn. Stat. §§ 524.2-1101 through 524.2-1116, and seeks federal qualified disclaimer treatment only if the selected interest and portion satisfy 26 U.S.C. § 2518 and Treas. Reg. §§ 25.2518-2 and 25.2518-3.

• Minn. Stat. § 524.2-1107(a) authorizes a person to disclaim, in whole or in part, any interest in or power over property, including a power of appointment, even if the creator imposed a spendthrift provision or other restriction on transfer or on the right to disclaim.
• Minn. Stat. § 524.2-1107(c) requires that the disclaimer (1) be in writing; (2) declare the writing as a disclaimer; (3) describe the interest or power disclaimed; (4) be signed by the Disclaimant and acknowledged in the manner provided for deeds of real estate to be recorded in this state; and (5) be delivered or filed in the manner provided in Minn. Stat. § 524.2-1114.
• Minn. Stat. § 524.2-1104 recognizes a federally tax-qualified disclaimer under the Act, subject to the bars in § 524.2-1106.

4. THE DISCLAIMER

The Disclaimant, intending to be legally bound, hereby UNQUALIFIEDLY DISCLAIMS and RENOUNCES the entire interest described in Section 2 or the specifically identified portion selected there. This Disclaimer becomes irrevocable as provided in Section 7.

This Disclaimer is made freely, voluntarily, and with full knowledge of its legal and tax consequences.

5. QUALIFIED-DISCLAIMER REPRESENTATIONS

The Disclaimant represents and certifies that:

☐ This Disclaimer is in writing, signed, and acknowledged as required by Minn. Stat. § 524.2-1107(c) and Treas. Reg. § 25.2518-2(b).

☐ The original Disclaimer is delivered or filed by the Minnesota method applicable to this interest under Minn. Stat. § 524.2-1114, and is received by the proper federal recipient within nine (9) months after the later of the transfer creating this interest or the Disclaimant's 21st birthday, or is treated as timely delivered under applicable federal mailing and holiday rules (26 U.S.C. § 2518(b)(2); Treas. Reg. § 25.2518-2(c)(2)).

☐ The Disclaimant has NOT accepted the disclaimed interest or any of its benefits, has not assigned, conveyed, encumbered, pledged, or transferred it or contracted to do so, has not executed a written waiver of the right to disclaim, is not insolvent when the disclaimer becomes irrevocable, and is not subject to any other bar under Minn. Stat. § 524.2-1106 (Treas. Reg. § 25.2518-2(d)).

☐ The disclaimed interest passes without any direction on the part of the Disclaimant (26 U.S.C. § 2518(b)(4); Treas. Reg. § 25.2518-2(e)).

☐ The disclaimed interest passes under the governing instrument and the Minnesota rule applicable to the selected interest, without a direction by the Disclaimant. Section 6 identifies the ordinary property-interest, joint-property, and power-of-appointment routes.

☐ This Disclaimer is intended as a tax-qualified disclaimer under Minn. Stat. § 524.2-1104 and 26 U.S.C. § 2518.

6. EFFECT AND PASSING OF THE DISCLAIMED INTEREST

For an ordinary property interest, Minn. Stat. § 524.2-1108 governs the effective time and who takes. The governing instrument's disclaimer provision controls. If none applies, an individual's interest generally passes as if the Disclaimant had died immediately before the interest was created; an interest contingent on surviving until distribution follows the statute's distribution-time rule. The statute separately addresses descendants and future interests.

For survivorship rights in jointly held property, apply Minn. Stat. § 524.2-1109, including its limits on the share that may be disclaimed. For a power of appointment or an interest arising under one, apply Minn. Stat. §§ 524.2-1111 to 524.2-1113 as appropriate. This form does not select a recipient of the disclaimed interest.

The Disclaimant does not direct to whom the disclaimed interest passes; it passes solely by operation of the governing instrument and Minnesota law.

7. IRREVOCABILITY AND BINDING EFFECT

Under Minn. Stat. § 524.2-1107(e), this Disclaimer becomes irrevocable when it is delivered or filed under § 524.2-1114 or becomes effective under §§ 524.2-1108 to 524.2-1113, whichever occurs later. After that point, the Disclaimant cannot withdraw it.

8. DELIVERY, FILING, AND RECORDING

Deliver or file the signed, acknowledged original by the route applicable to the interest under Minn. Stat. § 524.2-1114. Select the route and fill in the recipient below. Personal delivery, first-class mail, or another method resulting in receipt may be used; the state statute treats first-class mailing as delivered on its postmark date. Federal qualified-disclaimer status has its own recipient and timing requirements under 26 U.S.C. § 2518; a Minnesota delivery alone may not satisfy them.

Minnesota recipient / court and county: [________________________________]

Federal recipient under 26 U.S.C. § 2518(b)(2), if different: [________________________________]

For jointly held property, confirm that the portion stated in Section 2 does not exceed the share disclaimable under Minn. Stat. § 524.2-1109(a).

☐ Record the original Disclaimer in the Office of the County Recorder or Registrar of Titles of [COUNTY] County where real estate is located. A recorded real-estate disclaimer must contain a legal description to give constructive notice under Minn. Stat. § 524.2-1115; § 524.2-1114(l) addresses presumed delivery by recording.

9. SIGNATURE, ACKNOWLEDGMENT, AND NOTARIZATION

Executed this [____] day of [____________], 20[____].

Disclaimant Signature: ______________________________________

Printed Name: [________________________________]

ACKNOWLEDGMENT

STATE OF MINNESOTA )
COUNTY OF [____________] )

This instrument was acknowledged before me on this [____] day of [____________], 20[____], by [DISCLAIMANT FULL LEGAL NAME].

______________________________________
Notary Public
My commission expires: [__/__/____]

[NOTARIAL STAMP/SEAL]

10. VERIFICATION / DECLARATION

I, [DISCLAIMANT FULL LEGAL NAME], declare under penalty of perjury under the laws of the State of Minnesota that the foregoing is true and correct, that I have not accepted the disclaimed interest or any benefit thereof, and that I make this Disclaimer of my own free will.

Signature: ______________________________________
Date: [__/__/____]

11. CERTIFICATE OF DELIVERY / SERVICE

I certify that on the date(s) shown below the signed and acknowledged original of this Disclaimer was delivered, filed, or recorded by the route selected in Section 8. Additional copies, if any, were sent to the other recipients listed below.

Signature: ______________________________________
Printed Name: [________________________________]

12. ATTACHMENTS CHECKLIST

☐ Copy of the Last Will and Testament, trust instrument, or beneficiary designation creating the disclaimed interest
☐ Exhibit A — legal description of any real property disclaimed
☐ Certified copy of the Decedent's Death Certificate
☐ Proof of delivery / mailing / filing of the original
☐ Copy of the recorded Disclaimer (County Recorder / Registrar of Titles), if real property is involved
☐ File-stamped copy from the District Court (estate or trust proceeding)

SOURCES AND REFERENCES

• Minnesota Uniform Disclaimer of Property Interests Act, Minn. Stat. §§ 524.2-1101 to 524.2-1116 — https://www.revisor.mn.gov/statutes/cite/524.2-1101
• Minn. Stat. § 524.2-1107 (Power to disclaim; general requirements) — https://www.revisor.mn.gov/statutes/cite/524.2-1107
• Minn. Stat. § 524.2-1115 (Recording of disclaimer relating to real estate) — https://www.revisor.mn.gov/statutes/cite/524.2-1115
• 26 U.S.C. § 2518 (Disclaimers) — https://uscode.house.gov/us/usc/119-136/t26/s2518/
• Treas. Reg. § 25.2518-2 (Requirements for a qualified disclaimer) — https://www.ecfr.gov/current/title-26/section-25.2518-2
• Treas. Reg. § 25.2518-3 (Partial disclaimers) — https://www.ecfr.gov/current/title-26/section-25.2518-3