Disclaimer and Renunciation of Interest (Qualified Disclaimer) — Missouri

TIMING — IRC § 2518 (9-MONTH DEADLINE): To qualify as a federal "qualified disclaimer," the signed writing must be received by the transferor, legal representative, or legal-title holder within nine (9) months after the later of the transfer creating the interest or the disclaimant's 21st birthday, with no acceptance of the interest or its benefits. Missouri law independently requires delivery on or before nine (9) months after the transfer (or any later time provided in the particular case or under chapter 469), and before any acceptance (Mo. Rev. Stat. § 469.020.1). Verify the deadline with counsel before signing.

DISCLAIMER AND RENUNCIATION OF INTEREST (QUALIFIED DISCLAIMER)

STATE OF MISSOURI

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 an individual to whom property or an interest therein has been donatively transferred by any means, and who may disclaim under Mo. Rev. Stat. § 469.010, namely a(n): ☐ heir ☐ devisee ☐ legatee ☐ grantee ☐ donee ☐ surviving joint tenant ☐ beneficiary under a governing instrument or contract ☐ appointee 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 (Mo. Rev. Stat. ch. 474)
☐ 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 transfer described above.
☐ Partial disclaimer — the Disclaimant disclaims only the following fractional, percentage, or pecuniary portion of the transfer: [____________________] (e.g., an undivided ____% interest, or the sum of $[____________]). Under Mo. Rev. Stat. § 469.010, a disclaimed portion passes to the same ultimate taker(s) and in the same proportions as a disclaimer of all of the transfer.

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

3. STATUTORY AUTHORITY

This Disclaimer is made under Chapter 469 of the Revised Statutes of Missouri (Disclaimers of Property), Mo. Rev. Stat. §§ 469.010 through 469.120, and is intended to constitute a qualified disclaimer under 26 U.S.C. § 2518 and Treas. Reg. § 25.2518-2.

• Mo. Rev. Stat. § 469.010 provides that any individual to whom property or an interest is donatively transferred by any means (including a transfer resulting from another disclaimer) may disclaim all or any portion of the transfer; for all purposes the disclaimed interest is deemed to have passed directly from the transferor to the ultimate taker(s) and is not subject to the claim of any creditor of the Disclaimant.
• Mo. Rev. Stat. § 469.020.1 requires that the disclaimer be made by a writing showing an unconditional refusal to accept a transfer (or a portion of it), signed by the Disclaimant or representative, and delivered on or before nine (9) months after the transfer (or by any later time provided in the particular case or under chapter 469), and before any acceptance of the disclaimed interest.
• Mo. Rev. Stat. § 469.020.2 preserves the right to disclaim notwithstanding any contrary intention of the transferor and notwithstanding any spendthrift provision or similar restriction.

4. THE DISCLAIMER

The Disclaimant, intending to be legally bound, hereby gives an UNCONDITIONAL REFUSAL TO ACCEPT and IRREVOCABLY DISCLAIMS and RENOUNCES all (or, where a partial disclaimer is elected in Section 2, the stated fractional, percentage, or pecuniary part of) the transfer described in Section 2 above, together with all right, title, claim, and interest of every kind — whether vested or contingent, present or future, legal or equitable — therein.

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, shows an unconditional refusal to accept, and is signed by the Disclaimant (or representative), as required by Mo. Rev. Stat. § 469.020.1 and Treas. Reg. § 25.2518-2(b).

☐ State delivery, filing, or recording requirements stated above have been checked and completed: [METHOD / DATE / PROOF].
☐ For 26 U.S.C. § 2518(b)(2), the written refusal was received by the transferor, the transferor's legal representative, or the holder of legal title within nine months after the later of the transfer creating the interest or the disclaimant's 21st birthday: [RECIPIENT / DATE / RECEIPT PROOF].

☐ The Disclaimant has NOT accepted the disclaimed interest or any of its benefits within the meaning of Mo. Rev. Stat. § 469.030, and has taken no act that would preclude a later disclaimer (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)).

☐ As a result of this Disclaimer, the terms of the transfer are applied as if the Disclaimant had died immediately before the transfer, and the disclaimed interest passes directly from the transferor to the ultimate taker(s) (Mo. Rev. Stat. § 469.010).

☐ This Disclaimer is intended as a qualified disclaimer under 26 U.S.C. § 2518 and the regulations thereunder.

6. EFFECT AND PASSING OF THE DISCLAIMED INTEREST

Under Mo. Rev. Stat. § 469.010, unless the terms of the transfer otherwise provide, this Disclaimer causes the terms of the transfer to be applied to the disclaimed transfer and to any future interests taking effect thereafter as if the Disclaimant had died immediately before the transfer. For all purposes the disclaimed interest is deemed to have passed directly from the transferor to the ultimate taker or takers and is not subject to the claim of any creditor of the Disclaimant. A disclaimed portion passes to the same ultimate taker(s) and in the same proportions as a disclaimer of all of the transfer.

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

7. IRREVOCABILITY AND BINDING EFFECT

This Disclaimer is irrevocable and may not be modified, withdrawn, or rescinded once delivered. Under Mo. Rev. Stat. § 469.030, acceptance of the interest precludes a later disclaimer; the Disclaimant has not accepted and the Disclaimer, once delivered, binds the Disclaimant and all persons claiming through or under the Disclaimant.

8. DELIVERY, FILING, AND RECORDING

Pursuant to Mo. Rev. Stat. § 469.020.1, the Disclaimant shall (check all that apply):

☐ Deliver this Disclaimer to the transferor.

☐ Deliver this Disclaimer to the transferor's personal representative or other legal representative (e.g., the executor or administrator of the Decedent's estate, or the trustee).

☐ Deliver this Disclaimer to the holder of the legal title to the property to which the interest relates (for property passing under a nontestamentary instrument or contract).

☐ File this Disclaimer in the Probate Division of the Circuit Court of [____________] County, Missouri, if the Disclaimer involves an estate or property within the jurisdiction of that division (Mo. Rev. Stat. § 469.020.1).

☐ Record a copy of this Disclaimer in the Office of the Recorder of Deeds of [____________] County, Missouri, where the real property is located, if real property or an interest in real property is disclaimed, to provide notice of record.

9. SIGNATURE, ACKNOWLEDGMENT, AND NOTARIZATION

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

Disclaimant Signature: ______________________________________

Printed Name: [________________________________]

ACKNOWLEDGMENT

STATE OF MISSOURI )
COUNTY OF [____________] )

On this [____] day of [____________], 20[____], before me personally appeared [DISCLAIMANT FULL LEGAL NAME], to me known to be the person described in and who executed the foregoing instrument, and acknowledged that he/she executed the same as his/her free act and deed.

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

[NOTARY SEAL]

10. VERIFICATION / DECLARATION

I, [DISCLAIMANT FULL LEGAL NAME], declare under penalty of perjury under the laws of the State of Missouri 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 a true and correct copy of this Disclaimer was delivered to the following:

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
☐ Copy of the recorded Disclaimer (Recorder of Deeds), if real property is involved
☐ File-stamped copy from the Probate Division (Circuit Court), if filed

SOURCES AND REFERENCES

• Missouri Revised Statutes, Chapter 469 (Disclaimers of Property), §§ 469.010 to 469.120 — https://revisor.mo.gov/main/OneChapter.aspx?chapter=469
• Mo. Rev. Stat. § 469.020 (Disclaimer, how and when made; delivery) — https://revisor.mo.gov/main/OneSection.aspx?section=469.020
• 26 U.S.C. § 2518 (Disclaimers) — https://www.law.cornell.edu/uscode/text/26/2518
• Treas. Reg. § 25.2518-2 (Requirements for a qualified disclaimer) — https://www.law.cornell.edu/cfr/text/26/25.2518-2