Disclaimer and Renunciation of Interest (Qualified Disclaimer) — Nebraska

TIMING — IRC § 2518 (9-MONTH DEADLINE): To qualify as a federal "qualified disclaimer," this writing must be signed and delivered within nine (9) months after the date of the decedent's death or other transfer (or within 9 months after the disclaimant turns 21), with no acceptance of the interest or its benefits. Under Neb. Rev. Stat. § 30-2352(b), the instrument must be received within the same nine-month measuring period to be effective for Nebraska inheritance- and estate-tax purposes (Chapter 77, articles 20 and 21). Verify the deadline with counsel before signing.

DISCLAIMER AND RENUNCIATION OF INTEREST (QUALIFIED DISCLAIMER)

STATE OF NEBRASKA

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 to whom property or an interest in property has devolved within the meaning of Neb. Rev. Stat. § 30-2352(a), namely a(n): ☐ heir ☐ devisee ☐ person succeeding to a renounced interest ☐ donee ☐ beneficiary under a testamentary or nontestamentary instrument ☐ donee of a power of appointment ☐ grantee ☐ surviving joint owner or surviving joint tenant ☐ owner/beneficiary of an insurance contract or incident of ownership ☐ designated beneficiary of a transfer on death deed ☐ person with a statutory entitlement or election under the Nebraska Probate Code ☐ 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 (Nebraska Probate Code, Neb. Rev. Stat. § 30-2301 et seq.)
☐ Revocable or testamentary trust
☐ Beneficiary designation (life insurance, retirement plan, annuity, POD/TOD account, or security registered in beneficiary form)
☐ Transfer on death deed (Neb. Rev. Stat. § 76-3401 et seq.)
☐ 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 specific part, fractional share, undivided portion, or asset (Neb. Rev. Stat. § 30-2352(a)(1)): [____________________] (e.g., an undivided ____% interest, or the sum of $[____________]).

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

3. STATUTORY AUTHORITY

This Disclaimer (statutorily, a "renunciation") is made under Neb. Rev. Stat. § 30-2352 and is intended to constitute a qualified disclaimer under 26 U.S.C. § 2518 and Treas. Reg. § 25.2518-2.

• Neb. Rev. Stat. § 30-2352(a)(1) authorizes a person to whom property or an interest devolves to renounce, in whole or in part — or with reference to specific parts, fractional shares, undivided portions, or assets — by filing a written instrument of renunciation within the time and at the place provided.
• Neb. Rev. Stat. § 30-2352(a)(2) requires that the instrument (i) describe the property, part, or interest renounced; (ii) be signed and acknowledged by the person renouncing in the manner provided for the execution of deeds of real estate; (iii) declare the renunciation and the extent thereof; and (iv) declare that the renunciation is an irrevocable and unqualified refusal to accept the renounced interest.
• Neb. Rev. Stat. § 30-2352(b) governs to whom the instrument must be delivered, the nine-month tax-measuring period, the requirement to file in the county court where estate proceedings are or would be pending, and the requirement to record an interest in real estate.

4. THE DISCLAIMER

The Disclaimant, intending to be legally bound, hereby IRREVOCABLY and UNQUALIFIEDLY RENOUNCES and DISCLAIMS all (or, where a partial renunciation is elected in Section 2, the stated part, fractional share, undivided portion, or asset of all) right, title, claim, and interest of every kind — whether vested or contingent, present or future, legal or equitable — in and to the property and interest described in Section 2 above.

This instrument is an irrevocable and unqualified refusal to accept the renounced interest, as required by Neb. Rev. Stat. § 30-2352(a)(2)(iv). It 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 and signed and acknowledged by the Disclaimant (or the Disclaimant's legal representative) in the manner provided for the execution of deeds of real estate, as required by Neb. Rev. Stat. § 30-2352(a)(2) and Treas. Reg. § 25.2518-2(b).

☐ This Disclaimer is being delivered and received within nine (9) months after the later of (a) the date of the Decedent's death or the effective date of the transfer creating the interest, or (b) the date the Disclaimant attained age 21 (Neb. Rev. Stat. § 30-2352(b); 26 U.S.C. § 2518(b)(2)).

☐ The Disclaimant has NOT accepted the disclaimed interest or any of its benefits, and has not assigned, conveyed, encumbered, pledged, transferred, or contracted to transfer the interest (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 renounced interest passes as if the Disclaimant had predeceased the Decedent (or the donee of the power), and the renunciation relates back to the date of death for all purposes (Neb. Rev. Stat. § 30-2352).

☐ This Disclaimer is intended as a qualified disclaimer under 26 U.S.C. § 2518 and as a renunciation effective for Nebraska inheritance- and estate-tax purposes under Chapter 77, articles 20 and 21.

6. EFFECT AND PASSING OF THE DISCLAIMED INTEREST

Under Neb. Rev. Stat. § 30-2352, the renounced property or interest devolves as if the Disclaimant had predeceased the Decedent (or, for an interest taken under a power of appointment, as if the Disclaimant had predeceased the donee of the power). When the renunciation is made within the time periods set forth in subsection (b), the renunciation relates back for all purposes to the date of death of the Decedent (or the determinative event), and the Disclaimant is treated as never having had the renounced interest.

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

7. IRREVOCABILITY AND BINDING EFFECT

This Disclaimer is an irrevocable and unqualified refusal to accept the renounced interest and may not be modified, withdrawn, or rescinded once delivered or filed (Neb. Rev. Stat. § 30-2352(a)(2)(iv)). It is binding upon the Disclaimant and all persons claiming through or under the Disclaimant.

8. DELIVERY, FILING, AND RECORDING

Pursuant to Neb. Rev. Stat. § 30-2352(b), the Disclaimant shall (check all that apply):

☐ Deliver this instrument so that it is received by the transferor of the interest, the transferor's legal representative, the personal representative of a deceased transferor, the trustee of any trust in which the renounced interest exists, or the holder of legal title to the property to which the interest relates.

☐ File this instrument with the County Court of [____________] County, Nebraska, in which proceedings concerning the Decedent's estate are pending or would be pending if commenced (where the right to renounce arises as a result of the death of an individual).

☐ Record a copy of this instrument in the office of the Register of Deeds of [____________] County, Nebraska, in which the real estate lies, if an interest in real estate is renounced (Neb. Rev. Stat. § 30-2352(b)).

To be effective for purposes of determining Nebraska inheritance and estate taxes (Chapter 77, articles 20 and 21), this instrument must be received not later than nine (9) months after the later of the transfer date or the date the Disclaimant attains age 21.

9. SIGNATURE, ACKNOWLEDGMENT, AND NOTARIZATION

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

Disclaimant Signature: ______________________________________

Printed Name: [________________________________]

ACKNOWLEDGMENT

STATE OF NEBRASKA )
COUNTY OF [____________] )

The foregoing instrument was acknowledged before me on this [____] day of [____________], 20[____], by [DISCLAIMANT FULL LEGAL NAME], known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing instrument, who acknowledged before me that he/she executed the same as a free and voluntary act.

______________________________________
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 Nebraska that the foregoing is true and correct, that I have not accepted the renounced 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 (in person, or by registered or certified mail, return receipt requested) 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 (registered or certified mail receipts)
☐ Copy of the recorded Disclaimer (Register of Deeds), if real property is involved
☐ File-stamped copy from the County Court (estate proceeding)

SOURCES AND REFERENCES

• Neb. Rev. Stat. § 30-2352 (Renunciation of succession) — https://nebraskalegislature.gov/laws/statutes.php?statute=30-2352
• Nebraska Inheritance Tax / Estate Tax, Neb. Rev. Stat. ch. 77, arts. 20–21 — https://nebraskalegislature.gov/laws/browse-chapters.php?chapter=77
• 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