Disclaimer and Renunciation of Interest (Qualified Disclaimer) — Ohio

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. Ohio R.C. § 5815.36 sets no independent deadline; under R.C. § 5815.36(D) the disclaimer must be delivered, filed, or recorded before accepting any benefits of the disclaimed interest. Verify the 9-month federal deadline with counsel before signing.

DISCLAIMER AND RENUNCIATION OF INTEREST (QUALIFIED DISCLAIMER)

STATE OF OHIO

TABLE OF CONTENTS

1. Disclaimant Information
2. Identification of the Donative Instrument and Interest Disclaimed
3. Statutory Authority
4. The Disclaimer / Renunciation
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 disclaimant within the meaning of R.C. § 5815.36(A)(1), namely a(n): ☐ heir ☐ next of kin ☐ devisee ☐ legatee ☐ donee ☐ grantee ☐ person succeeding to a disclaimed interest ☐ surviving joint tenant / tenant by the entireties / survivorship tenant ☐ beneficiary under a testamentary or nontestamentary instrument ☐ person designated to take under a power of appointment ☐ fiduciary (as to fiduciary rights, powers, privileges, immunities) ☐ other: [____________________].

2. IDENTIFICATION OF THE DONATIVE INSTRUMENT AND INTEREST DISCLAIMED

Source of the interest (the "donative instrument") (check all that apply):
☐ Last Will and Testament of the Decedent
☐ Intestate succession (R.C. Ch. 2105)
☐ Inter vivos or testamentary trust
☐ Beneficiary designation (life insurance, retirement plan, annuity, POD/TOD account, or security registered in beneficiary form)
☐ Transfer-on-death designation affidavit (R.C. § 5302.22) for real property
☐ Joint tenancy / tenancy by the entireties / survivorship tenancy
☐ Power of appointment (testamentary or nontestamentary)
☐ Other: [________________________________]

Extent of the disclaimer:
☐ Full disclaimer — the Disclaimant disclaims the entire interest described above.
☐ Partial disclaimer — the Disclaimant disclaims only the following fractional, percentage, or pecuniary portion: [____________________] (e.g., an undivided ____% interest, or the sum of $[____________]).

Legal description of any real property disclaimed (or see attached Exhibit A); reference to record of the creating instrument: [________________________________]

3. STATUTORY AUTHORITY

This Disclaimer is made under Ohio Rev. Code § 5815.36 (Disclaiming testamentary and nontestamentary succession to real and personal property) and is intended to constitute a qualified disclaimer under 26 U.S.C. § 2518 and Treas. Reg. § 25.2518-2.

• R.C. § 5815.36(B)(1)–(2) authorizes a disclaimant to disclaim, in whole or in part, the succession to any property — and a fiduciary to disclaim any right, power, privilege, or immunity — by executing and delivering, filing, or recording a written disclaimer instrument.
• R.C. § 5815.36(B)(3) requires that the written instrument be signed and acknowledged by the disclaimant and contain (a) a reference to the donative instrument; (b) a description of the property, part of property, or interest disclaimed (and of any fiduciary right, power, privilege, or immunity disclaimed); and (c) a declaration of the disclaimer and its extent.
• R.C. § 5815.36(D) requires the disclaimer to be delivered, filed, or recorded before the disclaimant accepts any benefits of the disclaimed interest and after the taker and interest are finally ascertained.
• R.C. § 5815.36(L) confirms the right to disclaim exists irrespective of any spendthrift provision or similar restriction.

4. THE DISCLAIMER / RENUNCIATION

The Disclaimant, intending to be legally bound, hereby IRREVOCABLY DISCLAIMS and RENOUNCES all (or, where a partial disclaimer is elected in Section 2, the stated fractional, percentage, or pecuniary part 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 (including any fiduciary right, power, privilege, or immunity so described).

This Disclaimer is made freely, voluntarily, and with full knowledge of its legal and tax consequences. The Disclaimant has no power to revoke this Disclaimer and may not transfer or direct to be transferred to the Disclaimant the legal and equitable ownership of the disclaimed property (R.C. § 5815.36(E)).

5. QUALIFIED-DISCLAIMER REPRESENTATIONS

The Disclaimant represents and certifies that:

☐ This Disclaimer is a written instrument, signed and acknowledged by the Disclaimant, and contains a reference to the donative instrument, a description of the property/interest (and any fiduciary right or power) disclaimed, and a declaration of the disclaimer and its extent, as required by R.C. § 5815.36(B)(3) 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, and has not assigned, conveyed, encumbered, pledged, transferred, or contracted to transfer the interest, nor permitted any judicial sale of it (R.C. § 5815.36(J); 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 interest passes as if the Disclaimant had predeceased the Decedent (or the donee of an exercised power, or the effective date of a nontestamentary instrument), as provided by R.C. § 5815.36(G).

6. EFFECT AND PASSING OF THE DISCLAIMED INTEREST

Under R.C. § 5815.36(G), in the absence of express provisions to the contrary in the donative instrument, the disclaimed property (and any future interest taking effect at or after the termination of the disclaimed interest) descends, is distributed, or is otherwise disposed of, and is accelerated, as follows: (1) if intestate or testate succession is disclaimed, as if the Disclaimant had predeceased the Decedent; (2) if the Disclaimant is designated to take under a power of appointment exercised by a testamentary instrument, as if the Disclaimant had predeceased the donee of the power; (3) if the donative instrument is nontestamentary, as if the Disclaimant had died before its effective date; and (4) if a fiduciary right, power, privilege, or immunity is disclaimed, as if it had never been in the donative instrument.

Under R.C. § 5815.36(H), this Disclaimer is effective as of, and relates back for all purposes to, the date on which the taker and the taker's interest were finally ascertained.

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

7. IRREVOCABILITY AND BINDING EFFECT

This Disclaimer is irrevocable — the Disclaimant retains no power to revoke it (R.C. § 5815.36(E)(1)). Once executed and delivered, filed, or recorded as required by R.C. § 5815.36, this Disclaimer is final and binding upon all persons (R.C. § 5815.36(M)). A disclaimer is not a transfer or conveyance by the Disclaimant, and no creditor of the Disclaimant may avoid it (R.C. § 5815.36(N)(2)).

8. DELIVERY, FILING, AND RECORDING

Pursuant to R.C. § 5815.36(F), the Disclaimant shall (check all that apply):

☐ File this Disclaimer in the Probate Division of the Court of Common Pleas of [____________] County, Ohio, where proceedings for administration of the Decedent's estate have been (or may be) commenced, and deliver an executed copy personally or by certified mail to the personal representative of the Decedent's estate — for an interest created by a testamentary instrument or by intestate succession (R.C. § 5815.36(F)(2)–(3)).

☐ Deliver this Disclaimer personally or by certified mail to the trustee or other person having legal title to or possession of the property — for an interest created by a nontestamentary instrument (R.C. § 5815.36(F)(1)).

☐ File this Disclaimer with the County Recorder of [____________] County, Ohio, if the interest was created by a transfer-on-death designation affidavit under R.C. § 5302.22 (R.C. § 5815.36(F)(1)).

☐ Record an executed copy of this Disclaimer in the Office of the Recorder of [____________] County, Ohio, where the real estate is located, if an interest in real estate is disclaimed; the instrument shall describe the real estate with sufficient certainty and reference the record of the creating instrument (R.C. § 5815.36(F)(4)). A spouse of the Disclaimant has no dower or other interest in the real estate disclaimed.

9. SIGNATURE, ACKNOWLEDGMENT, AND NOTARIZATION

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

Disclaimant Signature: ______________________________________

Printed Name: [________________________________]

ACKNOWLEDGMENT

STATE OF OHIO )
COUNTY OF [____________] ) ss.

Before me, a Notary Public in and for said county and state, personally appeared [DISCLAIMANT FULL LEGAL NAME], who acknowledged that he/she did sign the foregoing instrument and that the same is his/her free act and deed.

In testimony whereof, I have set my hand and official seal this [____] day of [____________], 20[____].

______________________________________
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 Ohio 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 (in person or by certified mail) to the following:

Signature: ______________________________________
Printed Name: [________________________________]

12. ATTACHMENTS CHECKLIST

☐ Copy of the donative instrument (will, trust, beneficiary designation, or TOD affidavit) creating the disclaimed interest
☐ Exhibit A — legal description of any real property disclaimed (with reference to record of the creating instrument)
☐ Certified copy of the Decedent's Death Certificate
☐ Proof of delivery / mailing (certified mail receipts)
☐ Recorded copy of the Disclaimer (County Recorder), if real estate is involved
☐ File-stamped copy from the Probate Division of the Court of Common Pleas

SOURCES AND REFERENCES

• Ohio Rev. Code § 5815.36 (Disclaiming testamentary and nontestamentary succession) — https://codes.ohio.gov/ohio-revised-code/section-5815.36
• Ohio Rev. Code § 5815.36 (Justia, 2025) — https://law.justia.com/codes/ohio/title-58/chapter-5815/section-5815-36/
• 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