Disclaimer and Renunciation of Interest (Qualified Disclaimer) — Oregon

TIMING — IRC § 2518: For federal qualified-disclaimer treatment, this signed writing must reach a permitted recipient within nine months after the later of the transfer creating the interest or the disclaimant's 21st birthday, subject to the federal mailing and weekend/holiday rules in Treas. Reg. § 25.2518-2(c)(2). Oregon's disclaimer act supplies separate delivery routes and bars in ORS 105.642–105.643. Under ORS 105.629(5), irrevocability occurs at the later of delivery or filing and the disclaimer's statutory effective time. Verify both the federal deadline and the Oregon route before signing.

DISCLAIMER AND RENUNCIATION OF INTEREST (QUALIFIED DISCLAIMER)

STATE OF OREGON

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 and Optional Acknowledgment
10. Optional Factual 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 property or a power over property within the meaning of ORS 105.629, namely a(n): ☐ heir ☐ devisee ☐ legatee ☐ beneficiary of a testamentary or inter vivos trust ☐ beneficiary under a beneficiary designation (insurance, annuity, POD/TOD, retirement plan, or security in beneficiary form) ☐ surviving holder of jointly held property ☐ donee/appointee under a power of appointment ☐ taker in default ☐ fiduciary ☐ 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 (ORS chapter 112)
☐ Revocable, testamentary, or inter vivos trust
☐ Beneficiary designation (life insurance, retirement plan, annuity, POD/TOD account, or security registered in beneficiary form)
☐ Jointly held property with right of survivorship (ORS 105.634)
☐ 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 ORS 105.629(4) may be expressed as a fraction, percentage, monetary amount, term of years, limitation of a power, or any other interest or estate in the property: [____________________] (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.

Jointly held property: If disclaiming a survivorship right, identify the allowable portion under ORS 105.634(1), including contributions furnished by the Disclaimant; do not assume the whole interest may be disclaimed.

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

3. STATUTORY AUTHORITY

This Disclaimer is made under the Oregon Uniform Disclaimer of Property Interests Act, ORS 105.623 through 105.649, 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.

• ORS 105.629(1) authorizes a person to disclaim, in whole or in part, any interest in property or any 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.
• ORS 105.629(3) requires that, to be effective, a disclaimer must: (a) be in writing or otherwise recorded in a perceivable medium; (b) declare that the person disclaims the interest or power; (c) describe the interest or power disclaimed; (d) be signed by the person making the disclaimer; and (e) be delivered or filed in the manner provided in ORS 105.642.
• ORS 105.629(5) provides that a disclaimer is irrevocable when delivered or filed under ORS 105.642, or when it becomes effective under ORS 105.633 to 105.641, whichever occurs later. Under ORS 105.629(6), a disclaimer is not a transfer, assignment, or release.
• ORS 105.643 bars or limits a disclaimer in specified cases, including a prior written waiver, acceptance or transfer of the interest before effectiveness, and a judicial sale. ORS 105.648 separately restricts a disclaimer that would prevent recovery under ORS 411.620.

4. THE DISCLAIMER

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, monetary, or other 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, interest, or power described in Section 2 above.

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 and signed by the Disclaimant (or the Disclaimant's fiduciary), as required by ORS 105.629(3) and Treas. Reg. § 25.2518-2(b).

☐ For federal qualified-disclaimer treatment, this writing is received within nine (9) months after the later of the transfer creating this interest or the Disclaimant's 21st birthday (26 U.S.C. § 2518(b)(2)). Complete the separate Oregon delivery or filing steps in Section 8.

☐ 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)).

☐ The Disclaimant has not previously waived the right to disclaim, accepted or transferred the interest, or caused it to be sold at a judicial sale; and this disclaimer is not barred by ORS 105.643 or 105.648.

☐ The disclaimed interest passes under the governing instrument's disclaimer provision or, if no such provision applies, under the appropriate Oregon statutory default. The Disclaimant does not select the recipient.

6. EFFECT AND PASSING OF THE DISCLAIMED INTEREST

Under ORS 105.633, an ordinary property-interest disclaimer takes effect when the creating instrument becomes irrevocable or, for intestate succession, when the decedent dies. The instrument's disclaimer-disposition provision controls first. If none applies, the statutory default generally treats an individual Disclaimant as having died immediately before distribution, subject to the special descendant, estate, and future-interest rules in ORS 105.633(3)–(4). Confirm the actual recipient from the instrument and applicable default before delivery.

For a disclaimer of a right of survivorship in jointly held property, ORS 105.634 governs the passing 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 Oregon law.

7. IRREVOCABILITY AND BINDING EFFECT

This Disclaimer becomes irrevocable under ORS 105.629(5) at the later of delivery or filing under ORS 105.642 and its effective time under ORS 105.633 to 105.641. Once irrevocable, the Disclaimant may not withdraw it.

8. DELIVERY, FILING, AND RECORDING

Pursuant to ORS 105.642, delivery of this Disclaimer may be made by personal delivery, first class mail, or any other method likely to result in receipt. The Disclaimant shall (check all that apply):

☐ Deliver this Disclaimer to the personal representative of the Decedent's estate (interest created by will or by intestate succession); or, if no personal representative is serving, file it with a court having authority to appoint one (ORS 105.642(3)).

☐ Deliver this Disclaimer to the trustee then serving (interest in a testamentary or inter vivos trust); or, if no trustee is serving, as otherwise provided in ORS 105.642(4)–(5).

☐ For an inter vivos trust before it becomes irrevocable, deliver this Disclaimer to the settlor of a revocable trust or the transferor of the interest (ORS 105.642(5)(c)).

☐ For a beneficiary designation before it becomes irrevocable, deliver this Disclaimer to the person who made the designation (ORS 105.642(6)).

☐ Deliver this Disclaimer to the person obligated to distribute the interest (interest created by a beneficiary designation that has become irrevocable) (ORS 105.642(7)).

☐ Deliver this Disclaimer to the person to whom the disclaimed interest passes (disclaimer by a surviving holder of jointly held property) (ORS 105.642(8)).

☐ Deliver this Disclaimer to the holder of the power of appointment or the fiduciary acting under the instrument that created the power (ORS 105.642(9)–(10)).

☐ Record a copy of this Disclaimer in the real property records of the county recorder where any disclaimed real property is located, if the underlying transfer instrument may be recorded (ORS 105.646). Recording is optional under that section; failure to record does not affect validity between the Disclaimant and persons taking by reason of the disclaimer. Confirm any title or notice consequences before relying on an unrecorded instrument.

9. SIGNATURE, ACKNOWLEDGMENT, AND NOTARIZATION

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

Disclaimant Signature: ______________________________________

Printed Name: [________________________________]

OPTIONAL ACKNOWLEDGMENT FOR RECORDING

STATE OF OREGON )
COUNTY OF [____________] )

This instrument was acknowledged before me on [__/__/____] by [DISCLAIMANT FULL LEGAL NAME], who is personally known to me or who proved his/her identity to me on satisfactory evidence to be the person whose name is subscribed to the foregoing instrument, and who acknowledged that he/she executed the same voluntarily.

______________________________________
Notary Public — State of Oregon
My commission expires: [__/__/____]

[NOTARY SEAL]

10. OPTIONAL FACTUAL DECLARATION

I, [DISCLAIMANT FULL LEGAL NAME], confirm that the factual statements I made in this Disclaimer are true to the best of my knowledge, including that I have not accepted the disclaimed interest or its benefits.

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, by first class mail, or by another method likely to result in receipt) 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 (certified mail receipts or other proof of receipt)
☐ Copy of the recorded Disclaimer (county recorder), if real property is involved
☐ File-stamped copy from the probate court (estate proceeding), if filed

SOURCES AND REFERENCES

• Oregon Uniform Disclaimer of Property Interests Act, ORS 105.623 to 105.649 — https://www.oregonlegislature.gov/bills_laws/ors/ors105.html
• ORS 105.646 (Optional recording of a disclaimer) — https://www.oregonlegislature.gov/bills_laws/ors/ors105.html
• ORS 105.629, 105.633, 105.634, 105.642–105.643 and 105.648 (powers, effects, delivery, and bars) — https://www.oregonlegislature.gov/bills_laws/ors/ors105.html
• 26 U.S.C. § 2518 (qualified disclaimers) — https://uscode.house.gov/us/usc/119-136/t26/s2518/
• Treas. Reg. §§ 25.2518-2 and 25.2518-3 (federal qualification and partial interests) — https://www.ecfr.gov/current/title-26/part-25