Disclaimer and Renunciation of Interest (Qualified Disclaimer) — Rhode Island

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. Rhode Island law (R.I. Gen. Laws § 34-5-5) likewise requires execution and filing within nine (9) months of the death or determining event (subject to the age-21 rule and a court-approved extension). Verify the deadline with counsel before signing.

DISCLAIMER AND RENUNCIATION OF INTEREST (QUALIFIED DISCLAIMER)

STATE OF RHODE ISLAND

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. Filing, Service, 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 "beneficiary" within the meaning of R.I. Gen. Laws § 34-5-1 to whom an interest in property would pass under R.I. Gen. Laws § 34-5-2, namely a(n): ☐ heir / person taking by intestate succession ☐ devisee / legatee ☐ beneficiary of a testamentary trust ☐ donee / grantee ☐ beneficiary of an inter vivos trust ☐ beneficiary of an insurance or annuity contract ☐ surviving joint tenant or tenant by the entirety ☐ person succeeding to a disclaimed interest ☐ 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, testamentary, or inter vivos trust
☐ Insurance or annuity contract
☐ Joint tenancy or tenancy by the entirety with right of survivorship
☐ Deed, assignment, or other nontestamentary instrument of conveyance
☐ Other: [________________________________]

Extent of the disclaimer:
☐ Full disclaimer — the Disclaimant disclaims the entire interest described above.
☐ Partial disclaimer — the Disclaimant disclaims only the following portion (the interest disclaimed may be any fractional part, share, portion, dollar amount, specific asset, or lesser estate per § 34-5-1): [____________________] (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 is made under the Rhode Island Disclaimer of Certain Property Interests Act, R.I. Gen. Laws §§ 34-5-1 through 34-5-12, and is intended to constitute a qualified disclaimer under 26 U.S.C. § 2518 and Treas. Reg. § 25.2518-2.

• R.I. Gen. Laws § 34-5-2 authorizes a beneficiary, unless barred by § 34-5-9, to disclaim any interest in property that would otherwise pass to the beneficiary under a testamentary or nontestamentary instrument or by operation of law.
• R.I. Gen. Laws § 34-5-4 requires that the disclaimer be in writing, describe the interest in property being disclaimed, declare the disclaimer and the extent thereof, be clear and unequivocal, and be signed by the Disclaimant (or a duly appointed guardian, conservator, or legal representative).
• R.I. Gen. Laws § 34-5-5 requires that the disclaimer be executed and filed within nine (9) months of the death or determining event (subject to the age-21 rule and a court-approved extension).

4. THE DISCLAIMER

The Disclaimant, intending to be legally bound, hereby CLEARLY, UNEQUIVOCALLY, and 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.

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, clear and unequivocal, describes the interest disclaimed, and declares the disclaimer and its extent, as required by R.I. Gen. Laws § 34-5-4 and Treas. Reg. § 25.2518-2(b).

☐ This Disclaimer is being executed and filed within nine (9) months after the later of (a) the date of the Decedent's death or the effective date of the instrument creating the interest, or (b) the date the Disclaimant attained age 21 (R.I. Gen. Laws § 34-5-5; 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, and none of the contingencies in R.I. Gen. Laws § 34-5-9 that would waive or bar the right to disclaim is applicable (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 died immediately preceding the event determining that the Disclaimant is the beneficiary, as provided by R.I. Gen. Laws § 34-5-8.

6. EFFECT AND PASSING OF THE DISCLAIMED INTEREST

Under R.I. Gen. Laws § 34-5-8, unless the will or inter vivos instrument provides for another disposition, the disclaimed interest passes in the same manner as if the Disclaimant had died immediately preceding the event determining that the Disclaimant is the beneficiary of the interest. A future interest that takes effect at or after termination of the disclaimed interest takes effect as if the Disclaimant had so died. The Disclaimer relates back for all purposes to that date, and the disclaimed interest shall never vest in the Disclaimant (§ 34-5-8(c)).

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

7. IRREVOCABILITY AND BINDING EFFECT

Under R.I. Gen. Laws § 34-5-8(a), this Disclaimer is effective according to its terms and irrevocable upon execution in accordance with § 34-5-4 and filing in accordance with § 34-5-6. It may not thereafter be modified, withdrawn, or rescinded, and it is binding upon the Disclaimant and all persons claiming through or under the Disclaimant.

8. FILING, SERVICE, AND RECORDING

Pursuant to R.I. Gen. Laws § 34-5-6, the Disclaimant shall (check all that apply):

☐ File the original (or an attested copy) of this Disclaimer, for personal property, in the office of the Clerk of the Probate Court of the City/Town of [____________], Rhode Island, that had jurisdiction of the Decedent's estate (if the interest was created by will); or, if created by an inter vivos instrument, in the office of the Clerk of the Superior Court for the county where the donor or grantor resided (or Providence County if a nonresident) (§ 34-5-6(a)(1)).

☐ File this Disclaimer, for real estate, in the office charged with the recording of deeds in the city or town where the real estate is situated; and, if probate proceedings have been commenced, also with the Clerk of the Probate Court in which those proceedings are instituted (§ 34-5-6(a)(2)).

☐ Serve a copy of this Disclaimer by delivering in hand or by certified mail to the last known address of each person or entity having legal title to or possession of the disclaimed property (§ 34-5-6(b)).

9. SIGNATURE, ACKNOWLEDGMENT, AND NOTARIZATION

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

Disclaimant Signature: ______________________________________

Printed Name: [________________________________]

ACKNOWLEDGMENT

STATE OF RHODE ISLAND )
COUNTY OF [____________] )

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

______________________________________
Notary Public — State of Rhode Island
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 Rhode Island that the foregoing is true and correct, that I have not accepted the disclaimed interest or any benefit thereof, that none of the bars in R.I. Gen. Laws § 34-5-9 applies, 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 served (by hand delivery or certified mail) upon 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 service (certified mail receipts or return of hand delivery)
☐ Recorded copy of the Disclaimer (city/town recorder of deeds), if real property is involved
☐ Filed copy from the Probate Court or Superior Court Clerk
☐ Court order extending the time to disclaim, if applicable (§ 34-5-5)

SOURCES AND REFERENCES

• Rhode Island Disclaimer of Certain Property Interests, R.I. Gen. Laws §§ 34-5-1 to 34-5-12 — https://webserver.rilegislature.gov/Statutes/TITLE34/34-5/INDEX.htm
• R.I. Gen. Laws § 34-5-5 (Time for filing disclaimer) — https://law.justia.com/codes/rhode-island/title-34/chapter-34-5/section-34-5-5/
• R.I. Gen. Laws § 34-5-6 (Filing and service of disclaimer) — https://law.justia.com/codes/rhode-island/title-34/chapter-34-5/section-34-5-6/
• R.I. Gen. Laws § 34-5-8 (Disposition of disclaimed interest) — https://law.justia.com/codes/rhode-island/title-34/chapter-34-5/section-34-5-8/
• 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