Disclaimer and Renunciation of Interest (Qualified Disclaimer) — Utah

TIMING — IRC § 2518 (9-MONTH DEADLINE): To qualify as a federal "qualified disclaimer," this writing must be signed and delivered/filed 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. Utah Code § 75-2-801(2) imposes a parallel nine-month deadline under state law. Verify the controlling deadline with counsel before signing.

DISCLAIMER AND RENUNCIATION OF INTEREST (QUALIFIED DISCLAIMER)

STATE OF UTAH

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, or the representative of a person, to whom an interest in or with respect to property devolves by whatever means within the meaning of Utah Code § 75-2-801(1), namely a(n): ☐ heir ☐ devisee ☐ legatee ☐ beneficiary of a trust ☐ beneficiary under a nontestamentary instrument or contract (insurance, IRA, annuity, retirement plan, POD/TOD account, or security in beneficiary form) ☐ surviving joint tenant or tenant by the entireties ☐ appointee or taker 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 (Utah Code § 75-2-101 et seq.)
☐ Revocable or testamentary trust
☐ Nontestamentary instrument or contract / beneficiary designation (life insurance, IRA, retirement plan, annuity, POD/TOD account, or security registered in beneficiary form)
☐ Joint tenancy or tenancy by the entireties (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 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): [________________________________]

3. STATUTORY AUTHORITY

This Disclaimer is made under Utah Code § 75-2-801 and is intended to constitute a qualified disclaimer under 26 U.S.C. § 2518 and Treas. Reg. § 25.2518-2.

• Utah Code § 75-2-801(1) authorizes a person, or the representative of a person, to disclaim an interest in property in whole or in part by delivering or filing a written disclaimer, notwithstanding any spendthrift provision or similar restriction or any restriction on the right to disclaim in the governing instrument.
• Utah Code § 75-2-801(2) prescribes the time and manner of filing or delivery: for an interest under a testamentary instrument or by intestacy, the disclaimer of a present interest must be filed not later than nine months after the death of the deceased owner or deceased donee of a power; for an interest under a nontestamentary instrument or contract, not later than nine months after the effective date; for a future interest, within nine months after the event finally ascertaining the taker and indefeasibly vesting the interest.
• Utah Code § 75-2-801(5) bars the right to disclaim where there has been an assignment, conveyance, encumbrance, pledge, or transfer, a written waiver, an acceptance of the property or a benefit under it, or a judicial sale before the disclaimer is made.

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, 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 and signed by the Disclaimant (or the Disclaimant's representative), describes the property or interest disclaimed, and declares the disclaimer and its extent, as required by Utah Code § 75-2-801 and Treas. Reg. § 25.2518-2(b).

☐ This Disclaimer is being delivered and filed 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 (Utah Code § 75-2-801(2); 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 has not executed a written waiver of the right to disclaim (Utah Code § 75-2-801(5); 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 to the person(s) entitled to take as if the Disclaimant had predeceased the Decedent (or the donee of the power).

6. EFFECT AND PASSING OF THE DISCLAIMED INTEREST

Under Utah Code § 75-2-801, the disclaimed 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). A future interest takes effect as if the Disclaimant had died before the determinative event, and the disclaimer relates back for all purposes to the date of the Decedent's death, the date of the donee's death, or the determinative event, as applicable. A surviving joint tenant or tenant by the entireties may disclaim, as a separate interest, any property devolving by right of survivorship (§ 75-2-801(2)(c)).

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

7. IRREVOCABILITY AND BINDING EFFECT

This Disclaimer is irrevocable and may not be modified, withdrawn, or rescinded once delivered or filed. It is binding upon the Disclaimant and all persons claiming through or under the Disclaimant.

8. DELIVERY, FILING, AND RECORDING

Pursuant to Utah Code § 75-2-801(2), the Disclaimant shall (check all that apply):

☐ For an interest under a testamentary instrument or by intestacy: file this Disclaimer in a court with jurisdiction under Title 78A — in the district court of [____________] County, Utah, in which proceedings for the administration of the Decedent's estate have been or may be commenced.

☐ Deliver a copy of this Disclaimer, in person or by registered or certified mail, return receipt requested, to any personal representative or other fiduciary of the Decedent or donee of the power.

☐ For an interest under a nontestamentary instrument or contract: deliver or file this Disclaimer, and deliver a copy in person or by registered or certified mail, return receipt requested, to the person who has legal title to or possession of the interest disclaimed.

☐ Record a copy of this Disclaimer in the office of the County Recorder of [____________] County, Utah, where the real property is located, if real property or an interest in real property is disclaimed.

All delivery, filing, and recording must occur within the nine-month period described in Section 1 and Utah Code § 75-2-801(2).

9. SIGNATURE, ACKNOWLEDGMENT, AND NOTARIZATION

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

Disclaimant Signature: ______________________________________

Printed Name: [________________________________]

ACKNOWLEDGMENT

STATE OF UTAH )
COUNTY OF [____________] )

On this [____] day of [____________], 20[____], before me personally appeared [DISCLAIMANT FULL LEGAL NAME], proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the foregoing instrument, who acknowledged that he/she executed the same voluntarily.

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

[NOTARY SEAL]

10. VERIFICATION / DECLARATION

I, [DISCLAIMANT FULL LEGAL NAME], declare under criminal penalty under the laws of the State of Utah 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. (Utah Code § 78B-18a-105.)

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 (County Recorder), if real property is involved
☐ File-stamped copy from the district court (estate proceeding)

SOURCES AND REFERENCES

• Utah Code § 75-2-801 (Disclaimer of property interests) — https://le.utah.gov/xcode/Title75/Chapter2/75-2-S801.html
• 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