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 received by a federally permitted recipient by the nine-month date measured from the later of the transfer creating this interest or the disclaimant's 21st birthday (subject to the limited federal mailing and weekend/holiday rules in Treas. Reg. § 25.2518-2(c)(2)), with no acceptance of the interest or its benefits. Utah Code § 75-2-801(2) sets separate state filing or delivery periods by the type of interest. Verify both deadlines 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
☐ 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 undivided fractional or percentage interest, or specific pecuniary amount: [____________________]. For an undivided fraction, specify the fraction of every substantial right for the full term. For a pecuniary amount, identify it precisely and arrange for the disclaimed amount and its income to be segregated, with no benefit to the Disclaimant (Treas. Reg. § 25.2518-3(b)–(c)).

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 and 25.2518-3, if their requirements are met.

• 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, the ordinary period is nine months after the effective date, but a person unaware of the interest has nine months after learning of it; for a future interest, the period runs from the event finally ascertaining the taker and indefeasibly vesting the interest. Apply the state and federal clocks separately.
• 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 filed or delivered within the applicable Utah period and by the required method for this interest under Utah Code § 75-2-801(2). For a present testamentary or intestacy interest, filing generally runs from the relevant death; for a present nontestamentary interest, delivery or filing generally runs from the instrument's effective date. Future interests and a qualifying lack of knowledge have separate state timing rules.

☐ 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 by the transferor, the transferor's legal representative, the holder of legal title, or a person in possession of the property (26 U.S.C. § 2518(b)(2); Treas. Reg. § 25.2518-2(b)(2)–(c)). Court filing alone does not establish federal delivery to one of those recipients.

☐ 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, either to the Decedent's spouse or to a person other than the Disclaimant, as federal qualification requires (26 U.S.C. § 2518(b)(4); Treas. Reg. § 25.2518-2(a)(5), (e)).

☐ The recipient of the disclaimed interest is determined by the governing instrument and Utah Code § 75-2-801(4), without any designation by the Disclaimant.

6. EFFECT AND PASSING OF THE DISCLAIMED INTEREST

Under Utah Code § 75-2-801(4), an alternate disposition in the governing instrument controls. Otherwise, a disclaimed testamentary or intestate interest generally devolves as if the Disclaimant had predeceased the Decedent, subject to the statute's rules for surviving descendants. A disclaimed nontestamentary interest generally devolves as if the Disclaimant had predeceased the instrument's or contract's effective date, again subject to those descendant rules. The disclaimer relates back to the Decedent's death or the nontestamentary instrument's effective date, as applicable. Future interests are governed by the corresponding rules in subsection (4). A surviving joint tenant or tenant by the entireties may disclaim a survivorship interest as a separate interest under § 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

The Disclaimant makes this refusal irrevocably and without qualification, as required for a federal qualified disclaimer (26 U.S.C. § 2518(b); Treas. Reg. § 25.2518-2(a)(1)). Under Utah Code § 75-2-801(4)(c), the Disclaimer 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), complete each applicable step:

☐ For an interest under a testamentary instrument or by intestacy: file this Disclaimer in a court with jurisdiction under Title 78A. If estate administration proceedings have commenced in a district court, use that county: [____________] County, Utah.

☐ For a testamentary or intestate interest, 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.

Complete the required filing or delivery within the applicable Utah Code § 75-2-801(2) period. Subsection (2)(d) permits recording a copy when real property is disclaimed; it does not set the same deadline for that optional recording. For federal tax treatment, also ensure timely receipt by a recipient identified in Treas. Reg. § 25.2518-2(b)(2); a court filing by itself may not satisfy that requirement.

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 law 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-106.)

Signature: ______________________________________
Date: [__/__/____]

City and state or country where signed: [________________________________]

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:

Federal receipt record, if qualified-disclaimer treatment is intended: Authorized recipient and capacity: [________________________________]. Date received: [__/__/____]. Delivery or mailing proof: [________________________________].

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 court, if filing is required or used

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://uscode.house.gov/us/usc/119-138/t26/s2518/
• Treas. Reg. § 25.2518-2 (Requirements for a qualified disclaimer) — https://www.ecfr.gov/current/title-26/section-25.2518-2
• Treas. Reg. § 25.2518-3 (Disclaimer of less than an entire interest) — https://www.ecfr.gov/current/title-26/section-25.2518-3