AOC-E-210 — Disclaimer of Interest in Estate

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01 DISCLAIMANT INFORMATION

The person giving up the interest.

Disclaimant Full Name *

Disclaimant Address *

Disclaimant Phone

Disclaimant Email

Relationship to Decedent *

02 DECEDENT INFORMATION

Decedent Full Name *

Date of Death *

County *

Estate File Number (if probate opened)

03 INTEREST BEING DISCLAIMED

Type of Interest *

Description of Interest Being Disclaimed *

04 SCOPE OF DISCLAIMER

Is this a complete or partial disclaimer? *

05 EFFECTIVE DATE

Effective Date of Disclaimer *

Disclaimer is effective as of the date of the decedent's death for most purposes, but must be executed and filed within 9 months.

06 CERTIFICATIONS

The disclaimant has not accepted any benefit from, and has not exercised any rights with respect to, the interest being disclaimed, before executing this disclaimer, as required by G.S. 31B-1(c). *

The disclaimant understands that this disclaimer is irrevocable once filed with the Clerk of Superior Court, and that the disclaimed interest will pass as if the disclaimant had predeceased the decedent. *

07 NOTARIZATION

This section is completed by a Notary Public at the time of signing. Print and bring to a notary before filing.

STATE OF NORTH CAROLINA

County of

I, , Notary Public for the above County and State, certify that

___________________ personally appeared before me this day and acknowledged the due execution of the foregoing Disclaimer of Interest in Estate.

Witness my hand and official seal, this day of , 20 .

Notary Public

My commission expires:

08 ATTORNEY INFORMATION (OPTIONAL)

Attorney information is optional — this disclaimer may be filed without an attorney.

Attorney Name

NC Bar No.

Firm Name

Firm Address

Phone

FILING COUNTY

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DISCLAIMER RULES

Must disclaim within 9 months of the date of death (G.S. 31B-2)
Minors have until 9 months after turning 21 to disclaim
You CANNOT accept ANY benefit from the interest before disclaiming
Disclaimer is IRREVOCABLE once filed — cannot be undone
Must be in writing and notarized before filing
File with Clerk of Superior Court AND send copy to personal representative

WHY DISCLAIM

Estate planning: passes to next beneficiary without gift tax
Medicaid planning: avoid disqualification for public benefits
Creditor protection: disclaimer protects against disclaimant's creditors
Asset protection: disclaim into a trust instead of outright
Disclaimed interest passes as if disclaimant predeceased decedent

STATUTORY REFERENCE

G.S. 31B-1Disclaimer of interests

G.S. 31B-2Time limit (9 months)

G.S. 31B-3Effect of disclaimer

G.S. 31B-4Filing requirements