Transfer On Death Instrument (Todi) (Page 2 of 2) in pdf

Transfer On Death Instrument (Todi) Page 2

TRANSFER ON DEATH INSTRUMENT - PAGE 2 (TRANSFER TAX STAMP, EXEMPTION, WITNESS & NOTARY)

NAME OF OWNER

This Transfer is Exempt under provisions of 35 ILCS 200/31-45, Paragraph, Illinois Real Estate Transfer Tax Law.

DATE DOCUMENT EXECUTED

SIGNATURE OF OWNER OR REPRESENTATIVE

DATE DOCUMENT EXECUTED

SIGNATURE OF OWNER OR REPRESENTATIVE

WITNESS DECLARATION

We, the undersigned witnesses, hereby certify that the above Transfer on Death Instrument was on the date thereof signed

and declared by the Owner(s) as his/her/their Transfer on Death Instrument in our presence and that we, at his/her/their

request and in his/her/their presence and in the presence of each other, have signed our names as witnesses thereto,

believing to the best of our knowledge that the Owner(s) was/were at the time of signing of sound mind and memory, and

under no undue influence.

WITNESS 1 PRINTED NAME

WITNESS 1 SIGNATURE

WITNESS 1 ADDRESS

WITNESS 2 PRINTED NAME

WITNESS 2 SIGNATURE

WITNESS 2 ADDRESS

NOTARY VERIFICATION

STATE OF ILLINOIS

)

COUNTY OF _______________

)

I, the undersigned, a notary public in and for said County, in the State aforesaid, DO HEREBY CERTIFY that Owner(s) and

witnesses personally known to me to be the same persons whose names are subscribed on the foregoing instrument,

appeared before me this day in person and acknowledged that they signed, sealed, and delivered the said instrument as

their free and voluntary act, for the uses and purposes therein set forth.

Given under my hand and notarial seal this

day of

NOTARY PUBLIC SIGNATURE:

NOTARY PUBLIC STAMP:

SPECIAL NOTICE: THIS DOCUMENT HAS BEEN PROVIDED AS A COURTESY FROM THE COOK COUNTY RECORDER OF DEEDS

THIS IS NOT LEGAL ADVICE, OR ASSISTANCE WITH YOUR INDIVIDUAL ESTATE PLAN. FURTHERMORE, IT WAS PROVIDED

WITHOUT ANY TITLE EXAMINATION OR REVIEW OF YOUR INDIVIDUAL ESTATE. PLEASE CONSULT AN ATTORNEY IF YOU HAVE ADDITIONAL QUESTIONS.

Transfer On Death Instrument (Todi) Page 2