STATE OF SOUTH CAROLINA
)
IN THE PROBATE COURT
)
COUNTY OF GREENVILLE
)
FILING OF A DISCLAIMER FOR RECORD*
)
IN THE MATTER OF:
)
)
CASE NUMBER: ___________________
(Decedent/Incapacitated)
)
NOTE: THIS DOCUMENT IS NOT A DISCLAIMER;
THE DISCLAIMER MUST BE ATTACHED
1. Disclaimant information:
Full Legal Name:
_______________________________________________________________________
Address:
________________________________________________________________________
________________________________________________________________________
Transferor’s information:
Full Legal Name:
_______________________________________________________________________
Address:
________________________________________________________________________
________________________________________________________________________
2.
Filing the Disclaimer in this county is proper because:
It relates to a Decedent domiciled in this county at date of death (attach death certificate if not previously filed), or
It relates to a Guardianship or Conservatorship action ongoing in this county; Case Number(s): _______________
__________________________________________, or
After due diligence, the undersigned was unable to locate the Transferor for delivery of the attached Disclaimer but
has determined that this Court has jurisdiction to accept the Disclaimer for recording due to: _________________
__________________________________________________________________________________________.
NOTE: The Probate Court is not the proper Court for filing a disclaimer for record unless it is related to one of the
above matters.
3. Attached is the Disclaimer executed: __________________________________________________________.
Pursuant to SCPC 62-2-801, the undersigned delivers the Disclaimer of the above-referenced Disclaimant to the office of the
Probate Court of the above County.
Executed this __________ day of __________________________, 20_______.
Signature:
_______________________________________________
Name:
_______________________________________________
Address:
_______________________________________________
_______________________________________________
Telephone (Work):
_______________________________________________
(Home):
_______________________________________________
(Cell):
_______________________________________________
Email:
_______________________________________________
Relationship to Decedent/Estate
or Incapacitated Person :
_______________________________________________
* FILING A DISCLAIMER PURSUANT TO SCPC 62-2-801 DOES NOT IN ITSELF CONSTITUTE
A QUALIFIED DISCLAIMER IN ACCORDANCE WITH INTERNAL REVENUE CODE §2518.
FORM #447PC (1/2014)
62-2-801