Form 447pc - Filing Of A Disclaimer For Record

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STATE OF SOUTH CAROLINA
)
IN THE PROBATE COURT
)
COUNTY OF: ____________________________
)
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 Name:
_______________________________________________________________________
Address:
________________________________________________________________________
________________________________________________________________________
_________________________________________________________________________
Transferor’s information:
Full Name:
_______________________________________________________________________
Address:
________________________________________________________________________
________________________________________________________________________
_________________________________________________________________________
2.
Filing the Disclaimer in this county is proper because:
a. It relates to a Decedent domiciled in this county at date of death (attach death certificate if not previously filed).
b. It relates to Guardianship or Conservatorship action ongoing in this county; Case Number(s): _______________.
c. 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 of a disclaimer for record related to real property unless it is
related to one of the above matters in (a) or (b).
3. Attached is/are the Disclaimer(s) 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

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