Transfer On Death Instrument (Page 2 of 3) in pdf

Transfer On Death Instrument Page 2

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

, 20

_________________________________________________________________

notary Public

PrePared By and reTUrn TO:

name

address

nOTice Of deaTH affidaViT

and accePTance Of

Transfer On deaTH insTrUmenT

PrePared By and reTUrn TO:

name

address

send sUBseQUenT Tax BiLL TO:

name

address

recOrder’s sTamP

The undersigned beneficiary or beneficiaries, being duly sworn on oath, state as follows:

1. That

[name of owner] died on

, 20

[date], a resident of

county, illinois, owning residential real estate legally described below:

[legal description or attach exhibit]

2. That the street address of the residential real estate is

[address] and

the property identification number is

[Pin].

3. That the Transfer on death instrument is dated

and recorded as document no.

in the Office of the recorder for ___________________ county, illinois.

4. That the undersigned, whose names and addresses appear below, are all beneficiaries entitled to receive under the Transfer on

death instrument:

name

address

in wiTness wHereOf, the undersigned beneficiary(ies) hereby accept the transfer of residential real estate under the transfer on death

instrument this

day of

, 20

Beneficiary signature

Transfer On Death Instrument Page 2