Disclaimer form sample 2025

1. Click ‘Get Form’ to open the disclaimer form sample in the editor.
2. Begin by filling in the court name and county where the case is being filed. This information is crucial for proper identification of jurisdiction.
3. Next, enter the name of the decedent and their date of death in the specified fields. This establishes the context for your disclaimer.
4. In section one, provide details about your interest in the life insurance policy, including policy number and insurance company name. Ensure accuracy as this will be referenced later.
5. Indicate your entitlement to receive death proceeds by confirming your status as a primary beneficiary in section two.
6. Complete section four by renouncing any rights to the property or asset, ensuring compliance with state laws.
7. Finally, sign and print your name at the bottom of the form. If required, complete any notary acknowledgment sections as per your state’s regulations.

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