Transfer On Death Designation Affidavit

State of Ohio County of Cuyahoga ) ) ) Transfer on Death Designation Affidavit (O.R.C. Section 5302.22) I,____________________________________________________________________________________, being first duly sworn, deposes and states as follows: That _____________________________________________________________________________, the Affiant(s) is/are the owner(s) of record of the following real property located at: _______________________________________________________________________________________ as recorded in Volume _________ Page ________ or AFN______________________________ of Cuyahoga County Records. Legal Description ­ See Attached Permanent Parcel No. _______________________________________________ That title of record to the above property is held by Affiant(s) as follows: ___ Sole Owner ___ Tenant(s) in Common ___ Tenant(s) in Survivorship ___ Tenants by the Entireties Check only ONE of the following sections and then complete: A Single Beneficiary _____ or B Multiple Beneficiaries _____ Section A Affiant hereby designate(s) the entire undivided interest in the property to be transferred upon their death to: ____________________________________________________________________________ as sole beneficiary. Complete the following page if option B "Multiple Beneficiaries" applies. American LegalNet, Inc. www.FormsWorkFlow.com Section B That Affiant(s) hereby designate the entire undivided interest in the property held by them for transfer on death to the person or persons named below, as transfer on death beneficiaries, to receive the title upon the death of said Affiant(s). Name of Beneficiary Undivided Interest of Affiant(s) Type of Tenancy . __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ That ___________________________________________________, wife/husband of the Affiant, states that her/his dower rights are subordinate to the vesting of title to the real property in the transfer on death beneficiary or beneficiaries designated herein. This Affidavit, and the beneficiary designation(s) set forth herein, hereby revokes, replaces and supersedes any prior beneficiary designation(s) by Affiant(s), whether by deed or affidavit, related to the above-designated real property. __________________________________ Affiant __________________________________ Affiant SWORN TO BEFORE ME and subscribed in my presence this _______ day of ____________________________________, 20_____. ____________________________________ Notary Public Prepared By: __________________ American LegalNet, Inc. www.FormsWorkFlow.com