"Transfer on Death Instrument Form"

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PREPARED BY:
PROPERTY OWNER INFORMATION:
TRANSFER ON DEATH INSTRUMENT (TODI)
PURSUANT TO §755 ILCS 27/1 ET SEQ. (ILLINOIS RESIDENTIAL REAL PROPERTY TRANSFER ON DEATH INSTRUMENT
THIS TRANSFER ON DEATH INSTRUMENT (hereinafter referred to as a "TODI), which was executed on this
day of
in the year of
by
,
DAY OF THE MONTH
MONTH
YEAR
NAME(S) OF PROPERTY OWNER(S)
who reside at
NAME(S) OF PROPERTY OWNER(S)
FULL PROPERTY ADDRESS WITH CITY, STATE, ZIP CODE & COUNTY
being of sound mind and disposing memory, do hereby make, declare and publish this TODI stating as follows:
That the above referenced property owner(s) is/are the SOLE owner(s) of residential real estate under a duly recorded
as document
in the County of
DEED, recorded
DATE DEED RECORDED
DOCUMENT NUMBER
, State of Illinois. The residential real estate is legally described as:
COUNTY
WRITE LEGAL DESCRIPTION (BELOW OR ATTACH)
WITH THE PROPERTY IDENTIFICATION NUMBER (PIN) OF:
PROPERTY COMMONLY REFERRED TO ADDRESS:
The owner(s), being of competent mind and capacity, and waiving and releasing all rights under the Homestead Exemption
of the State of Illinois, do hereby convey and transfer, effective on death of the Owner last to die, the above-described real
BENEFICIARY DESIGNATION: ATTACH ADDITIONAL AS NEEDED
1
2
3
NAME:
ADDRESS:
CITY/STATE
SPECIAL NOTICE: THIS DOCUMENT HAS BEEN PROVIDED AS A COURTESY FROM THE COOK COUNTY RECORDER OF DEEDS
THIS FORM IS NOT LEGAL ADVICE OR ASSISTANCE WITH YOUR INDIVIDUAL ESTATE PLAN. FURTHERMORE, IT WAS PROVIDED WITHOUT
ANY TITLE EXAMINATION OR REVIEW OF YOUR INDIVIDUAL ESTATE. PLEASE CONSULT AN ATTORNEY IF YOU HAVE ADDITIONAL QUESTIONS.
PREPARED BY:
PROPERTY OWNER INFORMATION:
TRANSFER ON DEATH INSTRUMENT (TODI)
PURSUANT TO §755 ILCS 27/1 ET SEQ. (ILLINOIS RESIDENTIAL REAL PROPERTY TRANSFER ON DEATH INSTRUMENT
THIS TRANSFER ON DEATH INSTRUMENT (hereinafter referred to as a "TODI), which was executed on this
day of
in the year of
by
,
DAY OF THE MONTH
MONTH
YEAR
NAME(S) OF PROPERTY OWNER(S)
who reside at
NAME(S) OF PROPERTY OWNER(S)
FULL PROPERTY ADDRESS WITH CITY, STATE, ZIP CODE & COUNTY
being of sound mind and disposing memory, do hereby make, declare and publish this TODI stating as follows:
That the above referenced property owner(s) is/are the SOLE owner(s) of residential real estate under a duly recorded
as document
in the County of
DEED, recorded
DATE DEED RECORDED
DOCUMENT NUMBER
, State of Illinois. The residential real estate is legally described as:
COUNTY
WRITE LEGAL DESCRIPTION (BELOW OR ATTACH)
WITH THE PROPERTY IDENTIFICATION NUMBER (PIN) OF:
PROPERTY COMMONLY REFERRED TO ADDRESS:
The owner(s), being of competent mind and capacity, and waiving and releasing all rights under the Homestead Exemption
of the State of Illinois, do hereby convey and transfer, effective on death of the Owner last to die, the above-described real
BENEFICIARY DESIGNATION: ATTACH ADDITIONAL AS NEEDED
1
2
3
NAME:
ADDRESS:
CITY/STATE
SPECIAL NOTICE: THIS DOCUMENT HAS BEEN PROVIDED AS A COURTESY FROM THE COOK COUNTY RECORDER OF DEEDS
THIS FORM IS NOT LEGAL ADVICE OR ASSISTANCE WITH YOUR INDIVIDUAL ESTATE PLAN. FURTHERMORE, IT WAS PROVIDED WITHOUT
ANY TITLE EXAMINATION OR REVIEW OF YOUR INDIVIDUAL ESTATE. PLEASE CONSULT AN ATTORNEY IF YOU HAVE ADDITIONAL QUESTIONS.
TRANSFER ON DEATH INSTRUMENT - PAGE 2 (TRANSFER TAX STAMP, EXEMPTION, WITNESS & NOTARY)
NAME OF OWNER
This Transfer is Exempt under provisions of 35 ILCS 200/31-45, Paragraph, Illinois Real Estate Transfer Tax Law.
DATE DOCUMENT EXECUTED
SIGNATURE OF OWNER OR REPRESENTATIVE
DATE DOCUMENT EXECUTED
SIGNATURE OF OWNER OR REPRESENTATIVE
WITNESS DECLARATION
We, the undersigned witnesses, hereby certify that the above Transfer on Death Instrument was on the date thereof signed
and declared by the Owner(s) as his/her/their Transfer on Death Instrument in our presence and that we, at his/her/their
request and in his/her/their presence and in the presence of each other, have signed our names as witnesses thereto,
believing to the best of our knowledge that the Owner(s) was/were at the time of signing of sound mind and memory, and
under no undue influence.
WITNESS 1 PRINTED NAME
WITNESS 1 SIGNATURE
WITNESS 1 ADDRESS
WITNESS 2 PRINTED NAME
WITNESS 2 SIGNATURE
WITNESS 2 ADDRESS
NOTARY VERIFICATION
STATE OF ILLINOIS
)
SS
)
COUNTY OF _______________
)
I, the undersigned, a notary public in and for said County, in the State aforesaid, DO HEREBY CERTIFY that Owner(s) and
witnesses personally known to me to be the same persons whose names are subscribed on the foregoing instrument,
appeared before me this day 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 SIGNATURE:
NOTARY PUBLIC STAMP:
SPECIAL NOTICE: THIS DOCUMENT HAS BEEN PROVIDED AS A COURTESY FROM THE COOK COUNTY RECORDER OF DEEDS
THIS IS NOT LEGAL ADVICE, OR ASSISTANCE WITH YOUR INDIVIDUAL ESTATE PLAN. FURTHERMORE, IT WAS PROVIDED
WITHOUT ANY TITLE EXAMINATION OR REVIEW OF YOUR INDIVIDUAL ESTATE. PLEASE CONSULT AN ATTORNEY IF YOU HAVE ADDITIONAL QUESTIONS.
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