Utah Code § 75-6-416: Optional form of transfer on death deed.

(1) An individual may use the following form to create a transfer on death deed under this part:

REVOCABLE TRANSFER ON DEATH DEED

NOTICE TO OWNER

You should carefully read all information on the other side of this form. You may want to consult a lawyer before using this form.

This form must be recorded before your death or it will not be effective. The beneficiary must be a named person.

IDENTIFYING INFORMATION

Owner or Owners Making This Deed:

_______________________________

______________________________

Printed Name

Mailing Address

_______________________________

______________________________

Printed Name

Mailing Address

Legal Description of Property (Pursuant to Utah Code Section 57-3-105):

_________________________________________________________

Tax Identification Number for Property:

_________________________________________________________

PRIMARY BENEFICIARY

I designate the following beneficiary if the beneficiary survives me:

_______________________________

______________________________

Printed Name

Mailing Address

ALTERNATE BENEFICIARY (Optional)

If my primary beneficiary does not survive me, I designate the following alternate beneficiary if that beneficiary survives me:

_______________________________

______________________________

Printed Name

Mailing Address

TRANSFER ON DEATH

At my death, I transfer my interest in the described property to the beneficiaries as designated above.

Before my death, I have the right to revoke this deed.

SIGNATURE OF OWNER OR OWNERS MAKING THIS DEED

_______________________________

______________________________

Signature

Date

_______________________________

Printed Name

_______________________________

______________________________

Signature

Date

_______________________________

Printed Name

ACKNOWLEDGMENT

(Attach an affidavit of acknowledgment pursuant to Utah Code Section 46-1-6.5 to the form.)

(2) The other sections of this part govern the effect of the form described in Subsection (1) or any other instrument used to create a transfer on death deed.