NOTICE TO OWNER

This revocation must be recorded before you die or it will not be effective. This revocation is effective only as to the interests in the property of owners who sign this revocation.

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:

_________________________________________________________

REVOCATION

I revoke all my previous transfers of this property by transfer on death 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.)

Terms Used In Utah Code 75-6-417

• Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
• Deed: The legal instrument used to transfer title in real property from one person to another.
• Individual: means a natural person. See Utah Code 75-6-402
• Property: means an interest in real property located in this state that is transferable on the death of the owner. See Utah Code 75-6-402
• Sign: means , with present intent to authenticate or adopt a record other than a will:
       (51)(a) to execute or adopt a tangible symbol; or
       (51)(b) to attach to or logically associate with the record an electronic symbol, sound, or process. See Utah Code 75-1-201 v2
• Transfer on death deed: means a deed authorized under this part. See Utah Code 75-6-402
• Utah Code: means the 1953 recodification of the Utah Code, as amended, unless the text expressly references a portion of the 1953 recodification of the Utah Code as it existed:
       (42)(a) on the day on which the 1953 recodification of the Utah Code was enacted; or
       (42)(b)

            (42)(b)(i) after the day described in Subsection (42)(a); and

            (42)(b)(ii) before the most recent amendment to the referenced portion of the 1953 recodification of the Utah Code. See Utah Code 68-3-12.5