ORS 93.975 URPTDA 16

Form of transfer on death deed. ORS 93.948 to 93.979 govern the effect of an instrument used to create a transfer on death deed. The following form may be used to create a transfer on death deed:

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(ORS 93.948 to 93.979)

You should carefully read all information on 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.

Until a change is requested, the county clerk shall send tax statements to the following address:

Owner or Owners Making This Deed: Printed name: Mailing address: Printed name: Mailing address: Legal description of the property:

I designate the following beneficiary if the beneficiary survives me: Printed name: Mailing address, if available:

If my primary beneficiary does not survive me, I designate the following alternate beneficiary if that beneficiary survives me: Printed name: Mailing address, if available:

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.

After recording, the county clerk shall return the deed to:

Signature: Date: Signature: Date: State of County of This instrument was acknowledged before me on (date) by . (name(s) of person(s))

(Seal, if any) Title (and Rank) My commission expires: __________________________________________