CA Affidavit of Beneficiary to Revocable Transfer on Death Deed Signed on or After January 1, 2022

 AFFIDAVIT OF BENEFICIARY TO REVOCABLE TRANSFER

ON DEATH DEED SIGNED ON OR AFTER JANUARY 1, 2022

ORDER NO.     _____________________________

APN NO.          _____________________________

PROPERTY ADDRESS: _______________________________________________________

The undersigned Beneficiary hereby completes this Affidavit of Beneficiary to Revocable Transfer on Death Deed Signed On or After January 1, 2022 ("Affidavit") in connection with the above referenced order number with the understanding that title and/or escrow agent, ________________________________, _________________ and its title insurer, Stewart Title Guaranty Company, (collectively "Title Company") will be relying upon this Affidavit if Title Company elects to close the above order or issue title insurance, and that additional signed pages will be attached if necessary to be able to provide complete responses.

The undersigned Beneficiary, each for himself, herself and/or itself to the best of his/her/its knowledge, declares as follows:

1. ____________________________________________ (“Transferor”) executed that certain Revocable Transfer on Death Deed (“TODD") in favor of ____________________________ _____________________________________________(whether one or more “Beneficiary”) recorded ____________ as Instrument No. ______________________ of Official Records of _____________________ County, which was recorded on or before 60 days after the TODD was acknowledged before a notary.
   
   
2. The undersigned Beneficiary is not aware of and has no knowledge of any other Revocable Transfer on Death Deed having been executed by the Transferor. 
   
   
3. The description of the property in the TODD (the “Property”) falls within the definition of real property in Probate Code §5610(a) and (b) as either (1) land that is improved with 1 to 4 family residential dwelling units; or (2) a residential separate interest and its appurtenant common area in a common interest development, both of which are defined to not include  a parcel of agricultural land that is greater than 40 acres in size.
   
   
4. The Transferor was of sound mind and had the capacity to enter into a contract when the TODD was signed before a notary public and two witnesses.
   
   
5. The undersigned Beneficiary has no knowledge of Transferor's revocation of the TODD.
    
6. The undersigned Beneficiary has not, and will not, disclaim the transfer of the Property to the Beneficiary under the TODD.
    
7. The undersigned Beneficiary has served a statutory Notice of Revocable Transfer on Death Deed (the “Notice”) on the Transferor’s heirs in compliance with Probate Code §5681. The Notice was dated ________________ and was served on _______________________________________ ___________________________________________________________________________, by the following method(s) ______________________________________________________. (Attach a copy of the Notice to this Affidavit)
   
   
8. The undersigned Beneficiary has no knowledge of (i) any party contesting the enforceability or validity of the TODD or the transfer of the Property upon the death of the Transferor; or (ii) any notice of action (Lis Pendens) being recorded against the Property; or (iii) any lawsuits or claims against the Property.
   
   
9. The undersigned Beneficiary: (Check the appropriate item with an "X")

(     ) Is/Are the only known heir(s) of the Transferor.

(     ) Is/Are aware of the following heirs of the Transferor:
        _______________________________________________________________
        (include the undersigned when applicable)
(     ) Is an entity that is not related or affiliated with the Transferor or any heirs of the
         Transferor.

10. The Transferor is deceased and: (Check the appropriate items with an X)

(     ) An affidavit regarding the Transferor’s death pursuant to Probate Code § 5680, has been recorded and proof of such recording is attached herewith.

(     ) Evidence of Transferor's death will be recorded; the undersigned Beneficiary will complete an Affidavit - Death of Transferor Under Revocable Transfer on Death Deed and Affidavit - Notice of Revocable Transfer on Death Deed evidencing the Transferor's death, and will provide the completed document, along with a certified death certificate, to Title Company for recording no less than 130 days prior to closing.

(     ) An affidavit regarding the Notice of Revocable Transfer on Death Deed pursuant to Probate Code § 5682, has been recorded and proof of such recording is attached herewith.

(     )  Evidence of the affidavit regarding the Notice of Revocable Transfer on Death Deed will be recorded; the undersigned Beneficiary will complete an Affidavit - Death of Transferor Under Revocable Transfer on Death Deed and Affidavit - Notice of Revocable Transfer on Death Deed evidencing compliance with Probate Code § 5682, and will provide the completed document, along with a certified death certificate, to Title Company for recording no less than 130 days prior to closing.

 (     ) The change in ownership statement has been filed pursuant to R&T Code §480 and proof of such filing is attached herewith.

(     ) The change in ownership statement required pursuant to R&T Code §480 will be completed and filed prior to closing.

11. With regard to Medi-Cal benefits: (Check the appropriate item with an "X")

(     ) The Transferor received Medi-Cal benefits and, pursuant to Probate Code §215, the State Department, Director of Health Care Services has been notified of the Transferor’s death and provided a copy of the death certificate.

(     ) The Transferor was not receiving Medi-Cal benefits at the time of death.

12. There are no Medi-Cal funds or amounts due and owing to the State of California.

13. There will not be and is no estate tax due and owing.

14. There will not be any probate or administration of the Transferor's estate.

The undersigned Beneficiary, under penalty of perjury, hereby declares and certifies that the above information is truthful and accurate and intended to be relied upon by Title Company. The undersigned Beneficiary understands that Title Company, in its sole discretion, may elect to not proceed to close and insure the above referenced matter based upon the attestations above.

State of California

County of ______________________

Subscribed and sworn to (or affirmed) before me on this _______ day of ____________________, 20_______ by _________________________________________________________________, personally known to me or provided to me on the basis of satisfactory evidence to be the person(s) who appeared before me.