Jefferson County Disclaimer of Interest (Transfer on Death Beneficiary) Form
Last validated November 8, 2026 by our Forms Development TeamFormatted for recording in Jefferson County, for property anywhere in the county: rural and unincorporated areas as well as Fayette, Harriston, Lorman, Union Church.
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Jefferson County Disclaimer of Interest (Transfer on Death Beneficiary) Form
Fill in the blank Disclaimer of Interest (Transfer on Death Beneficiary) form formatted to comply with all Mississippi recording and content requirements.

Jefferson County Disclaimer of Interest (Transfer on Death Beneficiary) Guide
Line by line guide explaining every blank on the Disclaimer of Interest (Transfer on Death Beneficiary) form.

Jefferson County Completed Example of the Disclaimer of Interest (Transfer on Death Beneficiary) Document
Example of a properly completed Mississippi Disclaimer of Interest (Transfer on Death Beneficiary) document for reference.
All 3 documents above included • One-time purchase • No recurring fees
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Additional Mississippi and Jefferson County documents included at no extra charge:
Where to Record Your Documents
Jefferson County Chancery Clerk
Fayette, Mississippi 39069
Hours: 8:30 to 4:30 M-F
Phone: (601) 786-3021
Recording Tips for Jefferson County:
- Bring your driver's license or state-issued photo ID
- Ensure all signatures are in blue or black ink
- Check that your notary's commission hasn't expired
- Documents must be on 8.5 x 11 inch white paper
- Double-check legal descriptions match your existing deed
Cities and Jurisdictions in Jefferson County
Properties in any of these areas use Jefferson County forms:
- Fayette
- Harriston
- Lorman
- Union Church
Hours, fees, requirements, and more for Jefferson County
How do I get my forms?
Forms are available for immediate download after payment. The Jefferson County forms will be in your account ready to download to your computer. An account is created for you during checkout if you don't have one. Forms are NOT emailed.
Are these forms guaranteed to be recordable in Jefferson County?
Yes. Our form blanks are guaranteed to meet or exceed the applicable formatting requirements used for recording in Jefferson County, including margin requirements, font requirements, and other layout standards. This guarantee applies to formatting, not to the legal sufficiency of information entered by the user or the suitability of a form for a particular transaction.
Can I reuse these forms?
Yes. You can reuse the forms for your personal use. For example, if you have multiple properties in Jefferson County you only need to order once.
What do I need to use these forms?
The forms are PDFs that you fill out on your computer. The free Adobe Acrobat Reader is recommended, and most PDF apps also work. You do NOT enter your property information online - you download the blank forms and complete them privately on your own computer.
Are there any recurring fees?
No. This is a one-time purchase. Nothing to cancel, no memberships, no recurring fees.
How much does it cost to record in Jefferson County?
Recording fees in Jefferson County vary. Contact the recorder's office at (601) 786-3021 for current fees.
Questions answered? Let's get started!
A person named as the beneficiary of a Mississippi transfer on death deed is not required to take the property. This form prepares a disclaimer of interest by which one designated beneficiary refuses, in whole, the interest that a recorded Mississippi transfer-on-death deed would pass to that beneficiary at the transferor's death, under the Mississippi Uniform Disclaimer of Property Interests Act (2002/2010), Sections 89-22-1 through 89-22-37 of the Mississippi Code, and Section 91-27-31 of the Mississippi Real Property Transfer-on-Death Act.
A refusal, not a transfer
Mississippi defines a disclaimer as the refusal to accept an interest in property (Section 89-22-3). The person refusing conveys nothing and names no one. Section 89-22-9(g) states the point directly: a disclaimer made under the chapter is not a transfer, assignment, or release. That is what separates a disclaimer from a quitclaim deed from the beneficiary to a relative, and it is why the form carries no grantee, no consideration, and no warranty language. Where the disclaimed interest goes is fixed by statute and by the deed itself. Section 89-22-11 passes the interest according to any provision in the deed for a disclaimed interest and otherwise as if the disclaimant had died immediately before the time of distribution, and the transfer-on-death act's own rules in Section 91-27-27 then apply: the interest of a designated beneficiary who does not survive the transferor lapses, a lapsed share among concurrent beneficiaries passes to the others in proportion to their interests, and an alternate beneficiary named in the deed takes in the case the deed describes.
What the 2020 act changed
The disclaimer statute Mississippi used before 2020, Sections 89-21-1 through 89-21-17, carried a nine-month filing deadline and a recording step tied to it. Laws 2020, chapter 406, repealed that chapter effective July 1, 2020 and enacted the current act in its place, the same session law that created the transfer-on-death deed. The new act sets no state-law deadline of its own. The nine-month period survives only in Section 89-22-29, which ties a tax-qualified disclaimer to Section 2518 of the Internal Revenue Code and its conditions. The elements of an effective disclaimer now sit in one subsection, Section 89-22-9(d): a writing or other record that declares the disclaimer, describes the interest disclaimed, is signed by the person making it, and is delivered or filed in the manner Section 89-22-25 provides. The chapter prescribes no form, and this form is drafted to those four elements.
Why the legal description is on the form
Recording is the notice step for a disclaimer of Mississippi real estate. Section 89-22-31 provides that a disclaimer of an interest in or relating to real property does not provide constructive notice to all persons unless it contains a legal description of the property and is filed for recording in the office of the chancery clerk of the county where the property is located; an effective disclaimer that meets both conditions is constructive notice from the time of filing, while an unrecorded disclaimer remains valid between the disclaimant and the persons who take because of it. The form therefore carries the full legal description copied from the recorded transfer-on-death deed, the sectional indexing instruction Section 89-5-33(3) requires, and, on its first recorded page, the items Section 89-5-24(2) places there: the preparer statement, the return address, the disclaimant's name, mailing address, and telephone number, the title, and the indexing instruction, all below the three-inch margin the chancery clerk uses for recording data.
One beneficiary, the whole interest
The form recites exactly one disclaimant, a natural person who is a designated beneficiary named in a transfer-on-death deed recorded before the transferor's death, signing in that person's own right after the death. It identifies the deed by the transferor's name, the transferor's date of death, the recording date, and the chancery clerk's recording reference, and it fixes a disclaimer in whole: the disclaimant DISCLAIMS AND REFUSES TO ACCEPT the entire interest that would have passed under that deed. It recites that the disclaimant has not accepted the interest or a benefit under it, has not assigned, conveyed, encumbered, pledged, or transferred it, and has not waived the right to disclaim, the events that bar a disclaimer under Section 89-22-27, and it states that the disclaimer directs no disposition of the interest. One signature block headed DISCLAIMANT and one acknowledgment certificate in the Section 89-3-7(2) short form follow. The form is not set up as a partial disclaimer expressed as a fraction or percentage under Section 89-22-9(e), as a disclaimer by a personal representative, trustee, or agent in a representative capacity, or as a joint instrument for two beneficiaries; each designated beneficiary who refuses an interest signs a disclaimer of that beneficiary's own.
Signing and delivery
The disclaimant signs before a notarial officer, who completes the acknowledgment certificate; Section 89-22-9(d) itself asks only for a signature, and the acknowledgment is what makes the document recordable under Section 89-3-1. No spouse signs, because the homestead joinder rule of Section 89-1-29 reaches conveyances and encumbrances and a disclaimer is neither. Delivery under Section 89-22-25 is a separate element from recording, and the guide describes what that section provides for an interest created by a beneficiary designation, together with the point at which a disclaimer becomes irrevocable under Section 89-22-9(f). An affidavit relating to the transferor's death under Section 89-5-8, where one is used to place the death of record, is a separate instrument recorded apart from the disclaimer and not included in this package.
The package includes the fillable disclaimer form, a completed example filled in for a Madison County fact pattern, and the guide that walks through every numbered section, the delivery and recording rules, and the effect of the disclaimer under the transfer-on-death act. This description and the guide describe the form and the governing Mississippi statutes in general terms; they are not legal advice.
Important: Your property must be located in Jefferson County to use these forms. Documents should be recorded at the county recording office listed above.
This Disclaimer of Interest (Transfer on Death Beneficiary) meets all recording requirements specific to Jefferson County.
Our Promise
The documents you receive here are guaranteed to meet or exceed the applicable Jefferson County recording format requirements. If there is a rejection caused by our formatting, we will correct the issue or refund your payment. This guarantee applies to document formatting only and does not extend to information entered by the user, the selection of the form, or the legal effect of the completed document.
Save Time and Money
Get your Jefferson County Disclaimer of Interest (Transfer on Death Beneficiary) form done right the first time with Deeds.com Uniform Conveyancing Blanks. At Deeds.com, we understand that your time and money are valuable resources, and we don't want you to face a penalty fee or rejection imposed by a county recorder for submitting nonstandard documents. We constantly review and update our forms to meet rapidly changing state and county recording requirements for roughly 3,500 counties and local jurisdictions.
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