Medina County Disclaimer of Interest (Individual, Executed by Attorney-in-Fact) Form

When the person entitled to refuse an Ohio inheritance cannot sign the refusal personally, Section 5815.36(A)(1) of the Ohio Revised Code lets an attorney-in-fact who holds authority under a written power of attorney execute it in that person's place. This form prepares that disclaimer of interest in Ohio real estate for one individual disclaimant and one attorney-in-fact: the agent signs the instrument, the agent acknowledges it in the attorney-in-fact certificate of Section 147.55(E), and the disclaimant has no signature line at all.

Authority that lives in the power of attorney

The Ohio Uniform Power of Attorney Act supplies the measure of the written authority Section 5815.36(A)(1) describes. Section 1337.42(A) names seven acts an agent performs only under an express grant, and disclaiming is not one of the seven; Section 1337.52(B)(8) instead folds the power to disclaim a share in an estate, trust, or other beneficial interest into a grant of general authority over that subject, which Section 1337.43 incorporates by the subject's name or the section's citation. Section 2 of the form identifies the power of attorney by date and recording reference and recites that it grants the attorney-in-fact authority to act, including authority to disclaim the described interest, and that it is in effect on the date of signing. The recital states what the signer represents; the power of attorney itself is the source of the authority.

The agent signs, the principal refuses

The signature block is headed ATTORNEY-IN-FACT FOR DISCLAIMANT, and the sentence above it states that the instrument is signed for the disclaimant by the attorney-in-fact. Section 1337.42(G) gives an act the agent performs under the power of attorney the same effect as if the principal had performed it, so the refusal is the disclaimant's. The acknowledgment certificate is the statutory short form for a principal acting by an attorney in fact, and the officer certifies the agent's acknowledgment on behalf of the named principal. A power of attorney created under the act is durable under Section 1337.24 unless it says otherwise; under Section 1337.30(A)(1) it ends at the disclaimant's death, and the refusal of a deceased person's inherited interest is the personal representative's act under Section 5815.36(B)(4), a different pattern.

What the recorded copy carries

Section 5815.36(B)(3) lists the instrument's contents, and the form carries each: the donative instrument in Section 3 and the description of the interest with the declaration of its extent in Section 5. Because the interest is in real estate, Section 4 adds the legal description, the parcel number, the record of the instrument that created the interest, and the recorded instrument under which the decedent held title, laid out to the Section 317.114 recording standard. The power of attorney is a separate paper: Section 1337.04 requires recording of a power of attorney used to sign a deed, mortgage, land installment contract, or lease, and a disclaimer is none of those, yet examiners read a recorded disclaimer against the authority it recites, so Section 2 carries the recorder's citation for a power of attorney already of record.

The configuration this form recites

The form recites exactly one disclaimant, a natural person refusing in that person's own right, acting through exactly one attorney-in-fact, with one signature block and one acknowledgment certificate. Section 5 is free-form, so the whole of the interest or a described part is disclaimed in the same space. No spouse signs: Section 5815.36(F)(4) gives a disclaimant's spouse no dower or other interest in the real estate disclaimed. A devisee posted overseas whose spouse holds a durable power of attorney, and a trust beneficiary who no longer handles paperwork and whose son acts under a power of attorney signed years earlier, present the pattern this form recites. A disclaimant who signs personally, a guardian or personal representative acting under a probate court order, and two disclaimants on one instrument are not what this form is set up as. The federal clock of 26 U.S.C. Section 2518 runs nine months from the transfer that created the interest, and the completed example shows the agent's signature inside that window.

The package contains the fillable form, a completed example worked through a Hamilton County devise refused by the devisee's spouse as attorney-in-fact, and the guide covering each section, the delivery and filing paths of Section 5815.36(F), and the recording step. The description and the guide describe the form and the Ohio statutes generally and are not legal advice.