Vermont Disclaimer of Interest (Individual - Executed by Attorney-in-Fact)

This Vermont disclaimer of interest form is built around one execution pattern: a single individual disclaimant whose written refusal of an interest in Vermont real property is signed for the disclaimant by an agent, also called an attorney-in-fact, acting under a power of attorney. The instrument operates under the Vermont Uniform Disclaimer of Property Interests Act, 14 V.S.A. chapter 129, and its signature and notary blocks are drafted for the agent, not the disclaimant.

Authority the power of attorney must grant expressly

Vermont treats a disclaimer as one of the acts an agent cannot perform under general authority alone. Under 14 V.S.A. section 4031(a)(9), an agent may disclaim property, including a power of appointment, on the principal's behalf only if the power of attorney expressly grants that authority, and the Vermont statutory form power of attorney presents it as a specific authority the principal initials. The form's operative section recites that the agent acts under a power of attorney carrying that express grant, and the power of attorney's date and, where it is of record, its book and page in the town land records are entered in the agent section. A related statutory limit reaches agents outside the principal's close family: unless the power of attorney provides otherwise, an agent who is not an ancestor, spouse, or descendant of the principal may not use a disclaimer to move an interest in the principal's property toward the agent.

A refusal the law does not treat as a transfer

Vermont adopted chapter 129 in 2026, replacing the disclaimer act that had stood since 1986. Under the new chapter, a disclaimer is the refusal to accept an interest in or power over property. It is made in a writing that declares the disclaimer, describes the interest, and is signed, and it is delivered or filed in the manner the chapter provides. Once delivered or filed and effective, it is irrevocable, and the statute states that a disclaimer is not a transfer, assignment, or release: the disclaimed interest passes under the chapter's devolution rules and the will, trust, or other instrument that created it, not by any conveyance from the disclaimant. The chapter states bar events instead of a fixed state deadline, so acceptance of the interest, a voluntary assignment or encumbrance of it, a contract to convey it, a judicial sale, or a written waiver of the right to disclaim forecloses the disclaimer. Federal tax law runs separately: a qualified disclaimer under 26 U.S.C. section 2518 carries its own nine month timing for federal transfer tax treatment, and the Vermont chapter expressly gives state law effect to a disclaimer the Internal Revenue Code treats as never having passed to the disclaimant.

What this form recites

The form's ten sections collect the disclaimant, the agent and the power of attorney, the deceased owner and date of death, the source of the interest, the property's town, legal description, and address, the interest disclaimed and its extent, whole or partial, and the manner of delivery or filing. The operative section then declares the disclaimer in prose, and one signature line and one representative capacity acknowledgment certificate, following the Vermont statutory short form, carry the agent's execution. A principal who signed a durable power of attorney with the disclaimer authority initialed, and whose agent handles an inheritance the principal declines to accept, presents the pattern this form recites; a disclaimant signing personally follows a different execution pattern than this form carries.

Recording in the town land records

Vermont records land documents with the town or city clerk where the land lies; there is no county recording office for ordinary instruments. Chapter 129 permits the recorded disclaimer wherever an instrument transferring the disclaimed interest is required or permitted to be recorded, which places the refusal in the chain of title where a later examiner looks for it, and the statewide recording fee is $15.00 per page. The completed disclaimer is also delivered or filed as the chapter provides, commonly to the personal representative of the estate, and the form records how that was done.

The download includes the blank disclaimer as a fillable PDF, a completed example showing the entire instrument filled in for a realistic Vermont fact pattern, and a plain language guide that walks through every section, the representative acknowledgment, delivery, and recording. The materials are informational and are not legal advice.