TRANSFER ON DEATH INSTRUMENT

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TRANSFER ON DEATH INSTRUMENTOwner s name and address and Taxes TO:nameaddressaddressBeneficiary s name and address:nameaddressaddress recOrder s sTamP THis TRANSFER On DEATH INSTRUMENT made this day of , 20.

state of illinois, hereby convey(s) and transfer(s), effective on the death of the Owner last to die, the above-described real estate to: ... Given under my hand and notarial seal this day of , 20 . ... nOTice: This notice of death affidavit and cceptance form or equivalent form must be recorded by the beneficiary within 30 days of a

  Notice, Given, Hereby