TERMINATION OF DECEDENT’S INTEREST
THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
TERMINATION OF DECEDENT’S INTEREST - Wisconsin Reg. of Deeds Association form HT-110 and TOD-110. Approved 10.5.17
DECEDENT’S ADDRESS AT DATE OF DEATH
THE INTEREST OF THE DECEDENT IN THE PROPERTY LEGALLY DESCRIBED HEREIN IS TERMINATED
PURSUANT TO THE FOLLOWING WISCONSIN STATUTE AND TRANSFERRED AS PROVIDED BY
867.045 – real property in which the decedent was a joint tenant, had a vendor’s or
mortgagee’s interest, or had a life estate.
867.046 - property of a decedent specified in a marital property agreement, survivorship
marital property; a third party confirmation; or a nonprobate transfer on death as described
in 705.10(1) or 705.15.
Name and Return Address:
DOCUMENT UNDER WHICH DECEDENT’S INTEREST IN THE PROPERTY IS NOW TERMINATED –
Copy(ies) of which is/are attached:
Recorded Document No. ____________________Volume______________ Page__________
Deed Transfer on Death Land Contract Mortgage
Marital Property Agreement Other _________________
Parcel Identification Number:
SEND TAX STATEMENT TO:
Name(s) and address of owner(s) of the property immediately after the
decedent’s death; attach additional names & addresses if more than one
Interest of the signer of this document in the property:
joint tenant remainder person if a life estate
mortgagee land contract vendor
decedent’s spouse beneficiary of a marital property agreement
beneficiary of a transfer under 705.10(1) or 705.15
DECLARATION: To the best of undersigned’s knowledge and belief, the undersigned declares that this document is true, accurate, complete and in
conformity with the provisions and limitations of the Wisconsin Statutes.
PRINT NAME: _____________________________________
STATE OF ______________________________ )
COUNTY OF ____________________________ )
________________________________________ subscribed and
sworn to before me on: ____________________________, by the
above named person(s) who executed this document and
acknowledged the same.
Print Name: ____________________________________________
Notary Public, State of Wisconsin.
My Commission (is permanent) (expires _________________).
THIS DOCUMENT WAS DRAFTED BY:
Signature of Notary or other
person authorized to administer
an oath (as per 706.06, 706.07)
Print or type Name
DESCRIPTION OF THE PROPERTY TRANSFERRED (check all that apply):
REAL PROPERTY - legal description as set forth in the attached/referenced and previously recorded document
REAL PROPERTY - current legal description if different than the foregoing document
NON-REAL PROPERTY – property identified in the attached document, including. digital property, bank accounts and securities