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Disclaimer Of Interest Under Will

WHEREAS, I, of [ADDRESS], declare that I am a beneficiary under the Last Will and Testament (hereinafter the "Will") of [NAME OF DECEDENT] dated [DATE]; and

WHEREAS, on [DATE], the said [NAME OF DECEDENT] died; and

WHEREAS, on the [DATE], the Will was admitted to probate in the District of .............; and

WHEREAS, pursuant to Paragraph ... of ARTICLE ....... of the Will, I am a discretionary beneficiary of a trust to be held in accordance with the terms of ARTICLE ......... of the Will (hereinafter the "Trust"); and

WHEREAS, pursuant to Paragraph ... of ARTICLE ..... of the Will, I am nominated and appointed, with [NAME OF CO-TRUSTEE], as Trustee of the Trust; and

WHEREAS, pursuant to subparagraph ... of Paragraph ... of ARTICLE ........, I, as Trustee, am given certain discretionary powers to pay or apply net income or principal to or for a certain class of persons, in such amounts and proportions as the said [NAME OF CO-TRUSTEE] and I, as Trustees may determine.

NOW, THEREFORE, I hereby disclaim, renounce and refuse to accept the...

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