Recording requested by (name):
________________________________________ 
When recorded mail to
and mail tax statements to ________________________________________ 
________________________________________ 
________________________________________ 
________________________________________ 
		
REVOCATION OF REVOCABLE TRANSFER ON DEATH DEED
(California Probate Code Section 5600)

This deed revocation is exempt from documentary transfer tax under Rev. & Tax. Code §11930. This deed revocation is exempt from preliminary change of ownership report under Rev. & Tax. Code § 480.3.
Assessor’s Parcel No.: 
_____________________________	Declaration of Exemption From GC § 27388.1 Fee
 Transfer is exempt from fee per GC § 27388.1(a)(2):
     Transfer is subject to Documentary Transfer Tax    
     Transfer of residential dwelling to owner-occupier
 Transfer is exempt from fee per GC 27388.1(a)(1):
     $225.00 fee cap      Not related to real property	
IMPORTANT NOTICE: THIS FORM MUST BE RECORDED TO BE EFFECTIVE
This revocation form MUST be RECORDED on or before 60 days after the date it is notarized or it will not be effective. This revocation form only affects a transfer on death deed that YOU made. A transfer on death deed made by a co-owner of your property is not affected by this revocation form. A co-owner who wants to revoke a transfer on death deed that they made must complete and RECORD a SEPARATE revocation form.
PROPERTY DESCRIPTION
Print the legal description of the property affected by this revocation:
________________________________________________________________________ 
________________________________________________________________________ 
________________________________________________________________________ 
REVOCATION
I revoke any TOD deed to transfer the described property that I executed before executing this form.
SIGNATURE AND DATE 
Sign and print your name below (your name should exactly match the name shown on your title documents):

Date: _____________________ 	____________________________________ 
	(Signature of declarant)
	____________________________________ 
	(Typed or written name of declarant)
WITNESSES
To be valid, this form must be signed by two persons, both present at the same time, who witness your signing of the form or your acknowledgment that it is your form. The signatures of the witnesses do not need to be acknowledged by a notary public.

Witness #1
Print and sign your name

________________________________________ 

________________________________________ 
	Witness #2
Print and sign your name

________________________________________ 

________________________________________