STATE OF OHIO TRANSFER ON DEATH DESIGNATION
AFFIDAVIT
COUNTY OF _______________________ [RC 5302.22]
________________________________________ (name(s) of person(s) swearing affidavit), the Affiant, being
first duly sworn according to law, states as follows:
1. That the Affiant(s), ____________________________ (marital status), is/are now the owner(s) of
record of the following real property located at ________________________________________ (street
address), ____________________ (city/town), Ohio as recorded at Vol. _____, Page ______ of
________________ County deed records:
(insert full legal description of property)
Parcel #______________ Alt ID#_____________________
2. That title of record to the above property is held by the Affiant(s) as follows:
_____ Sole owner
_____ Tenant(s) in common
_____ Tenant(s) in survivorship
_____ Tenants by the entireties
3. That Affiant(s) hereby designate(s) the following as transfer on death beneficiary(ies) to receive
the Affiant(s)’ title to that property upon the death of the Affiant(s):
(Use the following paragraph if you’re transferring the entire interest to a single beneficiary.)
The entire undivided interest in the property for transfer on death to
___________________________________ (name of beneficiary) as transfer on death beneficiary, to
receive the title of Affiant(s) upon his/her/their death.
OR
(Use the following paragraph if less than the entire undivided interest is being transferred, or if transfer is
made to more than one beneficiary.)
The entire undivided interest in the property (or if less than entire interest, state the undivided
fractional interest owned by the Affiant(s) to be designated for transfer by each Affiant) for transfer on
death to the person(s) named below, as transfer on death beneficiary(ies), to receive the title of
the Affiant(s) upon his/her their/death, as follows:
Name of Beneficiary Undivided Interest of Type of Tenancy
Affiant(s)
1.
2.
3.
4.
4. That _________________________________, wife/husband of the Affiant, states that her/his
dower rights are subordinate to the vesting of title to the r