Embarking on the journey of updating your estate planning and beneficiary designations is a crucial step in ensuring that your assets and loved ones are taken care of according to your wishes. In the bustling city and county of Denver, the Office of the Clerk and Recorder facilitates this process with various forms, one of which is the DCR4021 form. This particular document, also known as the Revocation of Designated Beneficiary Agreement, plays a significant role for individuals who have previously entered into such agreements but, due to changes in circumstances or relationships, wish to revoke them. Bearing the seal of authority from Stephanie Y. O’Malley, the Clerk & Recorder and Public Trustee, the form requires detailed input from the applicant, including their full name, residence, and the initial beneficiary agreement's specifics. Importantly, the revocation becomes effective upon the recording of this document in the same county where the original Designated Beneficiary Agreement was recorded, signifying a critical step in altering one's estate planning landscapes. This process, underscored by legal statutes such as section 15-22-111 Colorado Revised Statutes, involves notarization and ultimately, the diligent recording by a county clerk, ensuring that the revocation is officially acknowledged and processed.
| Question | Answer |
|---|---|
| Form Name | Form Dcr4021 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | subscribed, SUBMIttAL, revokes, Colorado |
OFFICE OF THE CLERK AND RECORDER
CITY AND COUNTY OF DENVER
REVOCATION OF
DESIGNATED BENEFICIARY AGREEMENT
STEPHANIE Y. O’MALLEY
CLERK & RECORDER
PUBLIC TRUSTEE
his revocation form must be recorded in the same county as the Designated Beneiciary Agreement form it revokes.
I, ________________________________________, residing at _________________________________________________________________ ,
(Full Name)(Street Address, City, State, Zip)
entered into a Designated Beneiciary Agreement on ___________________________________________________________ ,with the following person:
(Date)
____________________________________________________________________________, whose last known address is:
(Full Name)
_______________________________________________________________________________________________________________
(Street Address, City, State, Zip)
in which I designated such person as a Designated Beneiciary. his Designated Beneiciary Agreement was
recorded on ____________________________________________ in the County of _________________________________________________.
(Date)
he indexing ile number of the Designated Beneiciary Agreement is _________________________________________________________.
I hereby revoke that Designated Beneiciary Agreement, efective on the date and time that this revocation is received for recording by the Clerk and Recorder of___________________________________________ County.
_________________________________________________ |
_________________________ |
(Signature) |
(Date) |
State of Colorado |
|
County of ____________________________________ |
|
his document was subscribed, sworn to, and acknowledged |
|
before me on _______________________________________. |
[SEAL] |
My commission expires: ______________________________. |
|
_____________________________________________ |
|
Signature of Notary Public |
|
APPLICANT: COMPLETE THIS BOX AT TIME OF ACTUAL SUBMITTAL TO COUNTY CLERK. (Leave box blank if submitting form by mail.) his revocation form is efective on the date it is received for recording by the County Clerk and Recorder. his form was received by the County Clerk and Recorder on
____________________________________________________, at _______________________________ o’clock.
FOR OFFICIAL USE ONLY
his Revocation of Beneiciary Agreement was recorded in my oice on _______________________________, at __________ o’clock, and, pursuant to section
Colorado Revised Statutes, I mailed a copy of this Revocation of Beneiciary Agreement to ____________________________________________________________ ,
at the address contained in this Revocation of Beneiciary Agreement.
Clerk and Recorder of_____________________________________________ County. By: __________________________________________________________
DCR4021 REV.6/17/09