Statement of Acknowledgement (Termination of Joint Tenancy)
MDT-ROW-254	Rev. 05/23
Page 1 of 2

Project ID:	enter text	Project No.:	enter text
Designation:	enter text	Parcel No.:	enter text

Add Surviving owner is the surviving owner of real property owned with add deceased owner who died on add dated died

The above-named parties owned real property located in Musselshell County, Montana as joint tenants, with right of survivorship. The real property is more particularly described as follows:

Add legal land description here

That the interest of add deceased owner in the above-described property is terminated. That the aggregate value of the interest in the joint tenancy property is less than the federal estate filing requirement. That the estate of add deceased owner is not involved in probate and there is no need for a personal representative to the estate.

This Statement of Acknowledgment is made pursuant to Section 72-16-503 and 7-4-2613(1)(c), MCA.

Dated:

__________________________________________

Add individual signing statement

State of
County of

This instrument was acknowledged before me on
(date)
By	Add name of signer
(name of person)
(Seal)
Notary Signature Line
Notary Printed Name
Notary Public for State of
Residing at:
My Commission Expires:	/	/	20