File No.
STATE OF NORTH CAROLINA
                                                                                            In The General Court Of Justice
                                                County                                       Superior Court Division
                                                                                             Before The Clerk
             IN THE MATTER OF THE ESTATE OF
Name Of Decedent
                                                                          RENUNCIATION AND WAIVER OF
                                                                               SPOUSAL YEAR’S ALLOWANCE
Date Of Death
                                                                                                      G.S. 31B-1; Ch. 30, Art. 4
I file this RENUNCIATION AND WAIVER OF SPOUSAL YEAR’S ALLOWANCE with the Clerk of Superior Court, pursuant to Chapter 
31B of the General Statutes of North Carolina.
  1.  The decedent died a resident of this county on the date shown above.
  2.   I understand that I am entitled, as the surviving spouse, to an allowance from the personal property of the decedent in the value 
     of sixty thousand dollars ($60,000).
  3.   I further understand that if the decedent’s estate does not currently contain personal property in the amount of the allowed 
     spousal year’s allowance, I would be entitled to a deficiency judgment to protect my right to claim the spousal year’s allowance 
     from the property that may later come into the decedent’s estate.
  4.   I waive and renounce any claim set forth in Paragraphs 2 and 3 for a spousal year’s allowance and any deficiency judgment. I 
     understand that this waiver and renunciation cannot be retracted at a later date which means I can never claim the spousal year’s 
     allowance after I file this form with the Clerk of Superior Court.
  5.   This filing only waives and renounces the spousal year’s allowance and any deficiency judgment; it does not constitute a waiver 
     of any other interest in the decedent’s estate to which I may be entitled.
                                                                  Name And Address Of Spouse
SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME
Date            Signature Of Person Authorized To Administer Oaths

         Deputy CSC      Assistant CSC      CSC     Magistrate
        Date Commission Expires                                   Date                       Telephone
  Notary
        County Where Notarized                                    Signature Of Spouse
 SEAL

 AOC-E-213, Rev. 1/19
 © 2019 Administrative Office of the Courts