The Affidavit of Confirmation (Transfer on Death) is the sworn statement, cited to O.R.C. 5302.222, that the Summit County Fiscal Office publishes for real property held under a Transfer on Death Designation Affidavit when the owner has died. It appears among the Summit County property tax forms on the Fiscal Office's forms page. It names the deceased owner, the recorded designation affidavit and the beneficiaries who survived. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the official PDF is published by the Summit County Fiscal Office.
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What is Affidavit of Confirmation (Transfer on Death) – Summit County, OH?
The Affidavit of Confirmation (Transfer on Death) is the sworn statement, cited to O.R.C. 5302.222, that identifies a deceased owner, the recorded Transfer on Death Designation Affidavit and the surviving beneficiaries, so that records show the property transferred to them.
The form is a notarized affidavit. It states that the signer has personal knowledge of the facts and ends with the statement that all records should reflect that the property described in Exhibit "A" is transferred from the deceased owner to the Transfer on Death beneficiaries or contingent beneficiaries. Exhibit "A" is the description of the real property, and Exhibit "B" is a certified copy of the owner's death certificate.
The Summit County Fiscal Office describes the form this way: when a person holding real property with a Transfer on Death Designation Affidavit dies, the Affidavit of Confirmation, along with the Medicaid Estate Recovery form, must be completed.
This form is not the Transfer on Death Designation Affidavit. That is a separate document, listed on the same Fiscal Office page, which lets an owner name beneficiaries who take title at death and does not give the beneficiary a present ownership interest. The Affidavit of Confirmation refers back to it by date and recording information. The form's footnote adds that a Transfer on Death Deed, as it existed before December 28, 2009, is treated the same way.
The Medicaid Estate Recovery form (O.R.C. 5302.221) is also a different document: it is a state-mandated form that accompanies this affidavit.
Who needs to file Affidavit of Confirmation (Transfer on Death) – Summit County, OH?
The main group is the person who signs as affiant after the owner of real property held under a Transfer on Death Designation Affidavit has died, usually in connection with the Transfer on Death beneficiaries or their representative. The form asks the affiant to swear to personal knowledge of the facts it lists.
Parts of the form apply only to some cases:
- Items 1 to 3 apply to every filing: the deceased owner, the recorded designation affidavit and the beneficiaries who survived or are in existence on the date of death.
- Item 4 is marked "For death of beneficiary(ies) only". Complete it only if a named beneficiary did not survive or is not in existence.
- Item 5 is marked "For contingent beneficiary(ies) only". Complete it only when a contingent beneficiary takes because of a death listed in item 4.
The Fiscal Office's April 2017 memo adds a duty for beneficiaries and their representatives. Under changes to O.R.C. 5302.221 effective April 6, 2017, the beneficiary or the beneficiary's representative must submit a copy of the completed Medicaid Estate Recovery form to the State of Ohio when the deceased owner or the owner's predeceased spouse was a Medicaid recipient, or when it is not known whether either was.
When to file Affidavit of Confirmation (Transfer on Death) – Summit County, OH
The triggering event is the death of a person who held real property with a Transfer on Death Designation Affidavit. The Summit County Fiscal Office says the Affidavit of Confirmation and the Medicaid Estate Recovery form must be completed at that point. The form prints no separate due date.
The Fiscal Office must give the Medicaid Estate Recovery form (O.R.C. 5302.221) to the beneficiary, or the beneficiary's representative, before it records the transfer of real property under O.R.C. 5302.222. Prepare the affidavit and its exhibits so they are ready when the transfer is to be recorded.
The Fiscal Office's memo says the beneficiary or representative is responsible for sending a copy of the completed Medicaid form to the State of Ohio when the deceased owner or the owner's predeceased spouse was a Medicaid recipient, or when that is unknown. The memo sets no date for that step.
Documents you need
- Exhibit "A": the description of the real property, attached to the affidavit; item 1 refers to it.
- Exhibit "B": a certified copy of the death certificate of the deceased owner, attached to the affidavit.
- Exhibit "C": certified copies of the death certificates of beneficiaries who did not survive, only if you complete item 4.
- The Medicaid Estate Recovery form (O.R.C. 5302.221): the Fiscal Office says it must be completed along with the Affidavit of Confirmation.
- A copy of the completed Medicaid Estate Recovery form for the State of Ohio, only if the deceased owner or predeceased spouse was a Medicaid recipient, or if that is unknown.
How to fill out Affidavit of Confirmation (Transfer on Death) – Summit County, OH
Enter the county
At the top, after "State of Ohio," write the county on the line "County of".
Identify the deceased owner
In item 1, enter the name of the deceased record owner and the date of death. Attach the property description as Exhibit "A" and a certified copy of the death certificate as Exhibit "B".
Describe the designation affidavit
In item 2, enter the date of the Transfer on Death Designation Affidavit, the recording number or book and page, and the county of the recording office. The footnote applies the same item to a Transfer on Death Deed as it existed before December 28, 2009.
List the surviving beneficiaries
In item 3, write the name and address of each Transfer on Death beneficiary who survived or is in existence on the date of the owner's death. The form has three lines.
Complete item 4 if a beneficiary died
Use item 4 only for beneficiaries who did not survive or are not in existence on that date. Enter each name and address, and attach certified death certificates as Exhibit "C".
Complete item 5 for contingent beneficiaries
Use item 5 only when, because of a death listed in item 4, contingent Transfer on Death beneficiaries take. Enter each name and address.
Sign and print the affiant's name
The affiant signs on the line marked "Signature of Affiant" and prints a name on the line below. Sign in front of the notary.
Complete the notary acknowledgment
The notary writes the name of the person who appeared, the day, month and year (20__) and the commission expiration date, and signs with an official seal. The block is pre-printed with the County of Summit.
Review and download the completed PDF
Check the names, dates and recording information against the recorded designation affidavit, and the exhibits you will attach. Download or print the completed PDF from FillingPDF and assemble the package described under How to submit.
How to submit Affidavit of Confirmation (Transfer on Death) – Summit County, OH
The form is prepared for the Summit County Fiscal Office, which records the transfer of real property under O.R.C. 5302.222. The form prints no mailing address, portal or appointment rule, so confirm how the Fiscal Office takes it through its website, https://fiscaloffice.summitoh.net/forms, before you deliver it.
What the package contains:
- The signed, notarized affidavit. The affiant signs and prints a name, and a notary public completes the acknowledgment block.
- Exhibit "A". The description of the real property.
- Exhibit "B". A certified copy of the death certificate of the deceased owner.
- Exhibit "C". Certified copies of the death certificates of any beneficiaries listed in item 4, only if item 4 is used.
- The Medicaid Estate Recovery form. The Fiscal Office says it must be completed along with this affidavit.
When the deceased owner or the owner's predeceased spouse was a Medicaid recipient, or it is not known, the beneficiary or the beneficiary's representative must also send a copy of the completed Medicaid form to the State of Ohio. For questions about Medicaid estate recovery, the memo lists the Ohio Medicaid Consumer Hotline at 1-800-324-8680 and www.medicaid.ohio.gov.
FillingPDF lets you fill out and download the PDF; submission follows the agency's channels.
Common mistakes to avoid
- Signing the affidavit without a notary public; the form ends with an acknowledgment block that the notary completes.
- Leaving out Exhibit "B", the certified copy of the owner's death certificate, which item 1 says is attached.
- Completing item 4 or item 5 when no beneficiary died; both are marked as applying only to a beneficiary's death or to contingent beneficiaries.
- Listing a beneficiary who did not survive in item 3, which is for those who survived or are in existence on the date of the owner's death.
- Using item 4 without attaching Exhibit "C", the certified death certificates of the beneficiaries listed there.
- Omitting the date and the recording number or book and page of the Transfer on Death Designation Affidavit in item 2, or the county of the recording office.
- Filing the affidavit without the Medicaid Estate Recovery form that the Fiscal Office says must be completed with it.
- Not sending a copy of the completed Medicaid form to the State of Ohio when the owner or predeceased spouse was a Medicaid recipient, or when that is unknown.
Frequently asked questions
What is the Affidavit of Confirmation (Transfer on Death)?
It is a notarized affidavit, cited to O.R.C. 5302.222, in which the signer names the deceased owner, the recorded Transfer on Death Designation Affidavit and the surviving beneficiaries. It states that records should show the property transferred from the owner to those beneficiaries.
When do I need to complete an Affidavit of Confirmation?
When a person who held real property with a Transfer on Death Designation Affidavit dies. The Summit County Fiscal Office says the affidavit and the Medicaid Estate Recovery form must be completed then. The form itself prints no separate deadline.
Do I need a notary for the Affidavit of Confirmation?
Yes. The form ends with a notary acknowledgment: the notary states that the named person appeared, acknowledged signing the instrument and that it is a free act, then adds the date, seal and commission expiration. Sign in front of the notary.
What documents attach to the Affidavit of Confirmation?
Exhibit "A" (the property description) and Exhibit "B" (a certified copy of the owner's death certificate) go with every affidavit. Exhibit "C", certified death certificates of beneficiaries who did not survive, is needed only if you use item 4.
What is the Medicaid Estate Recovery form that goes with it?
It is the state-mandated form under O.R.C. 5302.221. The Fiscal Office provides it to the beneficiary or representative before recording the transfer. If the owner or predeceased spouse was a Medicaid recipient, or you do not know, the beneficiary must send a copy to the State of Ohio.
When do I fill in items 4 and 5?
Only if a named beneficiary did not survive. Item 4 lists beneficiaries who did not survive or are not in existence, with Exhibit "C" death certificates. Item 5 lists contingent beneficiaries who take because of those deaths.
Is the Affidavit of Confirmation the same as the Transfer on Death Designation Affidavit?
No. The Transfer on Death Designation Affidavit is the earlier document in which an owner names beneficiaries, and it gives them no present ownership interest. The Affidavit of Confirmation is completed after the owner dies and refers back to the designation affidavit's date and recording.
Can I fill out the Affidavit of Confirmation online on FillingPDF?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is independent of the Summit County Fiscal Office and does not file or record the affidavit; you submit it through the Fiscal Office's channels after it is notarized.
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