ELECTION OF SURVIVING SPOUSE TO TAKE A ONE-HALF INTEREST OF DECEDENT'S INTEREST IN HOMESTEAD PROPERTY STATE OF _______________________ COUNTY OF _____________________ 1. The decedent, ____________________________________, died on ___________________. On the date of the decedent's death, the decedent was married to _______________________________, who survived the decedent. 2. At the time of decedent's death, the decedent owned an interest in real property that the affiant believes to be homestead property described in Section 4, Article X of the State Constitution, which real property is located in ___________________________ County, Florida and is described as: 3. Affiant elects to take one-half of decedent's interest in the homestead as a tenant in common in lieu of a life estate. 4. If affiant is not the surviving spouse, affiant is the surviving spouse's attorney in fact or guardian of the property, and an order has been rendered by a court having jurisdiction of the real property authorizing the undersigned to make this election. __________________________________ Affiant Sworn to and subscribed to before me on this , by Affiant, who is personally known to me (yes or no) day of ___________________________ , or who produced (type of identification) as identification. Notary Public State of Florida (Affix Notarial Seal) Bar Form No. P-4.0430 © Florida Lawyers Support Services, Inc. Revised January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com