Lady Bird Deed Intake Form Lady Bird DeedIntake Form Complete The Form Below Important Notice: Please note that Lady Bird Deeds are not available for properties owned by corporations or LLCs. Electronic recording is not accepted in the following Florida counties: Baker, Dixie, Glades, Lafayette, Levy, and Liberty.To record the deed, the client must visit the County Clerk’s Office in person. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. Address Property Beneficiary Contact Information Please provide the Information of person requesting or ordering the preparation of the Ladybird Deed. Choose the Correct Statement: *I am the property ownerI am completing this form on behalf of the property ownerRepresentative Name *Representative Phone *Representative Email *Is the property owner mentally capable of understanding and consenting to the notarization process? *Yes, the owner is mentally capableNo, the owner is not mentally capable of understanding or consenting to the notarization process.This includes being free from conditions such as Alzheimer’s, dementia, speech, hearing, vision or any other impairments affecting comprehension.Provide Property InformationHow Many Properties? 12345678Property Address *Address Line 1CityState / Province / RegionPostal CodeIn which county is the property located? *Select the county where your property is locatedAlachuaBaker (Manual Recording Only)BayBradfordBrevardBrowardCalhounCharlotteCitrusClayCollierColumbiaDeSotoDixie (Manual Recording Only)DuvalEscambiaFlaglerFranklinGadsdenGilchristGlades (Manual Recording Only)GulfHamiltonHardeeHendryHernandoHighlandsHillsboroughHolmesIndian RiverJacksonJeffersonLafayette (Manual Recording Only)LakeLee (ID/Passport Upload Required)LeonLevy (Manual Recording Only)Liberty (Manual Recording Only)MadisonManateeMarionMartinMiami-DadeMonroeNassauOkaloosaOkeechobeeOrangeOsceolaPalm BeachPascoPinellasPolkPutnamSanta RosaSarasotaSeminoleSt. JohnsSt. LucieSumterSuwanneeTaylorUnionVolusiaWakullaWaltonWashingtonProperty #2 InformationProperty #2 Address *Address Line 1CityState / Province / RegionPostal CodeIn which county is the property #2 located? *Select the county where your property is locatedAlachuaBaker (Manual Recording Only)BayBradfordBrevardBrowardCalhounCharlotteCitrusClayCollierColumbiaDeSotoDixie (Manual Recording Only)DuvalEscambiaFlaglerFranklinGadsdenGilchristGlades (Manual Recording Only)GulfHamiltonHardeeHendryHernandoHighlandsHillsboroughHolmes (Manual Recording Only)Indian RiverJacksonJeffersonLafayette (Manual Recording Only)LakeLee (ID/Passport Upload Required)LeonLevy (Manual Recording Only)Liberty (Manual Recording Only)MadisonManateeMarionMartinMiami-DadeMonroeNassauOkaloosaOkeechobeeOrangeOsceolaPalm BeachPascoPinellasPolkPutnamSanta RosaSarasotaSeminoleSt. JohnsSt. LucieSumter (Manual Recording Only)SuwanneeTaylorUnionVolusiaWakullaWaltonWashingtonProperty #3 InformationProperty #3 Address *Address Line 1CityState / Province / RegionPostal CodeIn which county is the property #3 located? *Select the county where your property is locatedAlachuaBaker (Manual Recording Only)BayBradfordBrevardBrowardCalhounCharlotteCitrusClayCollierColumbiaDeSotoDixie (Manual Recording Only)DuvalEscambiaFlaglerFranklinGadsdenGilchristGlades (Manual Recording Only)GulfHamiltonHardeeHendryHernandoHighlandsHillsboroughHolmes (Manual Recording Only)Indian RiverJacksonJeffersonLafayette (Manual Recording Only)LakeLee (ID/Passport Upload Required)LeonLevy (Manual Recording Only)Liberty (Manual Recording Only)MadisonManateeMarionMartinMiami-DadeMonroeNassauOkaloosaOkeechobeeOrangeOsceolaPalm BeachPascoPinellasPolkPutnamSanta RosaSarasotaSeminoleSt. JohnsSt. LucieSumter (Manual Recording Only)SuwanneeTaylorUnionVolusiaWakullaWaltonWashingtonProperty #4 InformationProperty #4 Address *Address Line 1CityState / Province / RegionPostal CodeIn which county is the property #4 located? *Select the county where your property is locatedAlachuaBaker (Manual Recording Only)BayBradfordBrevardBrowardCalhounCharlotteCitrusClayCollierColumbiaDeSotoDixie (Manual Recording Only)DuvalEscambiaFlaglerFranklinGadsdenGilchristGlades (Manual Recording Only)GulfHamiltonHardeeHendryHernandoHighlandsHillsboroughHolmes (Manual Recording Only)Indian RiverJacksonJeffersonLafayette (Manual Recording Only)LakeLee (ID/Passport Upload Required)LeonLevy (Manual Recording Only)Liberty (Manual Recording Only)MadisonManateeMarionMartinMiami-DadeMonroeNassauOkaloosaOkeechobeeOrangeOsceolaPalm BeachPascoPinellasPolkPutnamSanta RosaSarasotaSeminoleSt. JohnsSt. LucieSumter (Manual Recording Only)SuwanneeTaylorUnionVolusiaWakullaWaltonWashingtonProperty #5 InformationProperty #5 Address *Address Line 1CityState / Province / RegionPostal CodeIn which county is the property #5 located? *Select the county where your property is locatedAlachuaBaker (Manual Recording Only)BayBradfordBrevardBrowardCalhounCharlotteCitrusClayCollierColumbiaDeSotoDixie (Manual Recording Only)DuvalEscambiaFlaglerFranklinGadsdenGilchristGlades (Manual Recording Only)GulfHamiltonHardeeHendryHernandoHighlandsHillsboroughHolmes (Manual Recording Only)Indian RiverJacksonJeffersonLafayette (Manual Recording Only)LakeLee (ID/Passport Upload Required)LeonLevy (Manual Recording Only)Liberty (Manual Recording Only)MadisonManateeMarionMartinMiami-DadeMonroeNassauOkaloosaOkeechobeeOrangeOsceolaPalm BeachPascoPinellasPolkPutnamSanta RosaSarasotaSeminoleSt. JohnsSt. LucieSumter (Manual Recording Only)SuwanneeTaylorUnionVolusiaWakullaWaltonWashingtonProperty #6 InformationProperty #6 Address *Address Line 1CityState / Province / RegionPostal CodeIn which county is the property #6 located? *Select the county where your property is locatedAlachuaBaker (Manual Recording Only)BayBradfordBrevardBrowardCalhounCharlotteCitrusClayCollierColumbiaDeSotoDixie (Manual Recording Only)DuvalEscambiaFlaglerFranklinGadsdenGilchristGlades (Manual Recording Only)GulfHamiltonHardeeHendryHernandoHighlandsHillsboroughHolmes (Manual Recording Only)Indian RiverJacksonJeffersonLafayette (Manual Recording Only)LakeLee (ID/Passport Upload Required)LeonLevy (Manual Recording Only)Liberty (Manual Recording Only)MadisonManateeMarionMartinMiami-DadeMonroeNassauOkaloosaOkeechobeeOrangeOsceolaPalm BeachPascoPinellasPolkPutnamSanta RosaSarasotaSeminoleSt. JohnsSt. LucieSumter (Manual Recording Only)SuwanneeTaylorUnionVolusiaWakullaWaltonWashingtonProperty #7 InformationProperty #7 Address *Address Line 1CityState / Province / RegionPostal CodeIn which county is the property #7 located? *Select the county where your property is locatedAlachuaBaker (Manual Recording Only)BayBradfordBrevardBrowardCalhounCharlotteCitrusClayCollierColumbiaDeSotoDixie (Manual Recording Only)DuvalEscambiaFlaglerFranklinGadsdenGilchristGlades (Manual Recording Only)GulfHamiltonHardeeHendryHernandoHighlandsHillsboroughHolmes (Manual Recording Only)Indian RiverJacksonJeffersonLafayette (Manual Recording Only)LakeLee (ID/Passport Upload Required)LeonLevy (Manual Recording Only)Liberty (Manual Recording Only)MadisonManateeMarionMartinMiami-DadeMonroeNassauOkaloosaOkeechobeeOrangeOsceolaPalm BeachPascoPinellasPolkPutnamSanta RosaSarasotaSeminoleSt. JohnsSt. LucieSumter (Manual Recording Only)SuwanneeTaylorUnionVolusiaWakullaWaltonWashingtonProperty #8 InformationProperty #8 Address *Address Line 1CityState / Province / RegionPostal CodeIn which county is the property #8 located? *Select the county where your property is locatedAlachuaBaker (Manual Recording Only)BayBradfordBrevardBrowardCalhounCharlotteCitrusClayCollierColumbiaDeSotoDixie (Manual Recording Only)DuvalEscambiaFlaglerFranklinGadsdenGilchristGlades (Manual Recording Only)GulfHamiltonHardeeHendryHernandoHighlandsHillsboroughHolmes (Manual Recording Only)Indian RiverJacksonJeffersonLafayette (Manual Recording Only)LakeLee (ID/Passport Upload Required)LeonLevy (Manual Recording Only)Liberty (Manual Recording Only)MadisonManateeMarionMartinMiami-DadeMonroeNassauOkaloosaOkeechobeeOrangeOsceolaPalm BeachPascoPinellasPolkPutnamSanta RosaSarasotaSeminoleSt. JohnsSt. LucieSumter (Manual Recording Only)SuwanneeTaylorUnionVolusiaWakullaWaltonWashingtonCurrent Property Owners InformationHow many owners are on the title? *1234is any property owner deceased? *NoYes [ Death Certificate may be required ]Is the property address and mailing address the same? *YesNoMailing Address *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land IslandsCountryOwner InformationFull Name *Phone Number *Type of ID being used for notary? *Driver's LicenseIdentification CardPassportMarital Status *SingleMarriedWidowed [ Death Certificate may be required ]Deceased [ Death Certificate may be required ]Owner E-Mail *Owner #2 InformationFull Name *Phone Number *Type of ID being used for notary? *Driver's LicenseIdentification CardPassportMarital Status *MarriedSingleWidow / Widower [ Death Certificate may be required ]Owner E-Mail *Owner #3 InformationFull Name *Phone Number *Type of ID being used for notary? *Driver's LicenseIdentification CardPassportMarital Status *MarriedSingleWidow / Widower [ Death Certificate may be required ]Owner E-Mail *Owner #4 InformationFull Name *Phone Number *Type of ID being used for notary? *Driver's LicenseIdentification CardPassportMarital Status *MarriedSingleWidow / Widower [ Death Certificate may be required ]Owner E-Mail *Remainder Beneficiary InformationPlease provide the information below for whom you will be leaving property to.How Many Beneficiaries?12345678Full Name *Is this Beneficiary 18 years old or older? *YesNoFull Name *Is this Beneficiary 18 years old or older? *YesNoFull Name *Is this Beneficiary 18 years old or older? *YesNoFull Name *Is this Beneficiary 18 years old or older? *YesNoFull Name *Is this Beneficiary 18 years old or older? *YesNoFull Name *Is this Beneficiary 18 years old or older? *YesNoFull Name *Is this Beneficiary 18 years old or older? *YesNoFull Name *Is this Beneficiary 18 years old or older? *YesNoBeneficiary(ies) AddressOnly one address is required for all beneficiaries listed.Beneficiary Address *Address Line 1CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land IslandsCountryProperty Distribution Instructions & DetailsPlease specify how you'd like the property to be distributed among the remaining beneficiaries. If no information is provided, we will default to dividing the property equally among the beneficiaries as joint tenants with rights of survivorship. You can also use this space to provide any additional details, comments, or special instructions.Property DistributionAcknowledgement Regarding Preparation and Recording of Deed You are preparing a Florida Enhanced Life Estate Deed (Lady Bird Deed), and you are hiring LadyBirdDeedNow.com, a deed preparation company, to type and prepare the deed for you based on the written information you provide in this questionnaire. By proceeding, you acknowledge and agree: *I understand and accept the information provided aboveI agree to the Terms of Service and Privacy PolicyProceed to Checkout © 2025 Lady Bird Deed Now. All Rights Reserved. This site is protected by reCAPTCHA. © 2025 Lady Bird Deed Now. All Rights Reserved. This site is protected by reCAPTCHA.
