Va. Code § 64.2-636
The following form may be used to create an instrument of revocation under this article.
THIS REVOCATION MUST BE RECORDED BEFORE YOU DIE OR IT WILL NOT BE EFFECTIVE. THIS REVOCATION IS EFFECTIVE ONLY AS TO THE INTERESTS IN THE PROPERTY OF OWNERS WHO SIGN THIS REVOCATION.
THIS DEED IS EXEMPT FROM RECORDATION TAXES UNDER § 58.1-811J(J) OF THE CODE OF VIRGINIA OF 1950, AS AMENDED.
REVOCATION OF TRANSFER ON DEATH DEED
THIS REVOCATION OF TRANSFER ON DEATH DEED, dated as of the __________ day of _______________, is made by TRANSFEROR OR TRANSFERORS (the Grantor(s)), whose address is ________________________________________.
This Revocation of Transfer on Death Deed is made pursuant to the provisions of the Uniform Real Property Transfer on Death Act, Virginia Code, § 64.2-621 et seq.
In accordance with the provisions of the Uniform Real Property Transfer on Death Act, I revoke all my previous transfers of the below described property by transfer on death deed:
INSERT LEGAL DESCRIPTION
Witness the following signature and seals:
________________________________________ (SEAL)
TRANSFEROR
COMMONWEALTH OF VIRGINIA
CITY/COUNTY OF ____________________, to wit:
The foregoing instrument was acknowledged before me in the City/County of ____________________, Virginia this __________ day of _______________, by TRANSFEROR.
________________________________________
Notary Public
My commission expires: ____________________
Registration number: ____________________
Va. Code § 64.2-636