Form Mv-349.1 - Affidavit For Transfer Of Motor Vehicle printable pdf download

AFFIDAVIT FOR TRANSFER OF MOTOR VEHICLE

(Authorized by Section 5-3.1 of the Estates, Powers and Trusts Law)

INSTRUCTIONS: This form, along with the title or transferable registration properly completed, may be used to transfer a motor vehicle having a

value of twenty-five thousand dollars ($25,000) or less, owned by a person at the time of his/her death, to a surviving spouse or child or

children under the age of twenty-one years. It may also be used to transfer such a motor vehicle to another party for the benefit of a surviving

spouse or child or children under the age of twenty-one years. A COPY OF THE DEATH CERTIFICATE (CERTIFICATE OF DEATH OR

CERTIFICATION OF DEATH) MUST BE PROVIDED.

State of New York

)

ss.:

County of

)

____________________________________________________________________________________, being duly sworn, deposes and says:

1. (a) I am the surviving spouse of ____________________________________________________________________________________

(OR)

(b) I am the duly appointed guardian of

______________________________________________________________________________,

the surviving minor child or children of______________________________________________________________________________.

2. The said ___________________________________ died on the _________ day of ____________________, in the year of ____________.

3. At the time of his/her death, the said ___________________________________________________________________was the owner of a

______________

_____________ _______________

_____________________________

_____________________

(Year)

(Make)

(Model)

(Type)

Vehicle identification or serial number ___________________________________________________________.

4. The name of the person to whom the vehicle is being transferred is ________________________________________________________

Address: ______________________________________________________________________________________________________.

5. Check one of the following:

The above mentioned motor vehicle has a value of not more than twenty-five thousand dollars ($25,000).

The above mentioned motor vehicle has a value which exceeds $25,000, but pursuant to Estates, Powers and Trusts Law §5-3.1(a)(4),

I have paid to the estate the sum of $____________, the amount by which the value of such motor vehicle exceeds $25,000.

6. The above mentioned motor vehicle is the only motor vehicle belonging to the decedent that is being transferred under Section 5-3.1 of the

Estates, Powers and Trusts Law.

7. The deponent is a person qualified to take said motor vehicle under Section 5-3.1 of the Estates, Powers and Trusts Law, and hereby

makes claim to said motor vehicle.

8. The deponent is not a disqualified spouse under Section 5-1.2 of the Estates, Powers and Trusts Law, and hereby makes claim to said

motor vehicle. (See page 2.)

9. This affidavit is made for the purpose of securing a transfer of the above mentioned motor vehicle under the provisions of Section 5-3.1 of

the Estates, Powers and Trusts Law.

CERTIFICATION:

I certify that the information I have provided on this form is true and complete to the best of my knowledge.

WARNING: Intentionally making a false statement or providing false or misleading information in connection with this application is a criminal

offense that may subject you to criminal prosecution and/or administrative action under the Law.

_________________________________________________________________

Signature (Sign name in full)

Sworn to before me this _______day of _________________________________________, in the year of _______________.

__________________________________________________________ My Commission expires__________________________________

Notary Public or Commissioner of Deeds

(Date)

PAGE 1 OF 2

dmv.ny.gov

MV-349.1 (12/16)

Form Mv-349.1 - Affidavit For Transfer Of Motor Vehicle

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