Form Dpsmv 1696 - Louisiana Affidavit Of Heirship printable pdf download

LOUISIANA DEPARTMENT OF PUBLIC SAFETY & CORRECTIONS

OFFICE OF MOTOR VEHICLES

Affidavit of Heirship

This form is to be used only when a vehicle is registered in the name of a deceased owner and the heirs desire to confirm their ownership interest

THIS IS TO CERTIFY THAT

(deceased owner),

(Copy of Death Ccrtificate or Published Obituary Attached)

hereinafter referred to as decedent, is the registered owner ofthe following described vehicle:

Ycar

Make

Model

Vehicle Identification No.

Louisiana Title No

Current Louisiana License No.

DECLARATION

Upon my/our oath, I/we solemnly swear that the information on this form and the following statements as checked below are true and correct:

The decedent died intestate (i.e., no will).

The decedent died testate (copy of will or notarized statement by one in lawful possession of the original summarizing the disposition of

vehicles contained in the will attached).

l--'l Certificate of title attached.

l-'l

Certificate oftitle cannot be located and is, therefore, not available.

Undcr pcnaltics provided for providing false reports, I/we declare that this affidavit (including any accompanying schedules and statements) is to the bcst ofmy/our

knowlcdgc and bclicf, a true, correct, and completc identification of death circumstances

and legal heir ship ofthe named decedent.

ENTERNAME & ADDRESS OF SURVI\TNG SPOUSE

Swom and subscribcd bcforc mc

t h i s _

d a y o f _

, 2 0 _

Notary Public

Parish (County) State

ENTERNAME & ADDRESS OF HEIR OR LEGATEE

If Minor Mrrst l.ist Aqe

Rclation to Decedcnt

Swom and subscribed before mc

this -

day of-

,20 -

Notary Public

Parish (County) State

ENTER NAME & ADDRESS OF HEIR OR LEGATEE

If Minor. Must List Ase

Swom and subscribed beforc mc

t h i s -

d a y o f _

, 2 0 _

Notary Public

Parish (County) State

ENTER NAME & ADDRESS OF HEIR OR LEGATEE

If Minor. Must List Agc

A s e :

Signaturc

Swom and subscribed beforc mc

this -

day of-,20

Notary Public

Parish (County) State

Heirs And Legatees Must Be Listed

(Ifmore than four, please attach supplementary list)

lf there is only one surviving heir and he/she wishes to title the vehicle in his/her name, this affidavit with attachments will be acceptable. If one of the

heirs is a surviving spouse and he/she wishes to transfer the vehicle to a new owner, this affidavit of heirship must be completed by him./her as well as

all other heirs, but only the surviving spouse is required to execute anotarized bill ofsale or act ofdonation. Ifthere is no surviving spouse and the sale

or donation is to a new owner, a bill ofsale or act ofdonation must be executed by all heirs.

The applicant must surrender the previous title, if available.

Fees are $18.50 for transfer of title, $8.00 service handling fee, and license fees as applicable. If a UCC-I form is submitted to record a lien, an

additional fee of $15.00 must be submitted. If any other type security agreement is submitted, an additional fee of $10.00 must be submitted. If a lien

was reflected on the title of the decedent, the original paid note or a release of lien on the lienholder's letterhead is required. If a consideration is

expressed in a bill of sale, sales tax must also be computed or paid.

Please send check or money order made payable to Office of Motor Vehicles to cover any fees/taxes due. PLEASE DO NOT SEND CASH,

DPSMV 1696 (R 4/04)