Affidavit Of Surviving Spouse Template - Mass Rmv

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Affidavit of Surviving Spouse
Registry of Motor Vehicles
P.O. Box 55889 • Boston, MA • 02205-5889
Reference Information:
Reference Information:
Reference Information:
Reference Information:
Reference Information:
Owner Name: Last, First, Middle
Registration Number:
Title Number:
Vehicle Make:
Year:
VIN
I hereby certify that the above named decedent (copy of death certificate attached) was the
registered owner of the above described motor vehicle registered and used as a pleasure
vehicle in the Commonwealth.
I further certify that the said vehicle has not been disposed of otherwise by will and that
under the provisions of Massachusetts General Laws, Chapter 90D, Section 15A, the
interest in said vehicle shall pass to me as surviving spouse.
Signed under penalties of perjury.
Date: _______________________
Signature of Surviving Spouse: ________________________________________________
1. If you are selling the vehicle, complete this application and give it to the buyer along with
the death certificate and the assigned certificate of title.
2. If you are retaining ownership, go to an authorized Massachusetts insurance agent and
have them fill out, stamp, and sign an RMV-1 application. After verifying the information,
sign the RMV-1 application.
3 Bring the stamped RMV-1 along with this form, death certificate, and Certificate of title to
your nearest Branch office. If you are applying for a new registration, you will be charged
accordingly.
T20026-1210

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