Form Dpsmv 1696 - Affidavit Of Heirship
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1LOUISIANA 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 Certificate or Published Obituary Attached)
hereinafter referred to as decedent, is the registered owner of the following described vehicle:
Year
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).
[ ] Certificate of title attached.
[ ] Certificate of title cannot be located and is, therefore, not available.
Under penalties provided for providing false reports, I/we declare that this affidavit (including any accompanying schedules and statements) is to the best of my/our
knowledge and belief, a true, correct, and complete identification of death circumstances and legal heir ship of the named decedent.
ENTER NAME & ADDRESS OF SURVIVING SPOUSE
ENTER NAME & ADDRESS OF HEIR OR LEGATEE
If Minor, Must List Age
Name ____________________________________ Age: _______________
Name ______________________________________________________
Address ______________________________________________________
Address ____________________________________________________
City & State___________________________________________________
City & State ________________________________________________
Relation to Decedent ____________________________________________
Telephone ( ________ ) _______________________________________
Signature______________________________________________________
Signature ___________________________________________________
Sworn and subscribed before me
Sworn and subscribed before me
this __________ day of ___________ , 20 ______
this __________ day of ___________ , 20 ______
______________________________________________________________
____________________________________________________________
Notary Public Signature, Printed Name ID#
Parish (County) State
Notary Public Signature, Printed Name ID #
Parish (County) State
ENTER NAME & ADDRESS OF HEIR OR LEGATEE
ENTER NAME & ADDRESS OF HEIR OR LEGATEE
If Minor, Must List Age
If Minor, Must List Age
Name ____________________________________ Age: ______________
Name ____________________________________ Age: _______________
Address _____________________________________________________
Address ______________________________________________________
City & State__________________________________________________
City & State___________________________________________________
Relation to Decedent ___________________________________________
Relation to Decedent ____________________________________________
Signature_____________________________________________________
Signature______________________________________________________
Sworn and subscribed before me
Sworn and subscribed before me
this __________ day of ___________ , 20 ______
this __________ day of ___________, 20 ______
_____________________________________________________________
________________________________________________________________
Notary Public Signature, Printed Name
ID#
Parish (County) State
Notary Public Signature, Printed Name
ID#
Parish (County) State
Heirs And Legatees Must Be Listed
(If more than four, please attach supplementary list)
If 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 a notarized bill of sale or act of donation. If there is no surviving spouse and the sale
or donation is to a new owner, a bill of sale or act of donation must be executed by all heirs.
The applicant must surrender the previous title, if available.
Fees are $68.50 for transfer of title, $8.00 service handling fee, and license fees as applicable. If a UCC-1 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 09/15)
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