Form Tr-83b - Claim Of Heir And/or Beneficiary Affidavit

Download a blank fillable Form Tr-83b - Claim Of Heir And/or Beneficiary Affidavit in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Tr-83b - Claim Of Heir And/or Beneficiary Affidavit with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

KANSAS
CLAIM OF HEIR AND/OR
DEPARTMENT OF REVENUE
BENEFICIARY AFFIDAVIT
DIVISION OF VEHICLES
(Estate of No More than $40,000)
State of Kansas
)
)
ss.
County of
)
I,
, of lawful age, first being duly sworn state:
Name of Affiant(s)
(1) On,
,
died
Date
Name of Deceased
Testate
or
Intestate
at
,
City and State
leaving an estate not exceeding $40,000 in value, and I have attached a certified copy of the death certificate hereto.
(2) That no petition for the appointment of an executor or administrator of the decedent's estate is pending or has been granted.
(3) That all unpaid debts, claims or demands against the decedent or the decedent's estate and all estate and inheritance taxes due, if
any, on the property transfers involved, have been or will be paid.
(4) That the following are the names, ages, relationships and addresses of the beneficiaries under the decedent's will* or heirs of the
decedent: (If more space is needed, attach additional page.)
Name
Age
Relationship
Address
(5) That the decedent's estate consists of the following vehicle(s): (This form is intended for use of titling vehicle(s) into the names of
the beneficiaries under the decedent’s will* or heir(s) of the decedent. If there are more vehicles in the estate than space provided
herein, please complete a separate “Claim of Heir Affidavit”.)
Vehicle Value
Vehicle(s) Information
¾ $
VIN
Year
Make
Style
th’s)
• Ø
I certify to the best of my knowledge that the odometer reading for the above vehicle is: (no 10
)
Actual
Exceeds Mechanical Limits
Not Actual >
and the reading is:
WARNING-ODOMETER DISCREPANCY
¾ $
VIN
Year
Make
Style
th’s)
• Ø
I certify to the best of my knowledge that the odometer reading for the above vehicle is: (no 10
)
Actual
Exceeds Mechanical Limits
Not Actual >
and the reading is:
WARNING-ODOMETER DISCREPANCY
¾ $
VIN
Year
Make
Style
th’s)
• Ø
I certify to the best of my knowledge that the odometer reading for the above vehicle is: (no 10
)
Actual
Exceeds Mechanical Limits
Not Actual >
and the reading is:
WARNING-ODOMETER DISCREPANCY
(6) That affiant(s) has (have) the sole and exclusive right to succeed to the personal property of the decedent and that affiant(s) is
(are) over 18 years of age and is (are) legally competent in all respects to make this affidavit and to receive the personal property
listed herein, apportioned among the affiant or affiants, if more than one as follows:
.
* Attach a copy of the decedent’s will to this affidavit. (Refer to items 4 and 5 above.)
Wherefore, affiant(s) hereby request(s) that the vehicle listed in this affidavit be transferred to the affiant(s).
Signature(s)
Date
Hand Printed Name
Of Person(s) Signing Above
W
: Kansas statutes KSA 21-3711 provides that
8,
ARNING
FALSIFYING INFORMATION ON ANY REQUIRED DOCUMENT IS A SEVERITY LEVEL
NONPERSON
. KSA 21-3710 deals with forgery;
8
.
FELONY
FORGERY IS KNOWINGLY AND WITH INTENT TO DEFRAUD AND IS SEVERITY LEVEL
NONPERSON FELONY
TR-83b www (Revised 07/10)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go