Form 2305 - Affidavit To Establish Title To Exempt Property
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1MISSOURI DEPARTMENT OF REVENUE
FORM
MOTOR VEHICLE BUREAU
2305
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AFFIDAVIT TO ESTABLISH TITLE
(REV. 10-2005)
TO EXEMPT PROPERTY
IN THE ESTATE OF
, DECEASED
COUNTY OF
STATE OF MISSOURI
I,
, RESIDING AT
STREET ADDRESS
CITY
COUNTY
MISSOURI, BEING FIRST DULY SWORN, DEPOSE, AND STATE AS FOLLOWS:
NAME OF DECEDENT
1.
, WHOSE DOMICILE WAS
STREET ADDRESS
CITY
COUNTY
MISSOURI, DIED ON THE
DAY OF
YEAR
THAT SAID DECEDENT’S SURVIVORS ARE AS FOLLOWS:
2a.
THAT
, RESIDING AT
(NAME OF SPOUSE)
STREET ADDRESS
CITY
COUNTY
MISSOURI, WAS MARRIED TO THE DECEDENT, AND WAS NOT DIVORCED OR SEPARATED FOR MORE THAN ONE YEAR PRIOR TO
THE DEATH OF THE DECEDENT.
THAT DECEDENT WAS NOT SURVIVED BY A SPOUSE, AND THE NAMES, DATES OF BIRTH, AND ADDRESSES OF
2b.
DECEDENT’S UNMARRIED MINOR CHILDREN WHO ARE ENTITLED TO PROPERTY ARE AS FOLLOWS:
NAME
DATE OF BIRTH
ADDRESS
THAT THE RELATIONSHIP OF THE AFFIANT TO EACH OF THE ABOVE NAMED UNMARRIED MINOR CHILDREN IS:
2c.
THAT AT THE TIME OF DEATH, DECEDENT WAS OWNER OF A MOTOR VEHICLE (PASSENGER OR PICK-UP ONLY) DESCRIBED AS:
3.
YEAR
MAKE
VEHICLE IDENTIFICATION NUMBER
MODEL
CURRENT LICENSE NUMBER
4.
ARE THERE ANY PRE-NUPTIAL, ANTENUPTIAL, OR POST-NUPTIAL AGREEMENTS CONCERNING THE PERSONAL PROPERTY
OF THE DECEDENT?
YES
NO
IF YES, A COPY OF THE AGREEMENT MUST BE ATTACHED.
5.
THAT THIS IS THE ONLY MOTOR VEHICLE OWNED BY THE DECEDENT THAT IS BEING TRANSFERRED TO A SURVIVING
SPOUSE OR MINOR CHILDREN AS EXEMPT PROPERTY.
AFFIANT’S SIGNATURE
DATE
NOTARY INFORMATION
NOTARY PUBLIC EMBOSSER SEAL
STATE
COUNTY (OR CITY OF ST. LOUIS)
SUBSCRIBED AND SWORN BEFORE ME, THIS
DAY OF
YEAR
USE RUBBER STAMP IN CLEAR AREA BELOW.
NOTARY PUBLIC SIGNATURE
MY COMMISSION
EXPIRES
NOTARY PUBLIC NAME (TYPED OR PRINTED)
MO 860-0396 (10-2005)
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