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Nebraska Affidavit for Transfer of Decedent's Vehicle/Motorboat Form

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Nebraska Affidavit for Transfer of Decedent's Vehicle/Motorboat Form
Nebraska Affidavit for Transfer of Decedent
Printed on recycled paper Revised 7/2012
AFFIDAVIT FOR
TRANSFER OF DECEDENT’S
VEHICLE/MOTORBOAT
Neb. Rev. Stat. §30-24,125
1. Nebraska Certificate of Title must be attached, if available.
Any unreleased lien on the title will transfer to the new title.
2. Death Certificate must be attached.
AFFIDAVIT
State of Nebraska )
) ss.
County of )
I,
(Claimant Name)
(Address) (City) (State) (Zip)
and
(Claimant Name)
,
(Address) (City) (State) (Zip)
claim the vehicle/motorboat of
deceased, and
swear as follows: (Decedent’s Name)
1. the value of all the personal property in the decedent’s estate, wherever located, less liens and
encumbrances, does not exceed fifty thousand dollars ($50,000) – this does not include real estate;
2. thirty (30) days have elapsed since the death and a certified or authenticated copy of the death
certificate is attached;
3. I am related to the decedent as his or her , or if there
(Relationship)
is no relationship, the basis of my claim is: .
4. no application or petition for the appointment of a personal representative is pending or has been
granted;
5. no other person has a right to the interest of the decedent in the vehicle/motorboat; and
6. I am entitled to the title for the vehicle/motorboat.
VEHICLE/MOTORBOAT INFORMATION
Title # VIN/HIN
Year Make Model
I, or we, the person or persons claiming as successors under
this affidavit, hereby swear or affirm under penalty of perjury
under Neb. Rev. Stat
. §28-915, that the preceding is true and
material.
(Claimant’s signature)
(Claimant’s signature)
Subscribed and sworn to before me this
day of , .
(Notary Public or designated County Official)
Seal
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Nebraska Affidavit for Transfer of Decedent's Vehicle/Motorboat Form