Kansas

Department of Revenue

Division of Vehicles

/

DECEDENT’S Affidavit

(Pending Final Action on Will)

NOTE:This affidavit (TR-83a) can be used when there is a will, but the courts have not probated the will. The heirs may use this affidavit to obtain title or title and registration for ONE (1) vehicle pending final action on the will.

Name of

Heir:

Name ofDate of

DeceasedDeath

Vehicle Information

YearMakeStyleVIN

I certify to the best of my knowledge that the odometer reading is:

(One statement only must be checked.)

Actual
. / 0 / The mileage stated is in excess of its mechanical limits
ODOMETER READING
(No Tenths) / The odometer reading is not actual mileage*

*Warning - odometer Discrepancy

List surviving sole and only heirs at law:

Name /
Relationship

I, the undersigned affiant, do certify that I am a heir of the decedent referred to in this affidavit who departed this life intestate on the date recorded above and that the decedent was the lawful owner of the vehicle shown above. I further certify that the affiant is the surviving spouse of the decedent and claims title to the vehicle under provision of K.S.A. 59-403(1) as exempt personal property to the affiant. If there is no surviving spouse, the affiant claims title to the vehicle as surviving heir(s). Further, the affiant guarantees title to said vehicle to all subsequent purchases.

Affiant’s SignatureDate

Affiant’s Printed NameDate

TR-83a (Rev. 04/03)

Kansas

Department of Revenue
Division of Vehicles
/

Claim of heir Affidavit

(Estate No More than $20,000)

State of Kansas)

) ss.

County of)

I,being duly sworn state:

Name of Affiant(s)

(1)On,,died

DateName of Deceased

Testate or

Intestate at,

City and State

leaving an estate not exceeding$20,000 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:

Name
/
Age
/
Relationship
(5)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 below, apportioned among the affiants. (If more than one heir, all heir’s names will be shown on the title. If one or more heirs do not want the vehicle, that heir(s) will need to provide the remaining heir(s) with an affidavit disclaiming interest.)
Vehicle Information

VINYearMakeStyle

I certify to the best of my knowledge that the odometer reading is: (no 10th’s) / . / 0

and the reading is: Actual Exceeds Mechanical Limits Not Actual*

* Warning-odometer Discrepancy

Wherefore, affiant(s) hereby request(s) that the vehicle listed above be transferred to the affiant(s).

Signature(s)Date

Signature(s)Date

TR-83b (New 05/04)