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AFFIDAVIT OF SURVIVORSHIP ON MOTOR VEHICLE STATE OF WYOMING COUNTY OF NATRONA
) )ss ) , of lawful age, being first duly
sworn on oath, states: 1.
YEAR
That affiant and deceased, were the owners by an estate in joint tenancy of the following described motor vehicle(s) with such joint ownership evidenced by that (those) certain Certificate(s) of Title(s) Number(s) and issue date(s) as shown: MAKE
2. 3. 4.
VIN
TITLE #
ISSUE DATE
The decedent died on , as evidenced by the certified copy of the death certificate attached hereto. That said decedent is one of the joint tenants named in said Certificate of Title(s) and whose death terminated his/her previous estate in the above-mentioned property. Further affiant sayeth not. ______________________________________ Affiant
Subscribed and sworn to before me by _____________________________ this ________________ day of _______________________. _______________ Witness my hand and official seal. seal
______________________________________ Notary Public or Deputy County Clerk