Survivorship Affidavit

This affidavit can only be executed under the following circumstances: (1) decedent left a maximum of four boats, motor vehicles, trailers, or semi-trailers; (2) at least thirty (30) days have elapsed since decedent’s death; (3) either decedent failed to appoint of personal representative or status of appointment is currently pending; (4) value of the properties, disregarding location and considering liens plus encumbrances, amounts to a maximum of $100,000; (5) affiant is entitled to the vehicles; and (6) transfer of ownership will not prejudice the decedent’s creditors.Download

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Get forms online - tax.utah.gov	
Utah State Tax Commission	
XXDate of death
Section 4 - New Owner Information
Primary owner’s name (last, first, middle initial, or business name)
Street address (primary owner)
CityState
ZIP code
Mailing address, if different from Street Address (primary owner)	
City
State
ZIP code
Co-owner’s name (if at different street address, check here and list on back)	
Pursuant to Utah Code 75-3-1201, I hereby transfer the Certificate of Title issued for the
vehicle identified on this statement to the new owner shown below. I certify that the decedent
left not more than four boats, motor vehicles, trailers, or semi-trailers, and that 30 days have
elapsed since the death of the decedent. No appointment of a personal representative has
been granted or is pending. The value of the entire estate subject to administration wherever
located, excluding the boats, motor vehicles, trailers, or semi-trailers, less liens and
encumbrances, does not exceed $100,000. I further certify that I am entitled to the vehicle and
that this transfer will not prejudice the creditors of the decedent.
Place notary stamp in space below
Vehicle/Hull Identification Number (VIN/HIN)
Year
Make
Model
Body type
License plate number
State last registered	Trailer lengthWatercraft length	
ft________ in________
ft________ in________