Assignment of a Vehicle to a Surviving Spouse/Not Subject to Probate
PS2071-10 (04/13)
TITLE NUMBER
The following must accompany this document:
1. Minnesota Certificate of Title, properly completed
2. Proof of death (e.g. memorial card, newspaper clipping, or copy of death certificate)
3. Payment of title fee and filing fee
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
DRIVER AND VEHICLE SERVICES
445 Minnesota St. Ste 160
St. Paul, Minnesota 55101-5160
MODEL YEAR MAKE VEHICLE IDENTIFICATION NO.
PRINT NAME OF DECEASED (VEHICLE OWNER) LAST, FIRST AND MIDDLE DATE OF DEATH
RELATIONSHIP TO DECEASED
SIGNATURE
SURVIVING SPOUSE: I certify I am the surviving spouse of the person named above. I further certify, that I have selected this vehicle from the
personal property in the estate of the deceased and that this action is permitted by Minnesota Statute 524.2-403.
NOT SUBJECT TO PROBATE: I certify the estate of the above named person has not been and will not be probated and there are no
monetary claims or security interests relating thereto. This action is permitted by Minnesota statute 524.2-201.
For additional information contact a Deputy Registrar or the
Driver and Vehicle Services Division at:
• (651) 297-2126
• TTY/TDD (651) 282-6555 (for hearing impaired customers)
• dvs.dps.mn.gov
NOTARIZATION REQUIRED
Subscribed and sworn to before me
This
Day of
20
NOTARY PUBLIC
COUNTY
MY COMMISSION EXPIRES
