VSA 24 (01/25/2013)
I certify that:
1. The above named Vehicle Owner (decedent) is deceased;
2. I am an heir of the decedent's estate;
3. There has not been and there is not expected to be a qualification on the estate of the decedent;
4. (a) The decedent's debts have been paid or the proceeds from the sale of the above described motor vehicle will be
applied against the debts of the decedent; or
(b) The above described motor vehicle is property included in a claim for family allowance, exempt property or
homestead allowance of the estate (attested copy of claim filed with the court must be attached); and
5. The following are the names of all other persons having an interest in the above described motor vehicle:
I also certify and affirm that all information presented in this form is true and correct, that any documents I have presented
to DMV are genuine, and that the information included in all supporting documentation is true and accurate. I make this
certification and affirmation under penalty of perjury and I understand that knowingly making a false statement or
representation on this form is a criminal violation.
I/We, being the person(s) listed above as having a legal interest in the motor vehicle described on this form who are of legal
age, hereby consent to the transfer of title of the motor vehicle by the above named heir.
Section 4 CONSENT TO TRANSFER TITLE SIGNATURES
1. SIGNATURE 4. SIGNATURE
2. SIGNATURE 5. SIGNATURE
3. SIGNATURE 6. SIGNATURE
Section 3: HEIR CERTIFICATION
1. FULL LEGAL NAME (print) 4. FULL LEGAL NAME (print)
2. FULL LEGAL NAME (print) 5. FULL LEGAL NAME (print)
3. FULL LEGAL NAME (print) 6. FULL LEGAL NAME (print)
HEIR NAME (print)
DATE (mm/dd/yyyy)
HEIR SIGNATURE
Section 2: VEHICLE OWNER (DECEDENT) INFORMATION
NAME DATE OF DEATH (mm/dd/yyyy)
RESIDENCE ADDRESS AT TIME OF DEATH
Purpose: Use this form to document the authority of a deceased vehicle owner's heir to transfer ownership of a vehicle
titled in Virginia:
- when there has not been nor is there expected to be - a qualification on the estate, and
- an executor or administrator of the estate has NOT been appointed.
Instructions: Refer to information on page 2 to determine when to complete and file this form and for further instructions
regarding what information is required.
Section 1: VEHICLE INFORMATION
Note: Do not use this form if the vehicle is titled outside Virginia (see instructions on the back of the form).
CERTIFICATION OF AUTHORITY
TO TRANSFER VIRGINIA TITLE
VEHICLE IDENTIFICATION NUMBER (VIN) MAKE MODEL YEAR