TR-82 (Rev. 06/16)
KANSAS DEPARTMENT OF REVENUE
TRANSFER ON DEATH AFFIDAVIT
(This affidavit is used by the beneficiaries upon the death of the vehicle owner(s).)
www.ksrevenue.org
Individual(s) Named as Transfer on Death Beneficiaries:
certifies that applicant(s) is/are the transfer on death beneficiary(s) of
Name of Deceased
who departed this life on and that the deceased person(s) was the lawful owner(s) of the following vehicle:
Year: Make:
Style: VIN
Odometer Reading (No tenths): .0
I certify to the best of my knowledge that the odometer reading is (check one):
Actual
The mileage stated is in excess of its mechanical limits
The odometer reading is not actual mileage (Warning – Odometer Discrepancy)
I/we certify that the person(s) shown on the face of the Kansas certificate of title for the above vehicle is/are the last
registered owner(s) of the vehicle listed above and that I/we are also listed on the title as successor(s) upon the death of
the previous owner(s).
By my signature I swear that this is a true and correct statement. I am aware that the law provides severe penalties for
making false statements under oath.
Applicant’s Signature Applicant’s Printed Name
Applicant’s Signature Applicant’s Printed Name
Instructions
Attached verification that the vehicle was last titled in Kansas, to whom and who is shown as the Transfer on
Death beneficiary(s). Verification can be the title, last registration receipt or a verification of ownership issued by
either the County Treasurer or the Kansas Division of Vehicles.
Attach a copy(s) of the death certificate(s) for the owner(s) shown on the Kansas title.
If there is a lienholder listed on the face of the title, a notarized written lienholder’s consent to transfer the title
Form TR-128 is required or a notarized lien release from the lienholder of recorded.
If one of the beneficiaries shown on the title wishes to disclaim their interest in the vehicle they may do so by
completing a notarized affidavit conveying their interest to the other person named as beneficiary. At least one of
the parties listed as a beneficiary must title the vehicle in their name before transferring the ownership of the
vehicle.
If the name of a beneficiary listed on the deceased title is not the way it is to be listed on the beneficiary’s new
title, a One and the Same Affidavit form (TR-12) must be completed.
Take this completed affidavit and the above documentation to your Local County Treasurer’s motor vehicle office
when making application for title.
