Fillable STATEMENT OF TRANSFER OF VEHICLES TO A SURVIVING (Bad River Band Of Lake Superior Tribe Of Chippewa Indians)

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STATEMENT OF TRANSFER OF VEHICLES TO A SURVIVING (Bad River Band Of Lake Superior Tribe Of Chippewa Indians)

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STATEMENT OF TRANSFER OF VEHICLES
TO A SURVIVING SPOUSE, DOMESTIC PARTNER OR HEIR
Wisconsin Department of Transportation http://wisconsindmv.gov
MV2300 3/2020 342.17(4)(b) and s.867.03 Wis. Stats.
The transfer shall not affect any prior liens upon the vehicle(s).
Submit this form with the Certificate of Title (form MV2269 or T055) and Title & License Plate Application (form MV1).
There is no title transfer fee for surviving spouses or domestic partners.
The title transfer fee for heirs is $164.50 for each vehicle.
Name of Surviving Spouse, Domestic Partner or Heir
Drivers License
Street Address
City, State, ZIP Code
Name of Decedent
As Surviving Spouse or Domestic Partner
I state that the information given above is true and correct and that I shall be personally liable for the debts and charges of the
decedent, to the extent of the value of the vehicle(s), subject to s.859.25 Wisconsin Statutes.
X
(Surviving Spouse or Domestic Partner Signature) (Date)
VEHICLE
MAKE
IDENTIFICATION OR ENGINE NUMBER
MAXIMUM VALUE
TITLE
LOST
1
Yes
No
2
Yes
No
3
Yes
No
4
Yes
No
As an Heir of the Decedent
I state that the information given above is true and correct and that the decedent has no solely-owned property that
exceeds $50,000 in value according to the requirements of s.867.03 Wisconsin Statutes.
I have included an additional $20.00 replacement title fee if the box for “Title Lost – Yes” is checked.
X
(Signature of Heir) (Date)
X
(Signature of Heir) (Date)
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STATEMENT OF TRANSFER OF VEHICLES TO A SURVIVING (Bad River Band Of Lake Superior Tribe Of Chippewa Indians)

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Completed 12 November 2021

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