555 Wright Way
Carson City, NV 89711-0700
Reno/Sparks/Carson City (775) 684-4DMV (4368)
Las Vegas area (702) 486-4DMV (4368)
dmvnv.com
VP241 (4/2017)
Signatures must be originals. Photocopies are not acceptable.
Changes may not be made to this form once it is signed and witnessed.
TRANSFER ON DEATH - BENEFICIARY’S AFFIDAVIT FOR TITLE
NRS 482.247
This application is to be completed when the title cannot be located.
The application must be completed by the beneficiary with the “Transfer on Death” designation on
title record on file with the Department of Motor Vehicles.
The application must be notarized or witnessed by an authorized Nevada Department of Motor
Vehicles Representative.
A certified copy of the death certificate must be submitted, for each owner, listed on the title.
A $20 Title fee and $1 Technology fee must be submitted with the application ($21 total).
Vehicle Identification Number
Year
Make
Model
Current Odometer Reading (no tenths)
Owner(s) – (as listed on latest certificate of title)
Full Legal Name
First
Middle
Last
Full Legal Name
First
Middle
Last
Physical Address
Street
City
State
Zip Code
Mailing Address
Street
City
State
Zip Code
I certify that I am the beneficiary with the “Transfer on Death” designation of the described vehicle and that
the original Certificate of Title cannot be located. I hereby release, discharge and agree to hold harmless
the Nevada Department of Motor Vehicles of and from any and all liability to anyone whomsoever which may
arise by reason of any contest of the validity of the beneficiary named herein, or the validity of the beneficiary
in the manner prescribed in NRS 482. I declare under penalty of perjury the foregoing is true and correct.
Printed Full Legal Name of Beneficiary
First
Middle
Last
Physical Address
Street
City
State
Zip Code
Mailing Address
Street
City
State
Zip Code
State of Nevada, County of
Signed and sworn to before me on
Date
By
Signature of Affiant
Notary Stamp
Notary Public or Authorized Nevada DMV Representative