Fillable The trustee(s) may furnish this Certification of Trust (Arizona Department of Transportation)

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The trustee(s) may furnish this Certification of Trust (Arizona Department of Transportation)

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The trustee(s) may furnish this Certification of Trust to complete the title transaction. By completing this certificate,
the trustee(s) is stating the trust has not been revoked, modified, or amended in any manner that would cause the
representation(s) listed below to be incorrect. A new Certification of Trust form must be completed if there have been
changes/amendments to said trust. The Arizona Department of Transportation, Motor Vehicle Division, may require
the trustee(s) to furnish excerpts from the original trust and later amendments that designate the trustee(s) and
authorizes the trustee(s) to act in the pending transaction. I have read the above statement:
Initial here
Trust Description:
Title:
As it appears on the trust document
Date of Trust:
As it appears on the trust document
Revocable:
Yes No
If yes, who is authorized to revoke:
Trustor(s) (Settlor) (first, middle, last, suffix):
1.
2.
Trustee(s):
(first, middle, last, suffix)
Signature Requirements (Legal Status)*
Or And And/Or
Address:
Street Address
City
State
Zip
(first, middle, last, suffix)
Signature Requirements (Legal Status)*
Or And And/Or
Address:
Street Address
City
State
Zip
(first, middle, last, suffix)
Signature Requirements (Legal Status)*
Or And And/Or
Address:
Street Address
City
State
Zip
If additional trustees need to be listed: check the box below, complete an additional Certification of Trust form, and
submit forms together.
The undersigned trustee(s) hereby represent they are authorized to conduct any and all transactions on behalf of the
trust. I release, discharge and agree to hold harmless the Arizona Department of Transportation, Motor Vehicle Division
from any and all liability which may arise by reason of any contest to the validity of the trustee(s) designation(s) herein.
Trustee Printed Name
Trustee Signature
Trustee Printed Name
Trustee Signature
Acknowledged before me this date.
Notary or MVD Agent Signature
Date
County
State
Commission Expires
*Signature Requirements (Legal Status)
If you name two or more individuals as trustee(s) on this form, then the Legal Status box determines which signatures will be required for the
named trustee(s) to transfer ownership of the vehicle, license plates and/or fees, to apply for a refund, or to record loan information in the future.
Please indicate one of the following options in the box above:
OR Either of the trustees has full authority to transfer ownership, license plates and/or fees, or to record loan information. Signature of
either party will be accepted. Both signatures are not required.
AND Signatures of all parties, if more than one individual is listed as trustee will be required.
AND/OR Signatures of all parties, if more than one individual is listed as trustee will be required, if all are living. Upon proof of death, the
surviving trustee may sign alone.
CERTIFICATION OF TRUST
96-2002 R08/18
azdot.gov
For a Vehicle/Mobile Home Titled in a Trust
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The trustee(s) may furnish this Certification of Trust (Arizona Department of Transportation)

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Completed 27 May 2021

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