HomeMy WebLinkAboutAffidavit for Collection of Personal Property of the Decedent (Fillable)THE ESTATE OF )
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)
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DECEASED )
AFFIDAVIT FOR COLLECTION OF
PERSONAL PROPERTY OF THE DECEDENT
STATE OF HAWAII )
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COUNTY OF HAWAII )
I, , being first duly sworn on oath, deposes and says:
1. Affiant is the successor of the above named decedent, who died on , 20
A certified copy of the death certificate is submitted herewith.
2. No application or petition for the appointment of a personal representative is pending or has been granted in
this State.
3. Affiant is entitled to payment or delivery of the below mentioned motor vehicle by virtue of Section 560:3-1201,
Hawaii Revised Statutes, as amended,
(License Plate) (MAKE) (BODY TYPE)
(Vehicle Identification Number)
and by virtue of (explain relationship of affiant to decedent)
4. Affiant has read and understands Section 560:3-1202, Hawaii Revised Statutes:
§560:3-1202 Effect of affidavit. The person paying, delivering, transferring, or issuing personal
property or the evidence thereof pursuant to section 560:3-1201 is discharged and released to the same
extent as if the person dealt with a personal representative of the decedent. The person is not required
to see to the application of the personal property or evidence thereof or to inquire into the truth of any
statement in the affidavit. If any person to whom an affidavit is delivered refuses to pay, deliver, transfer,
or issue any personal property or evidence thereof, it may be recovered or its payment, delivery, transfer,
or issuance compelled upon proof of their right in a proceeding brought for the purpose by or on behalf of
the persons entitled thereto. Any person to whom payment, delivery, transfer or issuance is made is
answerable and accountable therefore to any personal representative of the estate or to any other person
having a superior right.
5. Further affiant sayeth naught.
Signature of Affiant
STATE OF HAWAII NOTARY CERTIFICATION(Place Notary Seal Here) (Place Notary Seal Here)
Subscribed and sworn to before me this
day of 20
Document Date:
Notary Name:
Document Description:
# of pages
Circuit
Notary Public,
Judicial Circuit, State of
My commission expires: Notary Signature
Hawai'i County is an Equal Opportunity Provider and Employer
Date
Revised 07/07/09