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VR-471 Beneficiary Designation for Vehicle Title

Motor Vehicle Administration6601 Ritchie Highway, Burnie, maryland 21062 For more information, please call: 410-768-7000 (to speak with a customer agent).TTY for the hearing impaired: 1-800-492-4575. Visit our website at: (12-14)TRANSFER UPON DEATHUse this form if sole owner of a Vehicle wants to designate a Designation For Vehicle TitleVEHICLE INFORMATIONM aryland Title Number Year Make Vehicle Identification NumberOWNER INFORMATIONName of Owner: First Middle LastOwner s Driver License / Soundex NumberDate of BirthAddress:County City State Zip CodePlease Note: To name a Beneficiary , the Vehicle cannot currently have a OF BENEFICIARYName of BeneficiaryDate of Birth (Optional)Relationship to Vehicle Owner (If there is no relationship, indicate None )Please Note.

Glen Burnie, Maryland 21062 For more information, please call: 410-768-7000 (to speak with a customer agent). TTY for the hearing impaired: 1-800-492-4575. Visit our website at: www.MVA.Maryland.gov VR-471 (12-14) TRANSFER UPON DEATH Use this form if sole owner of a vehicle wants to designate a beneficiary. Beneficiary Designation For Vehicle Title

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