APPLICATION FOR SURVIVING SPOUSE TRANSFER OF …

1 STATE OF FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES DIVISION OF MOTORIST SERVICES SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OR LICENSE PLATE AGENT S OFFICE APPLICATION FOR SURVIVING SPOUSE TRANSFER OF FLORIDA CERTIFICATE OF TITLE FOR A MOTOR VEHICLE OWNER S NAME AS IT APPEARS ON DRIVER LICENSE (FIRST, FULL MIDDLE/MAIDEN & LAST) DATE OF BIRTH FL DL OR ID CARD NUMBER 1. OWNER S MAILING ADDRESS OWNER S EMAIL ADDRESS 2. OWNER S PHYSICAL STREET ADDRESS IN FLORIDA (MANDATORY, UNLESS A MEMBER OF THE MILITARY) 3. OWNER S ONE TIME MAIL TO ADDRESS OR MAIL TO CUSTOMER NAME AND ADDRESS (IF REQUESTED) 4. MOTOR VEHICLE DESCRIPTION FLORIDA TITLE NUMBER VEHICLE IDENTIFICATION NUMBER MAKE/MANUFACTURER YEAR BODY COLOR 5. AM REQUESTING: EXPEDITED TITLE TITLE TO BE MAILEDTITLE TO BE HELD ELECTRONIC I certify that the vehicle identified will not be operated on the streets and highway of Florida until properly registered.

2 I certify the certificate of title is lost or destroyed. UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE. SIGNATURE OF OWNER TYPE NA ME OF OWNERDATE: _____ TITLE NUMBER: _____ AUDIT CONTROL NUMBER: _____ FAST TITLE ISSUED BY: _____ 82152 (07/2017)This no-fee title TRANSFER is authorized by: Section (7), Florida Statutes: Notwithstanding any other provision of this section, the department and tax collector may not charge any fee or service charge, except for the expedited title fee, if applicable, for a certificate of title issued for a motor vehicle solely to remove a deceased co-owner from the title registered in the names of two persons if the other co-owner is the SURVIVING SPOUSE . Expedited Title: An expedited title is available for a $10 fee.

3 The SURVIVING SPOUSE must provide proof of identity; valid driver license or identification card from any state or a valid passport. Documentation Required: An original or certified copy of the death certificate is mandatory; a copy of the marriage certificate is required unless the name of the SURVIVING SPOUSE is shown on the death certificate. Motor Vehicle Registration TRANSFER : The registration fee associated with the removal of the SURVIVING SPOUSE s name from the title was not included as a part of the no-fee title TRANSFER . Therefore, registration fee(s) which will vary based on the order of names on the title and the SURVIVING SPOUSE s birthdate, will be due at the time of the title TRANSFER . If a registration is not obtained at the time of the title TRANSFER , the customer is required to certify on the face of this form or sign a perjury clause non-use certification stating The motor vehicle identified will not be operated on the streets and highways of Florida until properly registered.

4 Visit the following website for current mailing addresses: HSMV 82152 (07/2017)