Free 3C-E-312AffitCollectAuto - Hawaii

STATE OF HAWAI`I
CIRCUIT COURT OF THE THIRD CIRCUIT
THE ESTATE OF

AFFIDAVIT FOR COLLECTION OF PERSONAL PROPERTY (AUTOMOBILE) OF THE DECEDENT
DATE OF DEATH

RELATIONSHIP OF AFFIANT TO DECEDENT

DECEASED

STATE OF HAWAI`I COUNTY OF HAWAI`I

) ) )

SS:

I, the undersigned affiant, being first duly sworn on oath, depose and say; 1. I am the successor of the above named decedent. A certified copy of the death certificate is submitted with this affidavit. 2. The asset sought to be transferred is a motor vehicle belonging to the decedent. 3. I am entitled to delivery of the motor vehicle referred to above and itemized below by virtue of H.R.S. Section 560:3-1201, as amended, and by virtue of my relationship to the decedent indicated above. 4. I have read and understand H.R.S. Section 560:3-1202 which is printed on the reverse side of this affidavit. 5. I make this affidavit for the purpose of collecting the following motor vehicle: VIN: HAWAI`I LICENSE NO: MAKE: MODEL: YEAR:

continuation page attached.
TYPE OR PRINT NAME AND RESIDENCE OF AFFIANT AFFIANT'S SIGNATURE

SUBSCRIBED AND SWORN TO BEFORE ME THIS DATE

DATE

NOTARY PUBLIC

MY COMMISSION EXPIRIES:

STATE OF HAWAI`I

SEE REVERSE SIDE

In accordance with the Americans with Disabilities Act and other applicable state and federal laws, if you require a reasonable accommodation for a disability, please contact the ADA Coordinator at the Circuit Court Administration Office at PHONE NO. 961-7440, FAX 961-7416, or TTY 961-7525 at least ten (10) working days prior to your hearing or appointment date.
Reprographics (03/07)

AFFIDAVIT FOR COLLECTION OF PERSONAL PROPERTY (AUTOMOBILE) OF THE DECEDENT 3C-E-312

CLEAR

Hawai`i Revised Statutes: §560:3-1202 Effect of affidavit. The person paying, delivering, transferring, or issuing personal property or the evidence thereof pursuant to affidavit is discharged and released to the same extent as if that person dealt with a personal representative of the decedent. That 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 therefor to any personal representative of the estate or to any other person having a superior right. [L 1996, c 288, pt of §1]

Reprographics (03/07)

AFFIDAVIT FOR COLLECTION OF PERSONAL PROPERTY (AUTOMOBILE) OF THE DECEDENT 3C-E-312