Columbiana County Clerk of Courts Title Division Anthony J. Dattilio, Clerk of Courts Transfer-on-death of a Motor Vehicle Watercraft or Outboard Motor Informational facts about Transfer-on-death beneficiary designation As the sole owner of the motor vehicle, watercraft or outboard motor, I do hereby intend and declare that upon my death, I am willinglsignating thy de is vehicle to a beneficiary or beneficiaries. I understand that the designated beneficiary o beneficiaries will be listed on the certifi-r cate of title for the item above as transfer-on-death beneficiary or beneficiaries. I un- derstand that the designation of a transfer-on-death beneficiary or beneficiaries on a cer- tificate of title has no effect on my ownership of the above item and that I may cancel or change the designation at any time without the consent of the transfer-on-death benefici- ary or beneficiaries. I further understand that upon my death, the ownership of the vehicle passes to the trans- fer-on-death beneficiary or beneficiaries who survive m, and if no dee signated transfer- on-death beneficiary or beneficiaries survives me, the item must be included in my pro- bate estate. I also understand that any transfer to a transfer-on-death beneficiary or bene- ficiaries as a result of this affidavit is not testamentary and that the designation of trans- fer-on-death beneficiary or beneficiaries does not limthe rights of any creditor of the it owner of the item against any transfer-on-death beneficiary or beneficiaries or other transferees. American LegalNet, Inc. www.USCourtForms.com>>>> 2 Anthony J. Dattilio Columbiana County Clerk of Courts AFFIDAVIT FOR DESIGNATION OF BENEFICIARY OR BENEFICIARIES BY THE SOLE OWNER FOR A MOTOR VEHICLE, WATERCRAFT OR OUTBOARD MOTOR CERTIFICATE OF TITLE. ORC. 2131.13(A) I being first duly sworn, state as follows: I being sole owner of the vehicle, watercraft or outboard Motor described, Year Make VIN/MIN Title number Do designate this vehicle, watercraft or outboard motor to: BENEFICIARY FULL LEGAL NAME SSN ADDRESS DATE OF BIRTH BENEFICIARY FULL LEGAL NAME SSN ADDRESS DATE OF BIRTH BENEFICIARY FULL LEGAL NAME SSN ADDRESS DATE OF BIRTH Sworn to before me in the State of and the Country of On this day of 20 Applicant/Owner Signature X Notary/Deputy Signature X My Commission expires on BMV 3811 05/02 American LegalNet, Inc. www.USCourtForms.com