Fillable Printable Affidavit of Fact Form - Texas

Affidavit of Fact Form - Texas

Date: / /

AFFIDAVIT OF FACT (PWD 314)

Check whether this ap plies to a boat, outboard motor or both and fill in all the b lo cks fo r each one checked.

Boat Information:

HIN or Serial #:

TX #: TX - Year Built

Make:

Motor Information: MIN or Serial #: Horse Power:

TX/M#:

(If known)

Year Built

Make:

Select Applicable Reason(s) for Affidavit

Correction to Title Information Item Never Titled, Registered or USGC Documented Payment of Insurance Claim

Correction to MSO Information Destroyed - Delete Item from TPWD Records Other - Describe Situation

No Title Availa ble Homemade Vessel - No Receipts Available

Explain your situation here. I hereb------- y attest

More space needed? See Back of Sheet See Attached Sheet

WARNING: Falsifying information on documents is a punishable offense. Texas Penal code, Chapter 37, Section 37.1 0. Any person who

knowingly mak es a false e ntry in, or false alteration of a gov ernmental record is guilty of a felony of the third degree punishable by

confinement in jail for any term of not more than 10 years or less than 2 years and p un ished by a fine not to exceed $1 0,000.

I HEREBY CERTIFY THAT ALL STATEMENTS IN THIS DOCUMENT ARE TRUE AND CORRECT TO THE BEST OF MY

KNOWLEDG E AND BELI EF

Signature:

Print Name:

Address:

City, State, Zip:

Phone Number: ( ) - Home Work Cell

(in case TPWD needs to contact you for clarification)

Texas Parks and Wildlife Department maintains the infor m ation collected through this form. With few exceptions , y ou are en titled to be informed about the information we collect.

Under Sections 552.021 and 552.023 of the Texas Government Code, you are also entitled to receive and review the information. Under Section 559.004, you are also entitled to

have this information corrected.

PWD 314 – A0900 (8/03)