Fillable Printable Affidavit of Ownership Form - Pennsylvania

Affidavit of Ownership Form - Pennsylvania

PFBC-734

(06/13)

O NOT US E THIS FORM IF THE BOAT IS DISPLAYI NG A PA REGISTRATION NUMB ER OR A REG I STRAT ION OF ANOTHER STATE.

This form is used to establish ownership of boats purchased at flea markets, yard/garage sales, auction/estate sales and other

private transactions where a bill-of-sale or Manufacturer’s Certificate of Origin (MCO) is not available and the boat was not

previously registered in Pennsylvania or any other state. Also, use this form to show ownership of a homemade or specially

constructed boat (include bills-of-sale for major components). This form is only valid when used with form REV-336, Application

for Boat Registration.

I/We ____________________________________________________________________________________________

whose residence is _________________________________________________________________________________

certify under penalty of law (18 Pa. C.S. §4904 (relating to unsworn falsification to authorities)) that the statements made

herein are true and correct to the best of my/our knowledge, information and belief. I/We certify that the boat described

below has been purchased from:

A. Seller or Org anization Information

Name of Seller or Organization

Address of Seller

City

State

Zip Code

Phone Number

B. Descriptio n o f Boat Purchased

Make of Boat

Model of Boat

Hull Identification Number (HIN) or Serial Number

Length of Boat

Purchase Date

Purchase Price

Does the boat currently have a Pennsylvania or other state registration number?

□ Yes □ No

If yes, place registration number here _________________________.

Signature of Purchaser Date

Signature of Co-Purchaser Date

For Official Use Only – Penns ylvania Fish and Boat Commission, Bureau of Law Enforcement

NCIC Verification: □ Reported Stolen □ Not Reported Stolen

NCIC Verification Date: ____________________ NCIC BLE Investigator: _________________________

AFFIDAVIT OF

PURCHASE/OWNERSHIP

Pennsylvania Fish & Boat Commission

Divis i on of Licens i ng & Registrati on

P.O. Box 68900

Harrisburg, PA 17106-8900

866-262-8734  Fax: 717-705-7931