Fillable Printable Boat Registration Application - Alaska

Boat Registration Application - Alaska

STATE OF ALASKA

DIVISION OF MOTOR VEHICLES

BOAT REGISTRATION APPLICATION

Notice: A copy of this application may be used as a temporary registration for up to 60 days. The

temporary registration becomes invalid when a certificate of number is issued by DMV.

BASIC BOAT INFORMATION - MUST BE COMPLETED IN FULL ON ALL APPLICATIONS

PRESENT AK BOAT NUMBER

REASON FOR APPLICATION

oNEW oTRANSFER OF OWNERSHIP oDUPLICATE DECAL ($5)

oRENEWAL oDUPLICATE CERTIFICATE ($5)

BOAT NAME (IF APPLICABLE)

CLASS OF BOAT

oPOWER BOAT (B1) $24

oNON-POWER BOAT (B2) $10 (Registration is optional for non-powered)

COMPLETE FOR NEW BOATS, TRANSFERS, OR WHEN INFORMATION HAS CHANGED

HULL IDENTIFICATION NUMBER (HIN) ADF&G # (IF ANY) LENGTH (FT) YEAR MAKE/BUILDER OF BOAT

BOAT TYPE

oA.RUNABOUT/SKIFF

oB.CABIN CRUISER

oC.PWC (i.e. JET SKI)

oD.HOUSEBOAT

oE.SAILBOAT

oF.OTHER

PROPULSION

oA.OUTBOARD

oB.INBOARD

oC.INBOARD/OUTDRIVE

oD.SAIL ONLY

oE.OARS/PADDLES

USE

oA.PLEASURE

oB.COMMERCIAL PASSENGER

oC.COMMERCIAL FISHING

oD.RENTAL

oE.OTHER

FUEL TYPE

oA.GAS

oB.DIESEL

oC.OTHER

oD.NONE

HULL MATERIAL

oA.ALUMINUM/METAL

oB.FIBERGLASS/PLASTIC

oC.WOOD

oD.INFLATABLE

oE.OTHER

HULL COLOR TRIM COLOR CABIN COLOR CONTACT TELEPHONE NUMBER

OWNER NAME AND ADDRESS INFORMATION - MUST BE COMPLETED IN FULL ON ALL APPLICATIONS

MAILING

ADDRESS:

STREET/PO BOX CITY STATE ZIP CODE

RESIDENCE

ADDRESS:

PHYSICAL LOCATION (NO PO BOX OR MAIL CACHE) CITY STATE ZIP CODE

OWNER FULL NAME (FIRST, MIDDLE, LAST, SUFF.) OR COMPANY NAME SSN* DOB DRIVER LICENSE #

I certify under penalty of law that I am the legal owner of the boat described in this application, that this boat is

used primarily in Alaska and that all statements in this application are true and correct. I also acknowledge that I

must notify DMV within 15 days of change of address or if the boat is destroyed, abandoned or becomes

documented.

PRINTED NAME AND SIGNATURE OF APPLICANT DATE

DMV USE ONLY

PREV. STATE STICKER NUMBER BATCH AMVC DOCS. ACCEPTED:

AK REG MCO

CARP. CERT. BOS

OWNER AFF. TITLE

FEES:

$5 $10 $24

PAYMENT TYPE:

CA CC CK

DATE

*The Social Security Number (SSN) will be used only for DMV purposes and will not be disclosed as part of a boat record. Disclosure of the SSN is not required by law.

Form 841 (Rev. 10/2009)

Alaska.gov/dmv

This application may be submitted in person or mailed to any DMV for processing.

Division of Motor Vehicles

ATTN: Correspondence Unit

1300 W Benson Blvd., STE 200

Anchorage AK 99503-3600