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Fillable Printable Boat Registration/Title Application - NYC

Fillable Printable Boat Registration/Title Application - NYC

Boat Registration/Title Application - NYC

Boat Registration/Title Application - NYC

COMPLETE and . WHEN AND APPLY, COMPLETE THOSE SECTIONS.
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457
3
6
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INSTRUCTIONS è
Print clearly in blue or black ink
Old Owner
3 of Name
OFFICE
USE
ONLY
OFFICE
USE
ONLY
New York State Department of Motor Vehicles
BOAT REGISTRATION/TITLE APPLICATION
(This form is also available on DMV’s web site - www.dmv.ny.gov)
FOR OFFICE USE ONLY
Batch File No.
oOriginal oRenewaloActivity oDuplicate
HULL MATERIALPROPULSION
o
OUTBOARD oIN BOARD
oI/O (IN/OUTBOARD)
oSAILoOTHER
FUEL
o
GAS oDIESEL
oELECTRIC
oOTHER oNONE
USEoPLEASURE oMANUFACTURER
oGOVERNMENT oLEASED oRENTAL
COMMERCIAL PASSENGER:
oUNDER 6 o6 OR MORE
oDEALER oCOMMERCIAL oFISHING - COMM.
3 of
Name
Sticker
HULL IDENTIFICATION NUMBER
COUNTY OF PRIMARY USE
MV-82B (4/14)
SPECIAL CONDITIONS:
YEAR
MAKELENGTH
TYPE OF BOAT
o
OPEN oCABIN
oHOUSE
oOTHER_____________
FeetInches
Reg.
No.
Proof Submitted
(Name and Ownership)
Stop/Response
Operator
Signature
NF OV PA SV XR
IF A TEMPORARY REGISTRATION WAS ISSUED:
If you assigned a registration number to this boat, place the registration number sticker over this box. If the boat already has a valid New York registration number, enter
the information below.
MARK THE BOX OF THE TYPE OF SERVICE YOU NEED. (For more information, refer to form MV-82.1B “Registering/Titling a Boat in New York State”.)
PAGE 1 OF 2
NY
DEALER
ONLY
1
2
4
Sales Tax
Information
Status
Value
($)
JurisdictionRateOut of StateAudit
Title
Lien
Lien
Number
Prior
Owner
3
AUTHORIZATION: The registrant described in is authorized to register the boat described in .
A different owner is only allowed when the boat is leased. IF YOU ARE NOT THE OWNER of this boat, the owner
must complete this section. Proof of ownership, proof of owner’s name and date of birth and copy of the
leasing agreement are required. NOTE: Do not complete this section if a completed Registration Authorization (form
MV-95) is attached or if you apply to renew the boat registration and the owner of that boat has not changed.
(Signature of owner or authorized person, and signature of co-owner)
(Date)
NAME OF CURRENT OWNER(Last, First, Middle)
NYS DRIVER LICENSE NUMBER OF OWNER
Month Day Year
DATE OF BIRTH
Apt. No.City or TownStateZip CodeCounty
ADDRESS WHERE THE OWNER GETS MAIL (Include Street Number and Name, Rural Delivery or box number)
Area Code
( )
DAY TELEPHONE NUMBER OF OWNER(Optional)
24
Lien Release
HOW DID YOU GET THE BOAT?
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TO BE COMPLETED ONLY BY A REGISTERED NEW YORK STATE BOAT DEALER
Registration Number:________________________________________________________________ Date Temp. Reg. Issued:__________________________
Dealer Name:________________________________________________________________Dealer Facility Number:__________________________
oRENEW a registration
oGet a TITLE ONLY for a 1987 or newer
motorized boat that is 14 or more feet long
oCHANGE the title (refer to )
oGet a FIRST REGISTRATION for a boat
oREPLACE the registration [mark one or both oDOCUMENToSTICKER]
oCHANGE the current registration (refer to )
Is this boat now DOCUMENTED oYes
by you?
oNo
Does this boat now have aoYes
NY REGISTRATION Number?
oNo
If “YES”, enter the
NY Registration Number
If “YES”, enter the
Document Number
If NO, are you in the processoYes
of Documenting the boat?
oNo
oNew oUsed
oLeased NewoLeased Used
If leased, YOU MUST ATTACH a copy
o WOOD oSTEEL
o PLASTIC oINFLATABLE
oFIBERGLASS oOTHER
oALUMINUM
M F
oo
Area Code
( )
oNew
oUsed
NAME CHANGE?
oYES (refer to ) oNO
ADDRESS CHANGE?
oYES oNO
Is this registration for a corporation
or partnership?
oYes oNo
NAME OF PRIMARY REGISTRANT (Last, First, Middle)
NYS driver license number of PRIMARY
SEX
THE ADDRESS WHERE PRIMARY REGISTRANT GETS MAIL
DAY TELEPHONE (Optional)
Month Day Year
DATE OF BIRTH
Month Day Year
Apt. No.City or TownStateZip CodeCounty of Residence
Apt. No.City or TownStateZip Code
THE ADDRESS WHERE PRIMARY REGISTRANT RESIDES IF DIFFERENT FROM THE MAILING ADDRESS.
(DO NOT GIVE A P.O. BOX.)
(Include Street Number and Name, Rural Delivery or box number. This address will be on the document.)
5
M F
oo
NAME OF CO-REGISTRANT (Last, First, Middle)
NYS driver license number of CO-REGISTRANT
SEX
DATE OF BIRTH
How did you get
the vehicle?
(mark one)
oLeased New
oLeased Used
Lienholder Name and
Mailing Address
Lien Filing Code
(Assigned
by DMV)
NY
DEALER
ONLY
Boat was
obtained from ________________________________________________________________________________________ ________________________________
Boat was
sold by
CHANGES (To change information on your current boat registration and/or title.)
ADDITIONAL LIENHOLDERS - List any lienholders in addition to the one specified on page 1 of this form.
Lien Filing Code _____________________________ Lienholder Name_______________________________________________________________
Mailing Address___________________________________________________________________________________________________________
Number and Street City State Zip Code
Lien Filing Code _____________________________ Lienholder Name_______________________________________________________________
Mailing Address___________________________________________________________________________________________________________
Number and Street City State Zip Code
NY DEALER CERTIFICATION:
I certify that all information provided on this application is true. I take
responsibility for the integrity of the papers delivered to the
Department of Motor Vehiclesoffice.
DEALER TRANSFER INFORMATION – Please complete the information below. For new boats, attach a Manufacturer’s Statement or Certificate of Origin
(MSO or MCO) and a bill of sale. For used boats, attach a signed title or transferable registration, along with bills of sale for any subsequent transactions.
MV-82B (4/14)
Signature of Dealer or Authorized Representative
Name and Address
Name and Address of your dealership
Facility No.Date of Sale
Date of Purchase
ç
REGISTRANT CERTIFICATION: I certify that the registration information presented is true, and that the registration is not currently under suspension or
revocation in any jurisdiction. If I am using a credit card for payment of any fees in connection with this application, I understand that my signature
below also authorizes use of my credit card.
(Sign Name in Full -Additional signature required for a partnership or if registering this boat in more than one name.)
(Print Name in Full - if registering for a corporation, print your full name and title)
IMPORTANT:Making a false statement in any registration application, or in any proof or statements in connection with it, or deceiving or substituting in
connection with this application, is a misdemeanor under Section 392 of the Vehicle and Traffic Law, and may also result in the revocation or suspension of the
registration pursuant to regulations established by the Commissioner. The Department makes no representation that it will issue a certificate of title or
transferable registration until the Commissioner is satisfied that the applicant is entitled to a certificate of title or transferable registration, and until all
documentation required to establish ownership of the boat is submitted and deemed to be satisfactory. Pending review of this application, neither the
Commissioner of the Department of Motor Vehicles nor any of his or her employees, deputies or agents assumes any liability or responsibility for repairs
performed, improvements made or work done to the boat referenced in this application.
CREDIT CARD AUTHORIZATION IF CARDHOLDER IS NOT THE APPLICANT:
My signature authorizes ____________________________________________ to use my credit card for payment of any fees in connection with this application,
and I understand that I must be present for this transaction.
Additional Signature
SIGN HERE
ç
Print Name Hereç
(Sign Name in Full)
Sign Hereç
(Cardholder - Sign Name in Full)
Sign Hereç
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PAGE 2 OF 2
D
E
A
L
E
R
O
N
L
Y
TO BE COMPLETED ONLY BY A REGISTERED NEW YORK STATE BOAT DEALER
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(Assigned by DMV)
(Assigned by DMV)
NAME CHANGE: Print your former name exactly like your former name is printed on the current registration or title.
FOR ALL CHANGES other than a name change, explain what the change is and the reason for the change.
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