Fillable Printable Vessel Title Application
Fillable Printable Vessel Title Application
Vessel Title Application
X X
1
2
(Seal or stamp)
Notarization / Certification – You don’t need your signature notarized if you sign in front of a vehicle licensing agent, who can certify your signature.
State of County of
Signed or attested before me on by
Name of person signing this document
Notary/Agent/Subagent signature
Notary printed or stamped name
Title and
Dealer or county/office number or notary expiration date
X
Vessel Title Application
Vessel – Please type or print plainly For title purposes only
Hull identification no (HIN) Primary use type Fuel type Model yr Make
Model Vessel type Hull material Engine drive Propulsion type
Length (ft) County of moorage Manufacturer Purchase price Date entered WA Quick title Historic donation
Ye s No Ye s No
Conditions (choose one)
Condition 1 means your vessel is well maintained.
Considerations may include, but are not limited to:
• Mechanically sound
• Minor repairs needed
• May have additional options added
• Low to average engine hours
Condition 2 means your vessel is in need of repair.
Considerations may include, but are not limited to:
• Areas are worn and faded even after cleanup
• Major repairs needed
• Corrosion, dents, cracks, and/or tears evident
• Higher than average engine hours
Registered owner – For additional owners, attach sheet with name, driver license/ID/TIN/EIN/UBI number, expiration date, and phone
information. Washington primary residence or principal place of business street address is required on the vessel record. For exceptions, see
Primary Residence Address Exception, form 420-004.
Owner type ID type Driver license/ID/TIN/EIN/UBI no Expiration date Phone type (Area code) Phone no
Registered owner name (Last, First, Middle, Suffix) or Business name Owner date of birth
Washington primary residence address (if an individual) or Washington principal place of business address (if a business)
Mailing address, if different than residence address (Street address or PO Box, City, State, ZIP code) or exception address
One-time mailing address, if applicable Email address
Owner type Joint tenants w/right of survivorship ID type Driver license/ID/TIN/EIN/UBI no Expiration date
Yes No
Registered owner name (Last, First, Middle, Suffix) or Business name Phone type (Area code) Phone no
Legal owner/Lienholder – Fill out if different than registered owner. For additional legal owner/lienholders, attach sheet with name, driver
license/ID/TIN/EIN/UBI number, expiration date, and address information.
Name of legal owner/lienholder (Last, First, Middle initial or Business name)
Legal owner/Lienholder type ID type Driver license/ID/TIN/EIN/UBI no Expiration date ELT participant
Yes No
Mailing address (Street address or PO Box, City, State, ZIP code)
Dealer
Dealer type Dealer no Dealer name Sale date Delivery date Vessel status
New Used Prev titled
Dealer authorized signature
Anyone who knowingly makes a false statement may be guilty of a felony under state law and upon conviction shall be punished by a fine,
imprisonment, or both. I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.
Signature of registered owner Title, if signing for business Signature of registered owner Title, if signing for business
Date and place signed Date and place signed
TD-420-289 (R1/17)WA
I certify that this information is correct. The vessel is clear of encumbrances
except as shown. Any required sales tax has been collected.
Click here to START or CLEAR, then hit the TAB button
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Choose one
Dealer sign here
Registered owner: Print completed form and sign here. Include title if business.
Registered owner: Sign here. Include title if business.
Enter date and place (city or county) signed
Enter date and place (city or county) signed
